本文拟对胸外无创性心脏起搏(External Noninvasive Cardiac Pacing,ENCP)技术的发展概况、技术改进和临床应用等有关问题作一扼要讨论。一、发展概况继发于诸多原因的心脏无收缩或缓慢心律失常所致心脏停搏,常规药物治疗殊难奏效。较为特异的措施是尽快行心脏紧急起搏。心脏停搏3～5分钟以上,中枢神经系统因缺氧过久可造成不可逆的损害。这类患者CPR的成败和预后的关键在于是否迅速恢复心脏搏动。目前所用的各种紧急起搏法,均有较大缺陷,实难达到临床应急的要求。经静脉心内膜电极法(TVECP)效果较可靠,目前应用较多,但此法需特殊的设备和相当的技术,费时费事,常常不能应急,基层及野外环境也无力应用,再则,某些病例对TVECP尚属禁忌,如三尖瓣置换术后、急性心内膜炎以及严重的凝血障碍等。另外不容忽视的是TVECP的心内膜电极尚有触发室速和室颤的潜在危险,尤其是新近发生急 This article aims to give a brief discussion on the development, technical improvement and clinical application of external noninvasive cardiac Pacing (PTC). First, the development of the situation Secondary to many causes of cardiac contractions or slow arrhythmia caused by cardiac arrest, conventional drug treatment is difficult to work. A more specific measure is to perform cardiac emergency pacing as soon as possible. Cardiac arrest more than 3 to 5 minutes, the central nervous system due to lack of oxygen can cause irreversible damage. The key to the success or failure of a patient’s CPR is whether or not to quickly revive the heart. Currently used in all kinds of emergency pacing, have greater shortcomings, it is difficult to meet the requirements of clinical emergency. The intravenous endocardial electrode method (TVECP) more reliable, currently used more, but this method requires special equipment and considerable technology, time-consuming and often can not be emergency, the grass-roots and the field environment is also unable to apply, and then, a Some cases of TVECP is still taboo, such as tricuspid valve replacement, acute endocarditis and severe coagulopathy. In addition can not be ignored is that TVECP endocardial electrodes have the potential risk of triggering ventricular tachycardia and ventricular fibrillation, especially the recent emergency