Haffajee C I
Cardiol Clin. 1985 Nov;3(4):515-26.
Artificial cardiac pacing has become a sophisticated therapeutic and diagnostic tool in the management of arrhythmic cardiac emergencies. Major innovations have occurred in the last three decades since the advent of temporary pacing, and today, pacing can be effected "physiologically" in both chambers. This has been the result of improved venous access techniques, technologic improvements in electrode design, and the development of sophisticated external pulse generators. It has become clear that ventricular pacing alone does not improve the hemodynamic derangement consequent upon ventricular bradycardia and AV dyssynchrony. The restoration of AV synchrony either by atrial pacing preceding ventricular events or by ventricular pacing at a defined AV delay following a sensed atrial event (P wave) can often reverse the hemodynamic derangement and result in both extension of life and more rapid reversal of the clinical compromise in certain cases of acute heart block. Temporary pacing has always been used for bradyarrhythmias, but more recently, antitachycardia pacing is being utilized increasingly in the acute care setting.
在心律失常性心脏急症的处理中，人工心脏起搏已成为一种复杂的治疗和诊断工具。自临时起搏问世后的过去三十年里出现了重大创新，如今，可在双腔实现“生理性”起搏。这得益于静脉通路技术的改进、电极设计的技术进步以及先进的体外脉冲发生器的发展。已明确仅心室起搏并不能改善心室心动过缓和房室不同步导致的血流动力学紊乱。通过在心室事件之前进行心房起搏，或在感知到心房事件（P波）后以设定的房室延迟进行心室起搏来恢复房室同步，在某些急性心脏传导阻滞病例中，常常可逆转血流动力学紊乱，延长生命并更快地逆转临床失代偿。临时起搏一直用于缓慢性心律失常，但最近，抗心动过速起搏在急性护理环境中的应用越来越多。
