经左锁骨下静脉起搏脉冲引导紧急床边临时心脏起搏

目的 经左锁骨下静脉途径研究起搏脉冲引导行紧急床边临时心脏起搏技术的优越性及可行性。方法 以Seldingel法穿刺左锁骨下静脉置入鞘管。设置起搏器频率超过患者自主心率20次／min、输出电流为5mA、感知电压为3mV，沿鞘管推送电极至心电监护显示脉冲信号及起搏心律。结果 18例患者获良好的起搏效果(操作时间5～10min，平均6．9min)。1例患者开始时起搏效果不良，约2h后好转；2例患者起搏效果差；后3例操作时间均超20min。21例患者术后均无并发症。结论 由起搏脉冲引导、经左锁骨下静脉行紧急床边临时心脏起搏起效迅速、成功率高且较安全。

Emergency bedside temporary cardiac pacing through the left subclavicular vein guided by pacemaker impulse]

OBJECTIVE: To investigate the feasibility and merits of emergency bedside temporary cardiac pacing through left subclavicular vein guided by pacemaker impulse. METHODS: The left subclavicular vein was punctured with Seldinger technique for insertion of a cannula. After setting the rate of pacemaker at 20 beat/min above the patients' spontaneous heart rate with output current of 5 mA and sensing voltage of 3 mV, the electrode was inserted through the cannula until the electrocardiograph displaying pulsed signal and pacing rhythm. RESULTS: Good pacing was achieved in 18 patients with one having poor pacing, which was improved 2 h later. The pacing was not satisfactory in two cases. No postoperative complications occurred in the 21 patients. CONCLUSION: Emergency bedside temporary cardiac pacing through the left subclavicular vein guided by pacemaker impulse is rapid and ensures high success rate and safety.