临床儿科杂志 ›› 2025, Vol. 43 ›› Issue (7): 549-553.doi: 10.12372/jcp.2025.25e0359

• 临床报道 • 上一篇    下一篇

经颈内静脉植入无导线心脏起搏器:1例15 kg先天性心脏病术后三度房室传导阻滞患儿临床实践与思考

何爽, 许欣, 周雪, 刘茜, 张蕾, 田杰, 吕铁伟()   

  1. 重庆医科大学附属儿童医院心血管科 国家儿童健康与疾病临床医学研究中心 儿童发育疾病研究教育部重点实验室 儿童发育重大疾病国家国际科技合作基地 重庆市卫生健康委儿童重要器官发育与疾病重点实验室(重庆 400014)
  • 收稿日期:2025-04-07 录用日期:2025-05-26 出版日期:2025-07-15 发布日期:2025-06-27
  • 通讯作者: 吕铁伟 E-mail:ltw200145@163.com
  • 基金资助:
    国家临床重点专科建设项目(010140)

Leadless cardiac pacemaker implantation via the internal jugular vein: clinical practice and reflection of a 15kg child with third-degree atrioventricular block after congenital heart surgery

HE Shuang, XU Xin, ZHOU Xue, LIU Qian, ZHANG Lei, TIAN Jie, LYU Tiewei()   

  1. Department of Cardiovascular Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Key Laboratory of Children's Vital Organ Development and Diseases of Chongqing Health Commission, Chongqing 400014, China
  • Received:2025-04-07 Accepted:2025-05-26 Published:2025-07-15 Online:2025-06-27
  • Contact: LYU Tiewei E-mail:ltw200145@163.com

摘要:

目的 探讨小年龄、低体重的先天性心脏病(先心病)术后合并三度房室传导阻滞(AVB)患儿,经颈内静脉植入无导线起搏器的安全性和可行性。方法 回顾性分析1例先心病术后合并三度AVB患儿的临床资料,以及经颈内静脉植入无导线起搏器的情况。结果 患儿,女,6.5岁,体重15 kg,因先心病修补术后并发三度AVB导致晕厥,在评估血管直径和心脏大小后,成功经颈内静脉植入AVEIR无导线心脏起搏器,术后起搏参数良好,临床症状消除,无起搏器相关并发症发生。结论 对于小年龄、低体重的儿童,经充分的术前血管和心脏评估,颈内静脉途径植入无导线心脏起搏器是安全可行的治疗方案。

关键词: 无导线起搏器, 先天性心脏病, 三度房室传导阻滞, 颈内静脉, 儿童

Abstract:

Objective To explore the safety and feasibility of implanting leadless pacemakers via the internal jugular vein in children with congenital heart disease (CHD) of small age and low weight who have developed third-degree atrioventricular block (AVB) after surgery. Methods A retrospective analysis was conducted on the clinical data of a child with grade three AVB after congenital heart disease surgery, as well as the implantation of leadless pacemaker through the internal jugular vein. Results A 6.5-year-old girl (weighing 15 kg) with syncope secondary to third-degree AVB following congenital heart defect repair underwent successful implantation of an AVEIR leadless cardiac pacemaker via the internal jugular vein after comprehensive evaluation of vascular diameter and cardiac dimensions. Postoperative pacing parameters were good, clinical symptoms were eliminated, and no pacemaker-related complications occurred. Conclusions In low-weight young children, after thorough preoperative vascular and cardiac function evaluations, the intracervical vein approach for leadless cardiac pacemaker implantation proves a safe and feasible choice.

Key words: leadless pacemaker, congenital heart disease, third-degree atrioventricular block, internal jugular vein, child

中图分类号: 

  • R72