【摘要】 目的探讨经股静脉应用球囊漂浮电极导管行床旁心脏临时起搏的方法学和可行性。方法对86例因多种心律失常需要临时起搏的患者应用球囊漂浮电极导管经股静脉进行心脏临时起搏,通过分析其起搏心电图图形特点、X线胸片和测量导管深度,判定该起搏方法的可行性和成功率,分析起搏失败的原因。结果经股静脉床旁心脏临时起搏起搏点主要为右心室心尖部和流出道,导管深度分别为(57.2±3.2)cm和(54.3±3.1)cm,右心室流出道起搏感知不良的发生率较心尖部高(P<0.05),两组间起搏阈值差异无统计学意义。通过起搏心电图图形和导管深度指导下应用球囊漂浮电极导管即刻成功率高达98.8%。结论经股静脉床旁应用球囊漂浮电极导管进行心脏临时起搏是一项安全有效、可行的起搏方法。更多还原

【Abstract】 Objective To investigate the methodology and feasibility of bedside temporary cardiac pacing with balloon-tipped floating catheter by femoral vein approach.Methods 86 patients in this study were treated with bedside temporary cardiac pacing by femoral vein for arrhythmias.A balloon-tipped floating catheter was inserted through the femoral vein in right ventricle,guided by the length of catheter in body and the QRS morphology of pacing electrocardiogram(ECG).After that,the pacing site was identified by X-ray fluoroscopy.Then,the feasibility and successful rate of this bedside temporary cardiac pacing,and the causes for failure were analyzed.Results Guided by the length of catheter and the QRS morphology of pacing ECG,the succesful rate of balloon-tipped floating catheter putted into right ventricle was 98.8%.The most successful pacing sites were located at the right ventricular apex(RVA) and right ventricular out-flow tract(RVOT).The lengths of catheter from the puncture sites to RVA and RVOT were (57.2±3.2)cm and (54.3±3.1)cm,respectively.Incidence of undersensing in RVOT pacing group was significantly higher than that in RVA pacing group(P<0.05).However,there was no significant difference in pacing threshold between these two groups.Conclusion The balloon-tipped floating catheter can be safely used for bedside temporary cardiac pacing by femoral vein for patients with diffrerent age with a high successful rate.更多还原