Leadless cardiac pacemaker implantations after infected pacemaker system removals in octogenarians
Satoshi Higuchi1
Ayako Okada2
Morio Shoda3
Daigo Yagishita1
Satoshi Saito4
Miwa Kanai1
Shohei Kataoka1
Kyoichiro Yazaki1
Hiroaki Tabata2
Hideki Kobayashi2
Wataru Shoin2
Takahiro Okano2
Koji Yoshie2
Koichiro Ejima1
Koichiro Kuwahara2
Nobuhisa Hagiwara1
1.Department of Cardiology,Tokyo Women's Medical University,Kawada-cho,Shinjuku-ku 8-1,Tokyo 162-8666,Japan2.Department of Cardiovascular Medicine,Shinshu University,School of Medicine,3-1-1 Asahi,Matsumoto,Nagano 390-8621,Japan3.Department of Cardiology,Tokyo Women's Medical University,Kawada-cho,Shinjuku-ku 8-1,Tokyo 162-8666,Japan;Department of Cardiovascular Medicine,Shinshu University,School of Medicine,3-1-1 Asahi,Matsumoto,Nagano 390-8621,Japan4.Department of Cardiovascular Surgery,Tokyo Women's Medical University,Kawada-cho 8-1,Shinjuku-ku,Tokyo 162-8666,Japan
摘要：Background Management of pacemaker (PM) infections among advanced aged patients possesses particular clinical challenges due to higher rates of concurrent cardiovascular disease and medical comorbidities.Novel leadless cardiac pacemakers (LCPs)may provide new opportunities for better management options in this population,however,there is limited data especially in Asian populations to guide the decision making.Methods We reviewed 11 octogenarians (median age:86[minimum 82-maximum 90]years;male:73％;median body mass in-dex (BMI):20.1 kg/m2) who received Micra Transcatheter Pacing System (Medtronic Inc,Minneapolis,MN) implantations follow-ing transvenous lead extractions (TLEs) for PM infections.Results All patients had more than two medical comorbidities (average 3.7 comorbidities).The indications for LCP implanta-tions were atrioventricular block in four patients,atrial fibrillation bradycardia in five,and sinus node dysfunction in two.Eight patients (73％) were bridged with temporary pacing using active fixation leads (median interval of 14.0 days),while one with severe dementia underwent a concomitant LCP implantation and TLE during the same procedure.Successful TLEs and LCP im-plantations were successfully accomplished in all without any complications.The median time from the TLE procedure to dis-charge was 22 days (minimum 7-maximum 136).All patients remained free of infections during a mean follow-up period of 17.2 ±6.5 months.Conclusions LCP implantations were safe and effective after removing the entire infectious PM system in all octogenarians.The novel LCP technology may offer an alternative option for considering a re-implantation strategy after transvenous PM infections in elderly patients,particularly those with severe frailty and PM dependency.
机标关键词：
论文发表日期：2021-07-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：9( 505-513 )