Objective To explore the clinical necessity, validity and safety of temporary cardiac pacemaker implantation for asymptomatic sinus node dysfunction patients receiving non - cardiac surgery. Methods Temporary cardiac pacemaker were implanted before surgery in 156 asymptomatic sinus node dysfunction patients positive to atropine test. Before implantation, transesophageal electrophysiologic examination was performed. The patients were divided into groups positive ( n = 32 ) and negative ( n = 124 ). Perioperative pacemaker work and related complications were observed. Results Pacemakers were successfully implanted in all patients ( 100.0% ), without bleeding, hematoma, cardiac perforation, cardiac tamponade, deep vein thrombosis, infective endocarditis or other complications. Fifteen patients had loose electrode placement ( 9. 6% ). Twenty -five patients had full or part pace - making in positive group during and after operations, and 10 in negative group, the difference was significant ( x2=71.75, P < 0. 05 ). Conclusion Implanting temporary cardiac pacemaker for asymptomatic sinus node dysfunction patients with non - cardiac surgery is necessary, valid and safe. Transesophageal electrophysiologic examination is more significant than atropine test to screening asymptomatic sinus mode dysfunction patients with non - caridac surgery before operation.%目的 探讨无症状性窦房结功能障碍患者非心脏手术前床旁临时起搏器植入的必要性、有效性及安全性.方法 选择2009-2011年我院手术科室要求会诊的无症状性窦性心动过缓患者,对所有阿托品试验阳性的156例患者于非心脏外科手术前床旁植入临时起搏器,植入起搏器前均行经食管电生理检查,经食管电生理检查诊断窦房结功能障碍,分为食管电生理检查阳性组和阴性组,观察围术期患者起搏器工作情况及临时起搏器相关的并发症情况.结果 156例患者均于术前床旁顺利植入临时起搏器,即刻起搏成功率100.0%,未发生出血、血肿、心肌穿孔、心包填塞、下肢静脉血栓、感染性心内膜炎等并发症;15例患者发生电极脱位,脱位率(9.6%).食管电生理检查阳性组共32例,术中、术后起搏器完全及部分起搏25例;食管电生理检查阴性组共124例,术中、术后完全及部分起搏10例;两组完全及部分起搏率间差异有统计学意义(χ2=71.75,P＜0.05).结论 无症状性窦房结功能障碍患者非心脏手术前床旁临时起搏器的植入必要且有效、安全.对于非心脏手术前植入临时起搏器的无症状性窦房结功能障碍患者的筛选,食管电生理检查较阿托品试验更有意义.
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