Wang Yefeng, Zuo Chao, Wang Xiang, Xiao Yunbin, Zeng Min, Yang Yufan, Chen Zhi
Department of Cardiology, Hunan Children's Hospital, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University, No. 86 Ziyuan Road, Changsha, 410007, Hunan, People's Republic of China.
Department of Pediatric Intensive Care Unit, Hunan Children's Hospital, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University, No. 86 Ziyuan Road, Changsha, 410007, Hunan, People's Republic of China.
Pediatr Cardiol. 2024 Aug 3. doi: 10.1007/s00246-024-03610-w.
To compare the efficacy and safety of bedside ultrasound-guided and fluoroscopy-guided transvenous cardiac temporary pacing in the treatment of bradyarrhythmia in children. Children treated by temporary intravenous cardiac pacing from January 2016 to June 2023 in Hunan Provincial Children's Hospital were enrolled, and the characteristics and data of the cases were summarized. Patients were divided into bedside ultrasound-guided group (ultrasound group) and fluoroscopy-guided group (fluoroscopy group) according to the implantation guidance methods. The efficacy, safety, and incidence of complications in children were compared, and follow-up analysis was carried out. A total of 30 children were enrolled, including 18 males and 12 females, with a median age of 5.5 (2.9, 10.0) years and a median weight of 18.7 (12.7, 32.7) kg. The most common primary diseases were fulminant myocarditis (13/30 cases) and congenital high-grade AVB (10/30 cases). Among them, the proportion of congenital high AVB in the fluoroscopy group was significantly higher than that in the ultrasound group, and the difference was statistically significant (p = 0.007). The implantation process was successful in all 30 children. From the time of pacing decision to implantation, the median time of ultrasound group was 56 (30, 60) min and that of fluoroscopy group was 154 (78,180) min, with a statistically significant difference (P < 0.001). A total of 5 cases developed complications. There was no statistically significant difference between the two groups (P > 0.05). Compared with traditional fluoroscopic temporary pacing, bedside ultrasound-guided temporary pacing technology can effectively shorten the operation time and reduce the occurrence of complications and has become a better choice for children's emergency and critical care treatment. The right internal jugular vein is preferred for intravenous implantation.
比较床旁超声引导与透视引导下经静脉心脏临时起搏治疗儿童缓慢性心律失常的疗效及安全性。选取2016年1月至2023年6月在湖南省儿童医院接受临时静脉心脏起搏治疗的儿童，总结病例特点及数据。根据植入引导方法将患者分为床旁超声引导组（超声组）和透视引导组（透视组）。比较儿童的疗效、安全性及并发症发生率，并进行随访分析。共纳入30例儿童，其中男18例，女12例，中位年龄5.5（2.9，10.0）岁，中位体重18.7（12.7，32.7）kg。最常见的原发病为暴发性心肌炎（13/30例）和先天性高度房室传导阻滞（10/30例）。其中，透视组先天性高度房室传导阻滞的比例显著高于超声组，差异有统计学意义（p = 0.007）。30例儿童植入过程均成功。从起搏决定至植入，超声组中位时间为56（30，60）分钟，透视组为154（78，180）分钟，差异有统计学意义（P < 0.001）。共5例发生并发症。两组间差异无统计学意义（P > 0.05）。与传统透视下临时起搏相比，床旁超声引导下临时起搏技术可有效缩短手术时间，减少并发症发生，已成为儿童急诊及危重症治疗的更佳选择。静脉植入首选右侧颈内静脉。
