Cardiothoracic Surgery Department, Royal North Shore Hospital, St Leonards, Australia.
Gen Thorac Cardiovasc Surg. 2022 Jul;70(7):595-601. doi: 10.1007/s11748-022-01831-5. Epub 2022 Jun 2.
Although epicardial pacing wires are routinely inserted after cardiac surgical procedures, there is little in the medical literature to help standardise their use and identify associated risks and benefits. Much of the decision-making surrounding pacing wires are based on the surgeon's preference and vary highly between centers.
A literature review was conducted exploring the evidence, indications, and current practice for temporary pacing wires. Risk factors for developing post-operative arrhythmias necessitating use of temporary pacing wires and complications were also reviewed.
Although temporary epicardial pacing wires have a crucial role to play in the post-operative recovery period, the current literature suggests that they should be considered on an individual basis in all high-risk patients including increased age, low ejection fraction, diabetes mellitus, elevated pulmonary artery pressures, prolonged cross clamp time, pacing required to wean from bypass, pre-operative arrhythmia, and multiple valvular and transplant operations. Although complications from pacing wires are low, this figure is likely underreported and further studies are required to focus on the risks and benefits of insertion.
尽管心脏手术后通常会插入心外膜起搏导线，但医学文献中几乎没有帮助标准化使用以及确定相关风险和益处的内容。起搏导线的决策在很大程度上取决于外科医生的偏好，并且在不同中心之间差异很大。
进行了文献回顾，探讨了临时起搏导线的证据、适应证和当前实践。还回顾了术后心律失常需要使用临时起搏导线的危险因素和并发症。
尽管临时心外膜起搏导线在术后恢复期间具有至关重要的作用，但目前的文献表明，在所有高危患者中，包括高龄、射血分数降低、糖尿病、肺动脉压升高、体外循环时间延长、需要起搏以脱机、术前心律失常以及多瓣膜和移植手术，都应根据个体情况考虑使用起搏导线。尽管起搏导线的并发症发生率较低，但这个数字可能被低估了，需要进一步的研究来关注插入的风险和益处。
