Ultrasound‐guided pacemaker implantation at the bedside: A lifesaving technique for cardiac emergencies

• Published in: Annals of noninvasive electrocardiology 2023-09, Vol.28 (5), p.e13071-n/a
• Main Authors: Xu, Rong‐Quan, Huang, Xiao‐Feng, Guo, Ping‐Qing, Cai, Hong‐Bin, Feng, Shao‐Dan, Lin, Zhi‐Hong
• Format: Article
• Language: English
• Subjects: Adverse events; Cardiac arrhythmia; cardiac emergencies; Catheters; Contraindications; echocardiogram; EKG; Electrocardiography; Electrodes; Emergencies; Emergency medical care; Heart; Heart rate; Hematoma; Intubation; Local anesthesia; Medical instruments; Original; Pacemakers; Phlebotomy; Pneumothorax; Radiation; rescue; Statistical analysis; Success; Surgery; temporary pacemaker; Thrombosis; Ultrasonic imaging; Ultrasound; ultrasound guidance; Veins & arteries
• ISSN: 1082-720X; 1542-474X
• DOI: 10.1111/anec.13071

Objective To investigate the safety and effectiveness of implanting temporary pacemakers using ultrasound‐guidance at the bedside for rescuing patients in case of cardiac emergencies. Methods We enrolled 194 patients with cardiac emergencies requiring temporary pacemakers in this study, and randomly assigned them to either a bedside ultrasound‐guided installation group or an electrocardiogram‐guided installation group. There were 105 cases in the bedside ultrasound‐guided installation group, aged approximately 66.3 ± 10.2 years, and 89 cases in the electrocardiogram‐guided installation group, aged approximately 65.8 ± 9.5 years old, and disease composition was similar between the two groups. We then compared the duration of the procedure, success rates, and occurrence of adverse events between the two groups. Results The two groups showed similar clinical characteristics. The success rates of venipuncture and temporary pacemaker electrode placement were both 100% in the bedside ultrasound‐guided installation group, compared to 87.8% and 96.7% respectively, in the electrocardiogram‐guided installation group, with a statistically significant difference between the two groups. The duration of puncture was significantly shorter in the bedside ultrasound‐guided installation group than in the electrocardiogram‐guided installation group, with statistically significant differences. Moreover, no adverse events such as hematoma, pneumothorax and electrode dislodgement occurred in the bedside ultrasound‐guided installation group, while 13 cases in the electrocardiogram‐guided installation group experienced adverse events, and the difference was statistically significant. Conclusions The bedside installation of temporary pacemakers using ultrasound guidance is a simple, safe, effective, and cost‐efficient procedure that boasts a high success rate, does not involve radiation, and enables accurate placement of the electrode catheter. Comparative analysis of the installation time, success rate, and complications of 105 temporary pacemakers guided by ultrasound and 89 temporary pacemakers guided by electrocardiogram.