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Successful leadless pacemaker implantation in a patient with dextroversion of the heart:A case report

World Journal of Clinical Cases 2023年第33期11卷 8089-8093页

作者： Na Li Hai-Xiong Wang Yue-Hui Sun Yan Shu Department of Cardiology Shanxi Cardiovascular HospitalTaiyuan 030000Shanxi ProvinceChina

BACKGROUND Dextroversion is defined as the presence of dextrocardia with situs solitus,dextroloop ventricles,and normally related great arteries.Dextrocardia can pose technical challenges when interventional treatments are required.However,the challenges posed by dextroversion can be amplified due to the disruption of typical anatomical relationships,the unpredictable positioning and boundaries of cardiac structures resulting from the shift,and the pathological processes influencing rotation.CASE SUMMARY A 73-year-old woman with cardiac dextroversion suffered from a recurrence of atrial fibrillation after her radiofrequency catheter ablation and Despite the cessation of antiarrhythmic medications,there were episodes of sinus pauses and symptomatic bradycardia,with heart rates dropping as low as 28 beats per minute.CONCLUSION Dextroversion makes the implantation of leadless pacemakers more challenging,and appropriate adjustments in fluoroscope angles may be crucial for intracardiac operations.Additionally,when advancing delivery systems,attention should be paid to rotational direction during valve-crossing procedures;changes in the perspective of posture angle between normal cardiac position and dextroversion can serve as references.

关键词： leadless pacemaker Dextroversion pacemaker implantation Case report

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A Meta-analysis of Major Complications between Traditional pacemakers and leadless pacemakers

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Cardiovascular Innovations and Applications 2021年第1期5卷 145-153页

作者： Diyu Cui Yimeng Liao Jianlin Du Yunqing Chen Department of Cardiology The Second Affiliated Hospital of Chongqing Medical UniversityChongqing 400010China

Objectives:We aim to compare the major complications between leadless pacemakers and traditional pacemakers.Background:leadless pacemakers,which are increasingly used in clinical practice,have several advantages compared with traditional pacemakers in avoiding pocket-and lead-related complications.However,the clinical effect of leadless pacemakers remains controversial.Methods:PubMed,Embase,the Cochrane Central Register of Controlled Trials(CENTRAL),the CNKI database,and the Wanfang database were searched from July 2013 to December 2019.Studies comparing leadless pacemakers and traditional pacemakers were included.The primary end point was major complications.The secondary end points were cardiac perforation/pericardial effusion,device revision or extraction,loss of device function,and death.Results:Six studies fulfi lled the inclusion criteria.Only four of the six studies reported data on major complications.leadless pacemakers were associated with a lower incidence of major complications(risk ratio 0.33,95%confi dence interval 0.25–0.44,Pleadless pacemakers have a higher risk of cardiac perforation or pericardial effusion(risk ratio 4.28,95%confi dence interval 1.66–11.08,P=0.003,I²=0%).No statistically signifi cant differences were found for mortality,device revision or extraction,and loss of device function.Conclusion:Compared with traditional pacemakers,leadless pacemakers have a signifi cantly decreased risk of major complications,but have a higher risk of cardiac perforation or pericardial effusion.

关键词： leadless pacemaker traditional pacemaker treatment effect complication meta-analysis

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