Del Nido P, Goldman B S
Division of Cardiovascular Surgery, Toronto General Hospital, Ontario, Canada.
J Card Surg. 1989 Mar;4(1):99-103. doi: 10.1111/j.1540-8191.1989.tb00262.x.
Temporary wires are routinely sutured to atrial and/or ventricular epimyocardium after open heart surgery. Despite the common problems of poor sensing or capture, dislodgement or retention, no criteria exists for proper placement or removal. This report describes clinical complications due to: failure of ventricular sensing, failure of ventricular capture, bleeding from right ventricular laceration with tamponade, avulsion of a side branch from a saphenous vein coronary bypass graft, and perforation of the superior epigastric artery. Appropriate placement of temporary wires for optimum function requires 2-cm electrode separation, application into both atrium and ventricle with a gentle redundant loop to exit near the midline, avoiding both coronary arteries and coronary artery bypass grafts. Gentle traction for removal is recommended on the day prior to discharge, especially for patients on antiplatelet or anticoagulant therapy.
心脏直视手术后，临时电极通常会缝合于心房和/或心室的心外膜。尽管存在感知不良或夺获不佳、移位或留存等常见问题，但对于正确放置或移除电极尚无标准。本报告描述了以下临床并发症：心室感知失败、心室夺获失败、右心室撕裂伴心包填塞出血、大隐静脉冠状动脉旁路移植术侧支血管撕裂以及上腹壁动脉穿孔。为实现最佳功能而正确放置临时电极需要电极间距为2厘米，轻柔地将电极放置于心房和心室，并在中线附近留出一个松弛的环形，同时避开冠状动脉和冠状动脉旁路移植术血管。建议在出院前一天轻柔牵拉电极以将其移除，对于接受抗血小板或抗凝治疗的患者尤其如此。
