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临时经静脉心脏起搏:当前实践调查。

Temporary transvenous cardiac pacing: a survey on current practice.

机构信息

Institute of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine, Policlinico S.Orsola-Malpighi University of Bologna, Bologna.

Division of Cardiology, S. Bortolo Hospital, Vicenza.

出版信息

J Cardiovasc Med (Hagerstown). 2020 Jun;21(6):420-427. doi: 10.2459/JCM.0000000000000959.

Abstract

BACKGROUND

Temporary transvenous cardiac pacing (TTCP) is a standard procedure in current practice, despite limited coverage in consensus guidelines. However, many authors reported several complications associated with TTCP, especially development of infections of cardiac implantable electronic devices (CIED). The aim of this survey was to provide a country-wide picture of current practice regarding TTCP.

METHODS

Data were collected using an online survey that was administered to members of the Italian Association of Arrhythmology and Cardiac Pacing.

RESULTS

We collected data from 102 physicians, working in 81 Italian hospitals from 17/21 regions. Our data evidenced that different strategies are adopted in case of acute bradycardia with a tendency to limit TTCP mainly to advanced atrioventricular block. However, some centers reported a greater use in elective procedures. TTCP is usually performed by electrophysiologists or interventional cardiologists and, differently from previous reports, mainly by a femoral approach and with nonfloating catheters. We found high inhomogeneity regarding prevention of infections and thromboembolic complications and in post-TTCP management, associated with different TTCP volumes and a strategy for management of acute bradyarrhythmias.

CONCLUSION

This survey evidenced a high inhomogeneity in the approaches adopted by Italian cardiologists for TTCP. Further studies are needed to explore if these divergences are associated with different long-term outcomes, especially incidence of CIED-related infections.

摘要

背景

尽管共识指南中对此的覆盖范围有限,但临时经静脉心脏起搏(TTCP)仍是目前实践中的标准程序。然而,许多作者报告了与 TTCP 相关的多种并发症,尤其是心脏植入式电子设备(CIED)感染的发生。本调查旨在提供有关 TTCP 的当前实践的全国性情况。

方法

使用在线调查收集数据,该调查向意大利心律失常和心脏起搏协会的成员进行了管理。

结果

我们从来自 17/21 个地区的 81 家意大利医院的 102 名医生那里收集了数据。我们的数据表明,在急性心动过缓的情况下采用了不同的策略,主要倾向于将 TTCP 限制在高级房室传导阻滞。然而,一些中心报告说在选择性手术中使用更多。TTCP 通常由电生理学家或介入心脏病专家进行,与以前的报告不同,主要通过股动脉入路和非漂浮导管进行。我们发现,在感染和血栓栓塞并发症的预防以及 TTCP 后管理方面存在高度的异质性,这与不同的 TTCP 量和急性心动过缓管理策略有关。

结论

本调查表明,意大利心脏病专家在 TTCP 方面的方法存在很大差异。需要进一步研究以探讨这些差异是否与不同的长期结果相关,特别是与 CIED 相关的感染发生率。

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