Computed Tomography-Verified Pacing Location of Micra Leadless Pacemakers and Characteristics of Paced Electrocardiograms in Bradycardia Patients.
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| Názov: | Computed Tomography-Verified Pacing Location of Micra Leadless Pacemakers and Characteristics of Paced Electrocardiograms in Bradycardia Patients. |
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| Autori: | Zhang J; Cardiac Pacing and Electrophysiology Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.; Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac Remodelling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China., Zhou X; Cardiac Pacing and Electrophysiology Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.; Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac Remodelling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China., Lu Y; Cardiac Pacing and Electrophysiology Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.; Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac Remodelling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China., Li Y; Cardiac Pacing and Electrophysiology Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.; Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac Remodelling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China., Xing Q; Cardiac Pacing and Electrophysiology Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.; Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac Remodelling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China., Tuerhong Z; Cardiac Pacing and Electrophysiology Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.; Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac Remodelling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China., Yang X; Cardiac Pacing and Electrophysiology Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.; Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac Remodelling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China., Xiaokereti J; Cardiac Pacing and Electrophysiology Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.; Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac Remodelling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China., Guo Y; Cardiac Pacing and Electrophysiology Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.; Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac Remodelling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China., Zhou X; Research and Technology Division, Cardiac Rhythm Management, Medtronic Inc., Minneapolis, Minnesota, USA., Kohnle S; Research and Technology Division, Cardiac Rhythm Management, Medtronic Inc., Minneapolis, Minnesota, USA., Zou S; Cardiac Rhythm Management, Medtronic (Shanghai), Shanghai, China., Tang B; Cardiac Pacing and Electrophysiology Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.; Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac Remodelling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China. |
| Zdroj: | Clinical cardiology [Clin Cardiol] 2025 Oct; Vol. 48 (10), pp. e70209. |
| Spôsob vydávania: | Journal Article |
| Jazyk: | English |
| Informácie o časopise: | Publisher: John Wiley & Sons, Inc Country of Publication: United States NLM ID: 7903272 Publication Model: Print Cited Medium: Internet ISSN: 1932-8737 (Electronic) Linking ISSN: 01609289 NLM ISO Abbreviation: Clin Cardiol Subsets: MEDLINE |
| Imprint Name(s): | Publication: Hoboken, NJ : John Wiley & Sons, Inc Original Publication: New York : G. Witzstrock |
| Výrazy zo slovníka MeSH: | Bradycardia*/therapy , Bradycardia*/physiopathology , Bradycardia*/diagnosis , Electrocardiography* , Pacemaker, Artificial* , Cardiac Pacing, Artificial*/methods , Tomography, X-Ray Computed* , Heart Rate*, Humans ; Male ; Female ; Aged ; Middle Aged ; Fluoroscopy ; Equipment Design ; Aged, 80 and over ; Retrospective Studies ; Treatment Outcome ; Predictive Value of Tests |
| Abstrakt: | 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. (© 2025 The Author(s). Clinical Cardiology published by Wiley Periodicals LLC.) |
| References: | J Interv Card Electrophysiol. 2021 Mar;60(2):239-245. (PMID: 32242303) Heart Rhythm. 2020 Oct;17(10):1759-1767. (PMID: 32417259) N Engl J Med. 2016 Feb 11;374(6):533-41. (PMID: 26551877) J Cardiovasc Electrophysiol. 2019 Oct;30(10):2002-2011. (PMID: 31338871) J Innov Card Rhythm Manag. 2018 May 15;9(5):3137-3146. (PMID: 32494491) Eur Heart J. 2014 May;35(18):1186-94. (PMID: 24347317) J Cardiovasc Electrophysiol. 2022 Jun;33(6):1244-1254. (PMID: 35419908) Heart Rhythm. 2012 May;9(5):728-35. (PMID: 22182495) Europace. 2018 Jul 1;20(7):1154-1160. (PMID: 28679175) J Interv Card Electrophysiol. 2023 Jun;66(4):941-949. (PMID: 36282369) Heart Rhythm. 2018 Dec;15(12):1800-1807. (PMID: 30103071) Indian Heart J. 2016 Mar-Apr;68(2):174-80. (PMID: 27133327) J Cardiol. 2022 Oct;80(4):332-338. (PMID: 35637122) Circ Arrhythm Electrophysiol. 2013 Aug;6(4):719-25. (PMID: 23742805) Heart Rhythm. 2019 Jun;16(6):896-902. (PMID: 30550834) Heart Rhythm. 2019 Jun;16(6):921-927. (PMID: 30633981) J Cardiovasc Electrophysiol. 2024 May;35(5):906-915. (PMID: 38433355) Heart Rhythm. 2021 Jul;18(7):1132-1139. (PMID: 33713856) |
| Grant Information: | This study was supported by Natural Science Foundation of Xinjiang Uygur Autonomous Region (Grant number 2022D01C486). |
| Contributed Indexing: | Keywords: bradycardia; cardiac computed tomography; leadless pacemaker; right ventricular septum |
| Entry Date(s): | Date Created: 20251007 Date Completed: 20251007 Latest Revision: 20251010 |
| Update Code: | 20251010 |
| PubMed Central ID: | PMC12501953 |
| DOI: | 10.1002/clc.70209 |
| PMID: | 41055208 |
| Databáza: | MEDLINE |
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Nájsť tento článok vo Web of Science | Abstrakt: | 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.<br />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.<br />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.<br />Conclusion: In routine Micra implantation, the pacing sites were often located in the anterior insertion region.<br /> (© 2025 The Author(s). Clinical Cardiology published by Wiley Periodicals LLC.) |
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| ISSN: | 1932-8737 |
| DOI: | 10.1002/clc.70209 |