床旁球囊漂浮电极起搏在心脏术后缓慢性心律失常中应用

Bedside temporary cardiac pacing with balloon-flotation electrode catheter in the treatment of bradyarrhythmia after cardiac surgery

目的评估心脏外科术后缓慢性心律失常行床旁球囊漂浮电极导管紧急心脏起搏的可行性和有效性。方法心脏外科术后并发缓慢性心律失常患者21例,均给予漂浮电极导管临时起搏治疗,观察临时起搏手术入路、手术时间、电极导管放置部位及起搏阈值,评估治疗成功率和安全性。结果本组起搏器电极安置经右侧锁骨下静脉15例,经右侧颈内静脉6例;手术时间5-12min;电极导管置入右心室心尖部18例,右心室流出道3例;起搏阈值〈1.0mV;床旁球囊漂浮电极起搏治疗成功率100%,发生导管移位、感知起搏不良各2例,无严重并发症发生。结论床旁球囊漂浮电极起搏操作简单,用于治疗心脏术后缓慢性心律失常安全、可行,疗效确切。

Objective To evaluate the feasibility and efficiency of bedside temporary cardiac pacing with balloon-flotation electrode catheter in the treatment of bradyarrhythmia after cardiac surgery.Methods Twenty-one patients with bradyarrhythmia after cardiac surgery underwent bedside temporary cardiac pacing with balloon-flotation electrode catheter.The temporary pacemaker approach,operation duration,the pacing site and threshold value were observed to assess the success rate and safety.Results Fifteen patients were placed balloon-flotation electrode catheter via right subclavian vein,and six patients via right internal jugular vein.The operation lasted for 5to 12 min.The electrode catheter reached the right ventricular apex in 18 patients,and reached the right ventricular outflow tract in 3.The pacing threshold value was lower than 1.0 mV.The success rate of bedside temporary cardiac pacing with balloon-flotation electrode catheter was 100%.The late displacement of electrode catheter and the dysfunction of pacemaker sensing occurred in 2cases respectively.No severe complications were found.Conclusion Bedside temporary cardiac pacing with balloon-flotation electrode catheter is safe,feasible and effective in the treatment for bradyarrhythmia after cardiac surgery.