应用主动固定电极经股静脉行临时心脏起搏的可行性和安全性

Feasibility and safety of temporary cardiac pacing via the femoral vein with an active fixed pacing lead

目的:探讨应用主动固定电极经股静脉行临时心脏起搏的可行性和安全性。方法:选取年龄≥14岁,具备临时心脏起搏适应证的患者25例,应用85 cm长的美敦力主动固定起搏电极经股静脉行临时心脏起搏。结果:临时起搏电极植入在右心室流入道间隔部位的24例,植入在右室流出道间隔部的1例。术中测试的起搏阈值为0.6(0.5,1.0)V,感知的R波振幅为8.0(6.7,11.2)mV,电极阻抗为(746.2±113.0)Ω,手术时间为(46.8±7.3)min,临时起搏电极体外段的长度为27.0(26.0,29.4)cm,X线曝光剂量为(15.3±3.0)mGy。术后24 h复测的起搏参数与术中测试的结果相似。临床转归为植入永久起搏器19例,心率恢复正常5例,院内死亡1例。25例患者术后均未出现并发症。结论:应用主动固定电极经股静脉行临时心脏起搏安全可行。

Objective:To discuss the feasibility and safety of performing temporary cardiac pacing via the femoral vein with an active fixed pacing lead.Methods:A total of 25 patients aged over 14 years with indications for temporary cardiac pacing were selected.Medtronic 85 cm long active fixed pacing lead was used for temporary cardiac pacing through femoral vein.Results:Temporary pacing leads were implanted in the right ventricular inflow tract septum in 24 cases and in the right ventricular outflow tract septum in 1 case.The pacing threshold was 0.6(0.5,1.0)V,the perceived R-wave amplitude was 8.0(6.7,11.2)mV,the electrode impedance was(746.2±113.0)Ω,and the operation time was(46.8±7.3)min,the length of the external section of the temporary pacemaker electrode was 27.0(26.0,29.4)cm,and the X-ray exposure dose was(15.3±3.0)mGy.The pacing parameters of retest 24 h after operation were similar to that of the intraoperative test.The clinical outcomes showed permanent pacemaker implantation were in 19 cases,heart rate returned to normal in 5 cases,hospital death in 1 case,and no postoperative complications occurred in 25 patients.Conclusion:Temporary cardiac pacing via femoral vein with active fixed pacing lead is safe and feasible.