床旁经左锁骨下静脉临时心脏起搏治疗缓慢性心律失常的临床应用

摘要

目的 探讨床旁经左锁骨下静脉临时心脏起搏治疗缓慢性心律失常的疗效与安全性.方法 在无X线透视下,为63例缓慢性心律失常患者经左锁骨下静脉路径床旁放置临时心脏起搏器,记录起搏效果、操作时间、电极放置部位等指标.结果 63例患者均穿刺左锁骨下静脉送入临时电极成功,即刻起搏成功率100%,起搏阐值为(1.95±0.12) V,操作时间(7.3±0.37) min,起搏电极放置位置:右心室尖部起搏9例(14.3%,9/63),右室流出道起搏53例(84.1%,53/63),冠状静脉窦内起搏1例(1.6%,1/63).无穿刺失败及其他并发症.结论 床旁经左锁骨下静脉临时心脏起搏术操作简便、起搏效果好,适合紧急临时心脏起搏患者使用.%Objective To discuss the curative effect of bedside temporary cardiac pacing via left subclavian vein on bradyarrhythmia and the safety. Methods The patients with bradyarrhythmia ( n = 63 ) were inserted temporary cardiac pacing via left subclavian vein without roentgenoscopy. The pacing effect, operation time and location of electrode placement were recorded. Results All temporary electrodes were implanted successfully via left subclavian vein in 63 patients. The success rate of immediate pacing was 100% ,pacing threshold was ( 1. 95 ±0. 12 ) V and operation time was (7.3 ± 0. 37 ) min. The locations of pacing electrode placement included right ventricular tip in 9 cases ( 14. 3% ,9/63 ),outflow tract of right ventricle in 53 cases ( 84. 1% ,53/63 ),and coronary vein in one case ( 1. 6% , 1/63 ). There were no puncture failure and other complications observed. Conclusion Bedside temporary cardiac pacing via left subclavian vein is easy in operation and pacing effect is excellent, which is suitable to the patients needing emergency and temporary cardiac pacing.