Temporary transvenous cardiac pacing: 6 years experience in one coronary care unit.
نویسندگان
چکیده
The role of temporary percutaneous endocardial pacing has been examined in a retrospective analysis of all paced patients admitted to one coronary care unit over a 6 year period. The majority of 162 cases (84.6%) were paced for complete heart block complicating acute myocardial infarction. These patients had a higher incidence of previous hypertension, myocardial infarction and diabetes, compared to matched controls (P less than 0.05, less than 0.02 and less than 0.001, respectively). Admission blood glucose levels were also higher (P less than 0.05). The in-hospital mortality was high (46.7%), especially for those with anterior myocardial infarction (74.5%). Twenty-five (15.4%) patients without recent myocardial infarction were paced for symptomatic brady-dysrhythmias, usually due to chronic complete heart block (Lenegre's disease) or sick sinus syndrome. Most later required permanent pacing. Complications of temporary pacing were more frequent in those who died, the most common being dysrhythmias during pacemaker insertion. Review of our cases suggests that whilst facilities for temporary pacing were extremely valuable, many cases treated were not haemodynamically compromised and probably did not require pacing. Guidelines should be established on coronary care units to prevent the unnecessary morbidity, mortality and expense of the procedure.
منابع مشابه
Pacemaker induced ventricular fibrillation in coronary care units.
Temporary transvenous pacing is an established treatment for many bradyarrhythmias associated with haemodynamic compromise in patients who have had acute myocardial infarction. Procedural complications associated with insertion of temporary pacing electrodes are well recognised and documented, as is subsequent loss of capture due to rising stimulation threshold or electrode displacement. Tempor...
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1. Lang R, David D, Klein HO, et al. The use of the balloon-tipped floating catheter in temporary transvenous cardiac pacing. Pacing Clin Electrophysiol 1981;4:491–6. 2. Trigano JA, Birkui PJ, Mugica J. Noninvasive transcutaneous cardiac pacing: modern instrumentation and new perspectives. Pacing Clin Electrophysiol 1992;15:1937–43. 3. Asano M, Mishima A, Ishii T, Takeuchi Y, Suzuki Y, Manabe T...
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ورودعنوان ژورنال:
- Postgraduate medical journal
دوره 65 762 شماره
صفحات -
تاریخ انتشار 1989