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

Rong-Quan Xu; Xiao-Feng Huang; Ping-Qing Guo; Hong-Bin Cai; Shao-Dan Feng; Zhi-Hong Lin

doi:10.1111/anec.13071

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

Ann Noninvasive Electrocardiol. 2023 Sep;28(5):e13071. doi: 10.1111/anec.13071. Epub 2023 Jul 19.

Authors

Rong-Quan Xu^{1

2}, Xiao-Feng Huang^{3

4}, Ping-Qing Guo^{3

4}, Hong-Bin Cai^{5

6}, Shao-Dan Feng^{3

4}, Zhi-Hong Lin^{3

4}

Affiliations

¹ Department of Ultrasound Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
² Department of Ultrasound Medicine, National RegionalMedical Center, Binhai Campus of the First Affiliated Hospital Fujian Medical University, Fuzhou, China.
³ Department of Emergency, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
⁴ Department of Emergency, National RegionalMedical Center, Binhai Campus of the First Affiliated Hospital Fujian Medical University, Fuzhou, China.
⁵ Department of Cardiovascular Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
⁶ Department of Cardiovascular Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital Fujian Medical University, Fuzhou, China.

Abstract

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.

Keywords: cardiac emergencies; echocardiogram; rescue; temporary pacemaker; ultrasound guidance.

Publication types

Randomized Controlled Trial

MeSH terms

Aged
Electrocardiography
Emergencies*
Heart
Humans
Middle Aged
Pacemaker, Artificial*
Ultrasonography, Interventional / methods

Abstract

Publication types

MeSH terms

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