心电图引导下非漂浮电极床旁心内起搏与起搏复律的临床应用

目的　探讨心电图引导下非漂浮电极床旁心内起搏与起搏复律的效果。方法　用改良的Seldinger方法穿刺左、右锁骨下静脉或右股静脉 ,置入 5F远端塑成直径为 10cmC型非漂浮起搏电极 ,进行床旁起搏和起搏复律。结果　床旁心脏起搏及起搏复律共 10 9例。进行床旁紧急心内起搏或保护性起搏 86例。其中 31例后来在植入埋藏式起搏器时 ,经X光透视证实临床起搏电极在心尖部 30例 ,在流出道 1例。 1例因心脏停搏 ,从右股静脉置入起搏电极进行起搏成功。进行床旁心内起搏复律 2 3例 ,其中室上性心动过速 17例 ,室性心动过速 6例。所有病例起搏及起搏复律成功。结论　心电图引导下非漂浮电极床旁心内起搏与起搏复律具有快速、简便、安全、有效和起搏稳定的优点 ,值得临床推广应用。

Cardiac pacing and anti - arrhythmia by bed using non- balloon catheter under ECG

Objective To investigate the efficiency of the percutaneous venous puncture to set temporary pacing catheter for temporary cardiac pacing and anti-arrhythmia by bed with the ECG. Methods To puncture the subclavian or right femoral vein with modified Seldinger method, then to set the 5F temporary non-balloon pacing catheter. These ends were mades 10 cm C type for emergency pacing and anti-arrhythmia.Results There were 109 cases in our group. 86 cases were emergency pacing, 30 of them were pacing catheter in the cardiac apex with X-ray when the perpetual pacing was done and 1 case was in right ventricle output. 1 case was treated with pacing through the right femoral vein because of the cardiac arrest. 23 cases were treated with emergency anti-arrhythmia by bed, 17 cases of them were paroxysmal AV junction tachycardia and 6 cases were paroxysmal ventricular tachycardia. All the patients were successful. Conclusion Pacing and anti-arrhythmia catheter for temporary cardiac pacing using non-balloon catheter under ECG by bed was simple, quick, safe, effective and stable pacing method. It should be widely used in clinical application.