Abinader E G, Sharif D, Malouf S, Goldhammer E
Heart Institute, Haifa Medical Center (Rothschild), Israel.
Isr J Med Sci. 1987 Aug;23(8):877-80.
The clinical records of 339 consecutive patients who had received temporary transvenous pacemakers were analyzed for indications, complications and malfunctions. Of the 156 patients who had had an acute myocardial infarction (AMI), 50% had had anterior wall and 43.6% inferior wall involvement. The route of electrode insertion was the antecubital vein in 71%, subclavian vein in 24%, internal jugular vein in 4%, and a femoral vein in the remainder. The indication for pacing in the AMI group was atrioventricular (A-V) block in 55%, fascicular block in 32% and other arrhythmias in 13% of the cases. In the non-AMI group, the indication for pacing was A-V block in 46.4%, sick sinus syndrome in 25%, preparation for noncardiac surgery in 12%, and diagnostic purposes in the remainder. Ventricular fibrillation (VF) occurred only in the AMI group and appeared in 9 (5.66%) of these cases. The site of infarction did not significantly affect the incidence of VF. Ventricular premature beats (VPBs) and ventricular tachycardia (VT) appeared in 28.8 and 12.8% of the AMI group and 4.4 and 3.3% of the non-AMI group, respectively. No difference in the incidence of myocardial perforation, sepsis, and phlebitis was encountered between the AMI and non-AMI groups. Total malfunction rate was significantly higher in the AMI group (15%) vs. the non-AMI group (4%). A higher rate of pacing malfunction was found when a semifloating electrode was used through the subclavian vein (14.3%) vs. a 6 or 7 French electrode through the antecubital vein (7%). Thus, temporary pacing is safe and associated with lower incidence of complications and malfunctions in non-AMI than in AMI subjects. Moreover, a lower incidence of malfunction was encountered when a 6 or 7 French electrode was inserted through the antecubital vein.
对339例连续接受临时经静脉起搏器治疗的患者的临床记录进行分析，以了解其适应证、并发症及故障情况。在156例急性心肌梗死（AMI）患者中，50%为前壁心肌梗死，43.6%为下壁心肌梗死。电极插入途径为肘前静脉的占71%，锁骨下静脉的占24%，颈内静脉的占4%，其余为股静脉。AMI组起搏适应证为房室（A-V）阻滞的占55%，束支阻滞的占32%，其他心律失常的占13%。非AMI组起搏适应证为A-V阻滞的占46.4%，病态窦房结综合征的占25%，非心脏手术准备的占12%，其余为诊断目的。心室颤动（VF）仅发生在AMI组，其中9例（5.66%）出现VF。梗死部位对VF发生率无显著影响。室性早搏（VPB）和室性心动过速（VT）在AMI组中的发生率分别为28.8%和12.8%，在非AMI组中的发生率分别为4.4%和3.3%。AMI组与非AMI组在心肌穿孔、败血症和静脉炎的发生率上无差异。AMI组的总故障发生率（15%）显著高于非AMI组（4%）。通过锁骨下静脉使用半漂浮电极时的起搏故障发生率（14.3%）高于通过肘前静脉使用6或7F电极时的发生率（7%）。因此，与AMI患者相比，临时起搏在非AMI患者中是安全的，且并发症和故障发生率较低。此外，通过肘前静脉插入6或7F电极时的故障发生率较低。
