心内膜心脏起搏应用于心跳骤停后之心脏复苏和治疗某些严重心律失常时,易达到起效迅速和保持血流动力学稳定的目的,在心脏复苏和治疗中是一项非常有效的措施。现将我院近两年来经右颈内静脉穿刺迅速置入心内膜临时起搏导管,实施起搏治疗4例的情况简介如下。1 资料和方法 4例均选用右胸锁乳突肌后下路途径,其穿刺点位于胸锁乳突肌后缘,锁骨上3±1cm处,穿刺针走行于胸锁乳突肌深面,针尖方向对着肋胸关节的纵隔,采用标准的seldinger技术,行右颈内静脉穿刺置管,置入7F硬质心内膜临时起搏导管;置管和定位以心内膜不同部位心电图变化特征为指引,当呈现出rS和S-T明显抬高之右心室心内膜心电特征时,表示导管尖端已与右室心内膜接触,即可行起搏治疗;刺激阈值0.5～1.0mA,脉冲宽度0.5ms,起搏阈值1.0V;如需较长时间置放起搏导 Endocardial cardiac pacing is a very effective cardiopulmonary resuscitation and treatment for cardiorespiratory arrest after cardiac arrest and for the treatment of certain serious arrhythmias, with the goal of rapid onset of action and hemodynamic stability The measure. Now in our hospital nearly two years through the right internal jugular vein puncture rapid placement of endocardial temporary pacing catheter, the implementation of pacing in 4 cases profile is as follows. 1 Materials and Methods 4 cases were selected after the right sternocleidomastoid approach, the puncture point in the posterior margin of the sternocleidomastoid muscle, supraclavicular 3 ± 1cm Department, the needle running in the sternocleidomastoid deep, The direction of the needle tip to the mediastinum of the rib and thoracic joint, the standard seldinger technology, right internal jugular vein catheterization, placement 7F rigid endocardial temporary pacing catheter; catheterization and positioning to different parts of the endocardial ECG changes Characteristics as guidelines, when showing rS and ST significantly elevated right ventricular endocardial ECG characteristics, said the catheter tip has been in contact with the right ventricular endocardium, viable pacing therapy; stimulation threshold 0.5 ~ 1.0mA, pulse Width 0.5ms, pacing threshold 1.0V; for a long time to place pacing lead