{"title":"经静脉植入式心脏转复除颤器(TV-ICD)植入左腋窝的安全性和可行性。","authors":"Yoshinari Enomoto, Mahito Noro, Yasutake Toyoda, Rina Ishii, Masako Asami, Takahito Takagi, Naohiko Sahara, Hikari Hashimoto, Shingo Kujime, Keijiro Nakamura, Hidehiko Hara, Masao Moroi, Kaoru Sugi, Masato Nakamura","doi":"10.1111/pace.14362","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Transvenous implantable cardioverter defibrillator (TV-ICD) systems are commonly implanted in the left anterior chest because of an easier implantation and better defibrillation threshold. This study aimed to evaluate the safety and feasibility of left axillary implantations of TV-ICD systems.</p><p><strong>Methods: </strong>We performed left axillary TV-ICD implantations and compared that to the major complication rate and operation time of the conventional TV-ICD implantation site (left anterior chest). The electrical parameter trends were also assessed in the left axilla group.</p><p><strong>Results: </strong>Seventy-six consecutive patients were evaluated for the analysis. Thirty-one patients had their system implanted in the left axilla and the reasons for the implantations included 29 patients for cosmetic reasons and two for post-infection conditions. The operation time and major complication rate were similar between the two groups (left anterior chest vs. left axilla: 134±62.4 min vs. 114±33.5 min, p = .11, 1/45 patient, 2.2% [pocket hematoma] vs. 1/31 patient, 3.2% [lead dislodgement], p = .77). During the follow up period (4.9±2.3years), no lead interruptions were observed in either group. The electrical lead parameters at the time of the implantation and follow up were similar in the study group (R wave sensing 20.8±33.4 vs. 11.2±7.42 mv, p = .34; lead impedance 464±64.7 vs. 418±135ohm, p = .22; pacing threshold [at 0.4 ms] 1.0±0.76 vs. 1.21±0.93V, p = .49).</p><p><strong>Conclusion: </strong>TV-ICD implantations in the left axilla were performed safely without increasing the operation time as compared to the conventional ICD implantation site. ICD implantations in the left axilla are an alternative in those not suitable for implanting TV-ICDs in the conventional implantation site.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1810-1816"},"PeriodicalIF":0.0000,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Safety and feasibility of implanting a transvenous implantable cardioverter defibrillator (TV-ICD) in the left axilla.\",\"authors\":\"Yoshinari Enomoto, Mahito Noro, Yasutake Toyoda, Rina Ishii, Masako Asami, Takahito Takagi, Naohiko Sahara, Hikari Hashimoto, Shingo Kujime, Keijiro Nakamura, Hidehiko Hara, Masao Moroi, Kaoru Sugi, Masato Nakamura\",\"doi\":\"10.1111/pace.14362\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Transvenous implantable cardioverter defibrillator (TV-ICD) systems are commonly implanted in the left anterior chest because of an easier implantation and better defibrillation threshold. This study aimed to evaluate the safety and feasibility of left axillary implantations of TV-ICD systems.</p><p><strong>Methods: </strong>We performed left axillary TV-ICD implantations and compared that to the major complication rate and operation time of the conventional TV-ICD implantation site (left anterior chest). The electrical parameter trends were also assessed in the left axilla group.</p><p><strong>Results: </strong>Seventy-six consecutive patients were evaluated for the analysis. Thirty-one patients had their system implanted in the left axilla and the reasons for the implantations included 29 patients for cosmetic reasons and two for post-infection conditions. The operation time and major complication rate were similar between the two groups (left anterior chest vs. left axilla: 134±62.4 min vs. 114±33.5 min, p = .11, 1/45 patient, 2.2% [pocket hematoma] vs. 1/31 patient, 3.2% [lead dislodgement], p = .77). During the follow up period (4.9±2.3years), no lead interruptions were observed in either group. The electrical lead parameters at the time of the implantation and follow up were similar in the study group (R wave sensing 20.8±33.4 vs. 11.2±7.42 mv, p = .34; lead impedance 464±64.7 vs. 418±135ohm, p = .22; pacing threshold [at 0.4 ms] 1.0±0.76 vs. 1.21±0.93V, p = .49).</p><p><strong>Conclusion: </strong>TV-ICD implantations in the left axilla were performed safely without increasing the operation time as compared to the conventional ICD implantation site. ICD implantations in the left axilla are an alternative in those not suitable for implanting TV-ICDs in the conventional implantation site.</p>\",\"PeriodicalId\":520740,\"journal\":{\"name\":\"Pacing and clinical electrophysiology : PACE\",\"volume\":\" \",\"pages\":\"1810-1816\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2021-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pacing and clinical electrophysiology : PACE\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.1111/pace.14362\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/10/6 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pacing and clinical electrophysiology : PACE","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1111/pace.14362","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/10/6 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
摘要
背景:经静脉植入式心律转复除颤器(TV-ICD)系统通常植入左前胸,因为植入更容易和更好的除颤阈值。本研究旨在评估左腋窝植入电视- icd系统的安全性和可行性。方法:采用左腋窝植入术,并与常规植入术部位(左前胸)的主要并发症发生率及手术时间进行比较。左腋窝组的电参数变化趋势也进行了评估。结果:对76例连续患者进行评估分析。31例患者将其系统植入左腋窝,植入原因包括29例美容原因和2例感染后情况。两组手术时间和主要并发症发生率相似(左前胸vs左腋窝:134±62.4 min vs 114±33.5 min, p = 0.11, 1/45例;2.2%[袋血肿]vs. 1/31例;3.2%[铅脱位],p = 0.77)。在随访期间(4.9±2.3年),两组均未见导联中断。研究组植入时和随访时的电导联参数相似(R波感应20.8±33.4 vs 11.2±7.42 mv, p = 0.34;引线阻抗464±64.7 vs. 418±135ohm, p = 0.22;起搏阈值[0.4 ms] 1.0±0.76 vs. 1.21±0.93V, p = 0.49)。结论:与常规ICD植入部位相比,在左侧腋窝植入TV-ICD是安全的,且不增加手术时间。对于那些不适合在传统位置植入电视-ICD的患者,在左腋窝植入ICD是一种选择。
Safety and feasibility of implanting a transvenous implantable cardioverter defibrillator (TV-ICD) in the left axilla.
Background: Transvenous implantable cardioverter defibrillator (TV-ICD) systems are commonly implanted in the left anterior chest because of an easier implantation and better defibrillation threshold. This study aimed to evaluate the safety and feasibility of left axillary implantations of TV-ICD systems.
Methods: We performed left axillary TV-ICD implantations and compared that to the major complication rate and operation time of the conventional TV-ICD implantation site (left anterior chest). The electrical parameter trends were also assessed in the left axilla group.
Results: Seventy-six consecutive patients were evaluated for the analysis. Thirty-one patients had their system implanted in the left axilla and the reasons for the implantations included 29 patients for cosmetic reasons and two for post-infection conditions. The operation time and major complication rate were similar between the two groups (left anterior chest vs. left axilla: 134±62.4 min vs. 114±33.5 min, p = .11, 1/45 patient, 2.2% [pocket hematoma] vs. 1/31 patient, 3.2% [lead dislodgement], p = .77). During the follow up period (4.9±2.3years), no lead interruptions were observed in either group. The electrical lead parameters at the time of the implantation and follow up were similar in the study group (R wave sensing 20.8±33.4 vs. 11.2±7.42 mv, p = .34; lead impedance 464±64.7 vs. 418±135ohm, p = .22; pacing threshold [at 0.4 ms] 1.0±0.76 vs. 1.21±0.93V, p = .49).
Conclusion: TV-ICD implantations in the left axilla were performed safely without increasing the operation time as compared to the conventional ICD implantation site. ICD implantations in the left axilla are an alternative in those not suitable for implanting TV-ICDs in the conventional implantation site.