临时经静脉起搏在重症监护病房或导管实验室进行。

IF 1.7 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Pace-Pacing and Clinical Electrophysiology Pub Date : 2025-02-01 Epub Date: 2025-01-10 DOI:10.1111/pace.15140
Julie Bastide, Francis Bessière, Antoine Delinière, Thomas Bochaton, Kévin Gardey, Arnaud Dulac, Christelle Haddad, Cyril Prieur, Danka Tomasevic, Gilles Rioufol, Eric Bonnefoy-Cudraz, Geoffroy Ditac
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引用次数: 0

摘要

背景:临时经静脉起搏(TTP)是一种常见的手术,主要在导管室(cath lab)进行,因为假定并发症发生率较低。本研究旨在评价在ICU放置TTP与在导管室放置TTP的疗效和安全性。方法:这项回顾性的现实研究纳入了2019年至2022年在三级护理ICU接受TTP治疗的所有患者。比较两组患者的特征、ttp相关数据、结局和并发症(ICU与cath lab)。结果:分析了193例接受TTP治疗的患者的数据;68.4%在ICU接受TTP治疗,31.6%在导管室接受TTP治疗。154例(79.8%)患者的主要适应症为房室传导阻滞。与cath实验室(100%)相比,操作人员在ICU(12.1%)中较少担任介入心脏病专家。结论:在日常临床场景中,无论操作人员的专业水平如何,在按照最佳实践进行操作时,在ICU中放置TTP似乎比在cath实验室中更安全。然而,TTP并发症仍然很高,应尽可能使用替代方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Temporary Transvenous Pacing Performed in the Intensive Care Unit or in the Catheterization Laboratory.

Background: Temporary transvenous pacing (TTP) is a common procedure, predominantly performed in the catheterization laboratory (cath lab) because of presumed lower complication rate. This study aims to evaluate the efficacy and safety of TTP placement in the ICU compared to TTP placement in the cath lab.

Methods: This retrospective, real-life study included all patients requiring TTP in a tertiary care ICU between 2019 and 2022. Patients' characteristics, TTP-related data, outcomes, and complications were compared between groups (ICU vs. cath lab).

Results: Data from 193 patients receiving TTP were analyzed; 68.4% received TTP in the ICU and 31.6% in the cath lab. The main indication was atrioventricular block in 154 patients (79.8%). The operator was less frequently an interventional cardiologist in the ICU (12.1%) compared to the cath lab (100%, p < 0.001). TTP in the ICU was more frequently performed using a jugular access (72.0% vs. 1.6%), a right-sided laterality (88.7% vs. 43.6%), and a balloon-tipped catheter (100% vs. 0%, p < 0.001 for all comparisons). Success was 100% in both groups. The overall complication rate was 16.6%, with no significant difference between both groups (14.4% ICU vs. 21.3% cath lab, p = 0.13), but a tendency toward higher complications in the cath lab group (especially tamponade, lead displacement, and CIED infection).

Conclusion: In a daily clinical scenario, TTP placement appears as safe in the ICU than in the cath lab, regardless of the operator's level of expertise when performed in accordance with best practices. Nevertheless, TTP complications remain high, and alternatives should be used whenever possible.

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来源期刊
Pace-Pacing and Clinical Electrophysiology
Pace-Pacing and Clinical Electrophysiology 医学-工程:生物医学
CiteScore
2.70
自引率
5.60%
发文量
209
审稿时长
2-4 weeks
期刊介绍: Pacing and Clinical Electrophysiology (PACE) is the foremost peer-reviewed journal in the field of pacing and implantable cardioversion defibrillation, publishing over 50% of all English language articles in its field, featuring original, review, and didactic papers, and case reports related to daily practice. Articles also include editorials, book reviews, Musings on humane topics relevant to medical practice, electrophysiology (EP) rounds, device rounds, and information concerning the quality of devices used in the practice of the specialty.
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