Key result
Bedside ultrasound guidance achieves 100% temporary pacing success vs. ECG guidance with zero complications.
Why the study?
The safety and effectiveness of bedside ultrasound-guided temporary pacemaker implantation for rescuing patients during cardiac emergencies needed investigation.
Does bedside ultrasound-guided temporary pacemaker implantation improve success rates and reduce adverse events compared to electrocardiogram-guided implantation in patients with cardiac emergencies?
RCT (n=194)
Randomly assigned
No
Does bedside ultrasound-guided temporary pacemaker implantation improve success rates and reduce adverse events compared to electrocardiogram-guided implantation in patients with cardiac emergencies?
Absolute Event Rate: 100% vs 87.8%
p-value: p=<0.001
Ultrasound-guided temporary pacemaker implantation is a safe and highly effective bedside technique for cardiac emergencies, eliminating radiation exposure and reducing procedural complications compared to traditional ECG-guided methods.
Supports ultrasound guidance as first-line for emergency temporary pacing; confirms RCT superiority in success and safety over ECG methods.
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.
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Xu et al. (2023) conducted an RCT in Cardiac emergencies requiring temporary pacemakers (n=194). Bedside ultrasound-guided temporary pacemaker implantation vs. Electrocardiogram-guided temporary pacemaker implantation was evaluated on Success rate of central venipuncture (p=<0.001). Bedside ultrasound-guided temporary pacemaker implantation achieved a 100% success rate for venipuncture and electrode placement with no adverse events, significantly outperforming the electrocardiogram-guided approach.
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