To Explore The Value Of Temporary Cardiac Pacemaker During Operations

ObjectiveIn non cardiac surgical patients, some patients with coronary heart disease (CHD), sinus bradycardia, atrioventricular block, often need temporary pacemaker to avoid intraoperative risks. But in some patients, temporary pacemaker in the peri-operation period did not play a pacemaker function in the peri-operation period, resulting in the waste of medical resources. In this article,we will retrospectively analyze some clinical data of the patients who received temporary pacemaker therapy before non cardiac sugery,to evaluate the usage of temporary pacemaker during operation and after operation,to discuss the indications of installing temporary pacemaker.MethodsSelecting274patients who received temporary pacemaker before non-cardiac surgery,and then dividing them into two groups:one is pacemaker group including90cases,another one is standby pacemaker group including184cases.Using SPSS18.0software to analyze them statistically,to compare that whether the leve of the index in the group differences has statistical significance(P<0.05for the difference was statistically significant).ResultsThe pacemakers’ working condition under different arrhythmia is ifferent. The pacemakers of patients with sinus bradycardia, Ⅲ degrees AVB, bilateral bundle-branch block,atrial fibrillation with long intrvals and tachycardia-bradycardia syndrome works often(P<0.05);The pacemakers of patients with II degree AVB,left posterior hemiblock,complete left bundle branch block works little(P>0.05)。Gender has no influence on the working condition of pacemaker(P>0.05).The pacemakers’ working condition of patients combined with different diseases is different.The pacemakers of patients combined with dilated cardiomyopathy and valvular heart disease works significantly more(P<0.05);The pacemakers of patients combined with coronary heart disease and hypertensive heart disease works significantly less(P >0.05).Anaesthetic technique has no influence on the working condition of pacemaker(P>0.05);The pacemakers of patients receive small and medium-sized surgery works less,but which receive big-sized surgery works more.(P<0.05)Conclusion1.For patients with sinus bradycardia, Ⅲ degrees AVB, bilateral bundle-branch block,atrial fibrillation with long intrvals and tachycardia-bradycardia syndrome, preoperative temporary pacemaker implantation has a protective effect.2.For patients combined with dilated cardiomyopathy and valvular heart disease temporary pacemaker implantation can effectively prevent the happening of the malignant arrhythmia events; For patients with coronary heart disease and hypertensive heart disease,preoperative temporary pacemaker implantation makes little protective sense.3.Although the proportion of temporary pacemaker working state under general anesthesia is higher than that under local anesthesia and lumbar anesthesia, but the type of anesthesia has little influence on the work condition of temporary pacemakers.4. The pacemakers of patients receive small and medium-sized surgery works less,but which receive big-sized surgery works more.Elderly patients undergoing non cardiac operation, if the situation, no matter how the size of pperation, anesthesia, best first temporary pacemaker implantation (1):severe sinus Beckoning bradycardia and atrioventriculardelay;(2) atrial fibrillation with long interval (>2s);(3) speed syndrome. When the patients have the following situation and combined with dilated cardiomyopathy, myocarditis, in large operation, during anesthesia may betemporary pacemaker implantation in order to ensure the safety of operation:Ⅱdegree atrioventricular block, double bundle branch block, completely left posterior hemiblock.