IF 1.7 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Pace-Pacing and Clinical Electrophysiology Pub Date : 2025-04-01 Epub Date: 2025-02-21 DOI:10.1111/pace.15165
Maciej Dyrbuś, Joanna Machowicz, Anna Kurek, Mariusz Gąsior, Mateusz Tajstra
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引用次数: 0

摘要

背景:近年来,无引线心脏起搏器(LPMs)的植入数量大幅增长。无导线起搏器的适应症往往与皮下植入式心律转复除颤器(sICD)的适应症重叠,因为它们大多被推荐用于经静脉装置被认为不合格或禁忌的患者。在植入 sICD 之前,患者应通过筛查,以验证固有节律和起搏节律中 QRS 形态的稳定性。本研究的目的是评估先前植入 LPM 的患者通过 sICD 筛查的阳性率,并评估固有节律和起搏节律期间向量之间的一致性:本研究纳入了 2024 年 5 月至 10 月期间接受心室 LPM 植入术的 22 名患者。植入后,使用专用系统对2-4个体位、固有节律和起搏节律、名义和紧急输出进行了自动sICD筛查:结果:所有患者的设备都植入了室间隔位置。QRS筛查结果显示,94.1%的患者在固有节律时至少有一个向量符合植入sICD的标准,而在名义和紧急起搏输出时,分别只有23.8%和28.5%的患者通过了筛查。23.5%的患者至少有一个向量的筛选一致性呈阳性:尽管几乎所有患者都在固有节律期间成功通过了筛查,但在起搏期间观察到的 QRS 评估阳性率却很低,这可能会引起人们对 LPM 和 sICD 在日常临床实践中的最佳共存状态的潜在担忧。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Automated Subcutaneous Implantable Cardioverter-Defibrillator Screening in Patients With Leadless Pacemakers.

Background: The number of leadless pacemakers (LPMs) implantations has seen a major growth in recent years. Indications for LPMs often overlap with indications for subcutaneous implantable cardioverter-defibrillators (sICDs), as they are mostly recommended in patients in whom transvenous devices are deemed ineligible or contraindicated. Before sICD implantation, the patient should pass screening to verify the stability of QRS morphology in intrinsic and paced rhythms. The aim of this study was to evaluate the percentage of positive sICD screening in patients with a previously implanted LPM and evaluate the concordance between the vectors during the intrinsic and paced rhythm.

Methods: Twenty-two patients who underwent implantation of the ventricular LPM from May to October 2024 were included in the present study. After the implantation, automated sICD screening was performed using the dedicated system, across 2-4 body positions, both during intrinsic and paced rhythms, in nominal, and emergency output.

Results: All patients had the devices implanted in the interventricular septal location. Screening for QRS indicated that 94.1% of patients fulfilled the criterion for implantation of sICD in at least one vector during intrinsic rhythm, while only 23.8% and 28.5% passed screening during nominal and emergency pacing outputs, respectively. Positive screening concordance in at least one vector was observed in 23.5% of patients.

Conclusions: Despite almost all patients having undergone successful screening during intrinsic rhythm, the low rates of positive QRS assessment were observed during pacing, what might raise potential concerns for an optimal coexistence of LPM and sICD in daily clinical practice.

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来源期刊
Pace-Pacing and Clinical Electrophysiology
Pace-Pacing and Clinical Electrophysiology 医学-工程:生物医学
CiteScore
2.70
自引率
5.60%
发文量
209
审稿时长
2-4 weeks
期刊介绍: Pacing and Clinical Electrophysiology (PACE) is the foremost peer-reviewed journal in the field of pacing and implantable cardioversion defibrillation, publishing over 50% of all English language articles in its field, featuring original, review, and didactic papers, and case reports related to daily practice. Articles also include editorials, book reviews, Musings on humane topics relevant to medical practice, electrophysiology (EP) rounds, device rounds, and information concerning the quality of devices used in the practice of the specialty.
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