Initial studies on the implanting sites of high and low ventricular septa using leadless cardiac pacemakers

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Annals of Noninvasive Electrocardiology Pub Date : 2023-06-21 DOI:10.1111/anec.13068

Qiao-yuan Li MD, Jian-zeng Dong MD, Cheng-jun Guo MD, Dong-ping Fang MD, Xu Liu MD, Wen-long Dai MD

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Abstract

Objective

To study the safety and electrical characteristics of various implanting sites of the Micra pacemaker.

Method

A total of 15 patients from Beijing Anzhen Hospital, Capital Medical University, were included, who were implanted with Micra leadless pacemakers and allocated to either the high ventricular septum group (eight patients) or the low ventricular septum group (seven patients) based on their individual patient factors and clinical conditions. The baseline of the patients, the implanting area, the electrocardiogram change after implantation, the implantation data, the threshold, R wave, impedance, and the date of the 1-month follow-up were then analyzed. With all of the data, the characteristics of different implantation sites of the Micra pacemaker were determined.

Results

Overall, the thresholds were low at implantation and remained stable over the 1-, 3-, 6-month, 1-, 2-, 3-, and 4-year follow-ups. On comparing the two groups, there was no difference in QRS duration at pacing (140.00 [40.00] ms vs. 179.00 [50.00] ms), threshold at implantation (0.38 [0.22] mV vs. 0.63 [1.00] mV), R wave at implantation ([10.85 ± 4.71] V vs. [7.26 ± 2.98] V), or impedance at implantation ([906.25 ± 162.39] Ω vs. [750.00 ± 173.40] Ω). While the difference in QRS duration between the two groups was not significant, the QRS duration of the high ventricular septum group exhibited a reduced tendency compared with that of the low ventricular group. The corrected QT interval during pacing exhibited a significant difference (440.00 [80.00] ms vs. 520.00 [100.00] ms; p < .05). For the 1-, 3-, 6-month, 1-, 2-, 3-, and 4-year follow-ups, there was no difference between the threshold of the high ventricular septum group and that of the low ventricular septum group (p > .05).

Conclusion

High ventricular septum pacing appears to be a safe site for implantation of the Micra pacemaker. It could entail a shorter QRS duration at pacing and could be more physiological than low ventricular septum pacing.

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无铅心脏起搏器植入高、低室间隔部位的初步研究

目的研究Micra起搏器不同植入部位的安全性和电特性。方法选取首都医科大学附属北京安贞医院15例植入Micra无导线起搏器的患者，根据患者个体因素及临床情况分为高室间隔组(8例)和低室间隔组(7例)。分析患者基线、植入面积、植入后心电图变化、植入数据、阈值、R波、阻抗、1个月随访日期。根据所有数据，确定了Micra起搏器不同植入部位的特征。结果总的来说，植入时的阈值较低，并在1、3、6个月、1、2、3、4年的随访中保持稳定。两组患者起搏时QRS持续时间(140.00 [40.00]ms vs. 179.00 [50.00] ms)、植入时阈值(0.38 [0.22]mV vs. 0.63 [1.00] mV)、植入时R波([10.85±4.71]V vs.[7.26±2.98]V)、植入时阻抗([906.25±162.39]Ω vs.[750.00±173.40]Ω)均无差异。两组QRS持续时间差异不显著，高室间隔组QRS持续时间较低室间隔组有减少趋势。起搏时校正的QT间期有显著差异(440.00 [80.00]ms vs. 520.00 [100.00] ms;p < .05)。随访1、3、6个月、1、2、3、4年，高室间隔组与低室间隔组的阈值差异无统计学意义(p > 0.05)。结论高室间隔起搏是Micra起搏器植入的安全部位。它可能导致起搏时QRS持续时间较短，可能比低室间隔起搏更具生理性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Noninvasive Electrocardiology 医学-心血管系统

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The ANNALS OF NONINVASIVE ELECTROCARDIOLOGY (A.N.E) is an online only journal that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. ANE is the first journal in an evolving subspecialty that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. The publication includes topics related to 12-lead, exercise and high-resolution electrocardiography, arrhythmias, ischemia, repolarization phenomena, heart rate variability, circadian rhythms, bioengineering technology, signal-averaged ECGs, T-wave alternans and automatic external defibrillation. ANE publishes peer-reviewed articles of interest to clinicians and researchers in the field of noninvasive electrocardiology. Original research, clinical studies, state-of-the-art reviews, case reports, technical notes, and letters to the editors will be published to meet future demands in this field.