床旁经左锁骨下静脉临时心脏起搏治疗急性心肌梗死心律失常

目的：探讨床旁经左锁骨下静脉临时心脏起搏治疗急性心肌梗死合并缓慢性心律失常患者的疗效与安全性。方法：在无X线透视下，为38例急性心肌梗死患者经左锁骨下静脉路径床旁安置临时心脏起搏器。结果：37例穿刺左锁骨下静脉送入临时电极成功，即刻起搏成功率97．3％，手术开始至起搏成功时间8．0±2．2min，电极导管留置时间1～21d，其中2例电极导管脱位。31例急性心肌梗死经临时起搏后，心肌供血得到改善，恢复自主心律，顺利渡过超急期，1例过渡到安置埋藏式心脏起搏器。结论：床旁经左锁骨下静脉安置临时心脏起搏器成功率高，快速，能改善急性心肌梗死并发严重缓慢心律引起的血流动力学变化，适合于临床推广应用。

Application of Bedside Transvenous Temporary Cardiac Pacing via Left Subclavian Vein in Acute Myocardial Infarction

Objective：To investigate the clinical effects and safety of bedside temporary cardiac pacing via left subclavian vein in patients with acute myocardial infarction （AMI） complicated with slow arrhythmia. Methods： Thirty-eight patients with AMI were received the insertion of the temporary cardiac pacing via left subclavian vein without the guidance of roentgenoscopy. Results：Thirty-seven cases with AMI received insertion of the bedside temporary cardiac pacing via left subclavian vein successfully without severe complications. The total successful rate was 97. 3%. Time for successful pacing was 8.0 ± 2.2 minutes. The catheter was kept in the right ventricular for 1-21 days, During the pacing, electrode dislocation occurred in 2 cases, Thirty-one cases recovered with normal cardiac rhythm, and 1 case received implantable pacemaker consequently. Conclusion：The successful rate of inserting elec trode through the left subclavian vein to ventricle for pacing without the guidance of roentgenoscopy is high, which may benefit AMI patients with bradycardia.