{"title":"计算机断层扫描验证Micra无铅起搏器起搏位置和心动过缓患者起搏心电图特征","authors":"Jianghua Zhang, Xianhui Zhou, Yanmei Lu, Yaodong Li, Qiang Xing, Zukela Tuerhong, Xu Yang, Jiasuoer Xiaokereti, Yankai Guo, Xiaohong Zhou, Samantha Kohnle, Siyuan Zou, Baopeng Tang","doi":"10.1002/clc.70209","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>The leadless pacemakers are implanted routinely under fluoroscopic image, yet the pacing sites and corresponding paced electrocardiography (ECG) remain unclear. This study was to determine the computed tomography (CT)-verified location of the leadless Micra pacemakers (Micra) and ECG characteristics.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Twenty consecutive patients who met the pacemaker indications for bradycardia and underwent fluoroscopy assisted Micra implantation were enrolled. All subjects underwent a postoperative CT scan to determine the precise location of the Micra pacing tip. Paced 12-lead ECG characteristics were analysed and correlated with the Micra tip location.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>In the nine partitions of fluoroscopic RAO images, 14 (70%) of 20 patients had the Micra tip in zone 5, 5 (25%) in zone 6 and 1 in zone 2. Reconstructed CT 3-D cardiac images found Micra tips mostly clustered near the anterior insertion between the RV septum and free wall with 12 cases at the insertion-septal side and 8 at the free-wall side. ECG morphological analysis found that the peak deflection index in ECG lead V1 was 0.409 ± 0.058 for Micra tips at the insertion-septal side and 0.527 ± 0.062 in the free-wall side (<i>p</i> < 0.001 between two sides) and <i>R</i> wave amplitude in lead V6 appeared larger for Micra tips in the free-wall group compared to Micra tips in the insertion-septal group, while there was no difference in QRS duration between two sides.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>In routine Micra implantation, the pacing sites were often located in the anterior insertion region.</p>\n </section>\n </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 10","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70209","citationCount":"0","resultStr":"{\"title\":\"Computed Tomography-Verified Pacing Location of Micra Leadless Pacemakers and Characteristics of Paced Electrocardiograms in Bradycardia Patients\",\"authors\":\"Jianghua Zhang, Xianhui Zhou, Yanmei Lu, Yaodong Li, Qiang Xing, Zukela Tuerhong, Xu Yang, Jiasuoer Xiaokereti, Yankai Guo, Xiaohong Zhou, Samantha Kohnle, Siyuan Zou, Baopeng Tang\",\"doi\":\"10.1002/clc.70209\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>The leadless pacemakers are implanted routinely under fluoroscopic image, yet the pacing sites and corresponding paced electrocardiography (ECG) remain unclear. This study was to determine the computed tomography (CT)-verified location of the leadless Micra pacemakers (Micra) and ECG characteristics.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Twenty consecutive patients who met the pacemaker indications for bradycardia and underwent fluoroscopy assisted Micra implantation were enrolled. All subjects underwent a postoperative CT scan to determine the precise location of the Micra pacing tip. Paced 12-lead ECG characteristics were analysed and correlated with the Micra tip location.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>In the nine partitions of fluoroscopic RAO images, 14 (70%) of 20 patients had the Micra tip in zone 5, 5 (25%) in zone 6 and 1 in zone 2. Reconstructed CT 3-D cardiac images found Micra tips mostly clustered near the anterior insertion between the RV septum and free wall with 12 cases at the insertion-septal side and 8 at the free-wall side. ECG morphological analysis found that the peak deflection index in ECG lead V1 was 0.409 ± 0.058 for Micra tips at the insertion-septal side and 0.527 ± 0.062 in the free-wall side (<i>p</i> < 0.001 between two sides) and <i>R</i> wave amplitude in lead V6 appeared larger for Micra tips in the free-wall group compared to Micra tips in the insertion-septal group, while there was no difference in QRS duration between two sides.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>In routine Micra implantation, the pacing sites were often located in the anterior insertion region.</p>\\n </section>\\n </div>\",\"PeriodicalId\":10201,\"journal\":{\"name\":\"Clinical Cardiology\",\"volume\":\"48 10\",\"pages\":\"\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-10-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70209\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/clc.70209\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Cardiology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/clc.70209","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Computed Tomography-Verified Pacing Location of Micra Leadless Pacemakers and Characteristics of Paced Electrocardiograms in Bradycardia Patients
Introduction
The leadless pacemakers are implanted routinely under fluoroscopic image, yet the pacing sites and corresponding paced electrocardiography (ECG) remain unclear. This study was to determine the computed tomography (CT)-verified location of the leadless Micra pacemakers (Micra) and ECG characteristics.
Methods
Twenty consecutive patients who met the pacemaker indications for bradycardia and underwent fluoroscopy assisted Micra implantation were enrolled. All subjects underwent a postoperative CT scan to determine the precise location of the Micra pacing tip. Paced 12-lead ECG characteristics were analysed and correlated with the Micra tip location.
Results
In the nine partitions of fluoroscopic RAO images, 14 (70%) of 20 patients had the Micra tip in zone 5, 5 (25%) in zone 6 and 1 in zone 2. Reconstructed CT 3-D cardiac images found Micra tips mostly clustered near the anterior insertion between the RV septum and free wall with 12 cases at the insertion-septal side and 8 at the free-wall side. ECG morphological analysis found that the peak deflection index in ECG lead V1 was 0.409 ± 0.058 for Micra tips at the insertion-septal side and 0.527 ± 0.062 in the free-wall side (p < 0.001 between two sides) and R wave amplitude in lead V6 appeared larger for Micra tips in the free-wall group compared to Micra tips in the insertion-septal group, while there was no difference in QRS duration between two sides.
Conclusion
In routine Micra implantation, the pacing sites were often located in the anterior insertion region.
期刊介绍：
Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery.
The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content.
The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.
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