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Effect of Bedside Ultrasound-Guided Versus Fluoroscopy-Guided Transvenous Cardiac Temporary Pacing in Children with
Yefeng Wang1, Chao Zuo1, Xiang Wang1
1Department of Cardiology, Hunan Children's Hospital, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University, No. 86 Ziyuan Road, Changsha, 410007, Hunan, People's Republic of China.
Insights
Bedside ultrasound guidance for temporary cardiac pacing in children significantly reduces procedure time compared to fluoroscopy. This safer, faster method is ideal for pediatric emergency care, showing comparable complication rates.
Area of Science:
- Pediatric Cardiology
- Medical Imaging
- Critical Care Medicine
Background:
- Bradyarrhythmia in children necessitates temporary cardiac pacing.
- Traditional fluoroscopy-guided pacing carries risks and can be time-consuming.
- Evaluating novel, safer guidance techniques is crucial for pediatric critical care.
Purpose of the Study:
- To compare the efficacy and safety of bedside ultrasound-guided versus fluoroscopy-guided transvenous cardiac temporary pacing in children.
- To assess procedure time and complication rates between the two guidance methods.
Main Methods:
- Retrospective analysis of 30 children undergoing temporary transvenous cardiac pacing.
- Patients divided into bedside ultrasound-guided (ultrasound group) and fluoroscopy-guided (fluoroscopy group) cohorts.
- Comparison of implantation success, procedure duration, and complication incidence.
Main Results:
- All 30 implantations were successful.
- Ultrasound group procedure time (median 56 min) was significantly shorter than fluoroscopy group (median 154 min) (P < 0.001).
- Complication rates were similar between groups (P > 0.05), with 5 total cases.
Conclusions:
- Bedside ultrasound-guided temporary pacing is effective and safe for pediatric bradyarrhythmia.
- Ultrasound guidance offers a significant reduction in procedure time compared to fluoroscopy.
- This technique presents a superior option for emergency and critical care in children.
Abstract:
To compare the efficacy and safety of bedside ultrasound-guided and fluoroscopy-guided transvenous cardiac temporary pacing in the treatment of bradyarrhythmia in children. Children treated by temporary intravenous cardiac pacing from January 2016 to June 2023 in Hunan Provincial Children's Hospital were enrolled, and the characteristics and data of the cases were summarized. Patients were divided into bedside ultrasound-guided group (ultrasound group) and fluoroscopy-guided group (fluoroscopy group) according to the implantation guidance methods. The efficacy, safety, and incidence of complications in children were compared, and follow-up analysis was carried out. A total of 30 children were enrolled, including 18 males and 12 females, with a median age of 5.5 (2.9, 10.0) years and a median weight of 18.7 (12.7, 32.7) kg. The most common primary diseases were fulminant myocarditis (13/30 cases) and congenital high-grade AVB (10/30 cases). Among them, the proportion of congenital high AVB in the fluoroscopy group was significantly higher than that in the ultrasound group, and the difference was statistically significant (p = 0.007). The implantation process was successful in all 30 children. From the time of pacing decision to implantation, the median time of ultrasound group was 56 (30, 60) min and that of fluoroscopy group was 154 (78,180) min, with a statistically significant difference (P < 0.001). A total of 5 cases developed complications. There was no statistically significant difference between the two groups (P > 0.05). Compared with traditional fluoroscopic temporary pacing, bedside ultrasound-guided temporary pacing technology can effectively shorten the operation time and reduce the occurrence of complications and has become a better choice for children's emergency and critical care treatment. The right internal jugular vein is preferred for intravenous implantation.
