von Musil Clemens Walter, Riederer Valentina, Pilsbacher Leonhard, Paulus Carina Maria, Rudinger Severin, Bodlee Sophia, Gmeiner Jonas, Fischer Julius, Steffen Julius, Peterß Sven, Kääb Stefan, Sinner Moritz, Lackermair Korbinian, Orban Martin, Massberg Steffen, Scherer Clemens
Department of Medicine I, LMU University Hospital, Ludwig-Maximilians-University (LMU) Munich, Marchioninistraße 15, 81377, Munich, Germany.
DZHK (German Centre for Cardiovascular Research), Munich Heart Alliance, Munich, Germany.
Sci Rep. 2025 Jul 19;15(1):26241. doi: 10.1038/s41598-025-10364-9.
Temporary transvenous cardiac pacing (TTP) is commonly used to manage hemodynamically compromising, drug-refractory brady- and tachyarrhythmias in the intensive care setting. Despite previous studies analyzing TTP treatment, data on its use in patients with cardiogenic shock (CS) remain limited. This retrospective exploratory analysis aimed to investigate the utilization of TTP in patients experiencing CS, with a particular focus on treatment characteristics, complication rates, predictive factors, and outcomes across different subgroups. We retrospectively included registry data from 184 patients who underwent TTP therapy from 1561 cases of CS treated at the Intensive Care Units (ICUs) of two university hospitals in Germany between 2010 and 2023. Bradycardia due to acute myocardial infarction was the primary indication for TTP implantation in patients with CS. The median duration of TTP therapy was 65 h, during which complications occurred in 12.0% of cases, 3.3% were classified as severe. We found that culprit lesions in the Right Coronary Artery (RCA) were more likely to necessitate TTP treatment in patients with acute myocardial infarction complicated by cardiogenic shock (AMI-CS) (OR 2.52, 95% CI 1.54-4.11, p < 0.001). In non-AMI-CS patients, age (OR 1.03, 95% CI 1.01-1.05, p < 0.005) and myocarditis (OR 3.21, 95% CI 1.19-8.64, p = 0.02) were associated with a higher incidence of TTP therapy during ICU treatment. Further studies are needed to validate these observations.Trial registration: LMUshock registry (WHO International Clinical Trials Registry Platform Number DRKS00015860).
临时经静脉心脏起搏（TTP）常用于重症监护环境中处理血流动力学不稳定、药物难治性的缓慢性和快速性心律失常。尽管此前有研究分析TTP治疗情况，但关于其在心源性休克（CS）患者中的应用数据仍然有限。这项回顾性探索性分析旨在研究CS患者中TTP的使用情况，特别关注不同亚组的治疗特征、并发症发生率、预测因素和结局。我们回顾性纳入了2010年至2023年间在德国两家大学医院重症监护病房（ICU）接受治疗的1561例CS患者中184例接受TTP治疗患者的登记数据。急性心肌梗死所致心动过缓是CS患者植入TTP的主要指征。TTP治疗的中位持续时间为65小时，在此期间12.0%的病例发生并发症，3.3%为严重并发症。我们发现，右冠状动脉（RCA）罪犯病变在急性心肌梗死合并心源性休克（AMI-CS）患者中更有可能需要TTP治疗（OR 2.52，95%CI 1.54-4.11，p<0.001）。在非AMI-CS患者中，年龄（OR 1.03，95%CI 1.01-1.05，p<0.005）和心肌炎（OR 3.21，95%CI 1.19-8.64，p=0.02）与ICU治疗期间TTP治疗的较高发生率相关。需要进一步研究来验证这些观察结果。试验注册：LMUshock注册库（世界卫生组织国际临床试验注册平台编号DRKS00015860）。
