Utility and safety of prolonged temporary transvenous pacing using an active-fixation lead: comparison with a conventional lead.
Transvenous temporary pacing is associated with a substantial dislocation rate reported to range from 10 to 37%. The aim of the study was to assess the safety and utility of a recently introduced 3.5 Fr temporary pacing lead using active fixation in a consecutive series of 36 patients with prolonged (> or = 48 hours) transvenous temporary pacing (validation group). A group of 36 patients with prolonged transvenous pacing managed with a passive-fixation lead just prior to the introduction of the active-fixation lead served as a control group (reference group). Pacing related adverse events included dislocation, inappropriate pacing (i.e., two-fold or greater increase of initial pacing threshold), local infection, and thrombosis. There were no significant differences in patient characteristics or duration of pacing (5.84 +/- 2.4 days in the reference group vs 5.94 +/- 2.6 days in the validation group). Acute pacing threshold was significantly higher in the validation group as compared to the reference group (1.38 +/- 0.67 V vs. 0.7 +/- 0.21 V, P < 0.01). The dislocation rate was significantly lower in the validation group as compared to the reference group (5.5 vs 33.3%, P < 0.001). There were 11 (31%) pacing related adverse events in the validation group versus 21 (58%) in the reference group (P < 0.01). The vast majority of patients in the validation group (75%) had ambulatory temporary pacing. Thus, transvenous temporary pacing using active fixation is safe and is associated with a low dislocation rate and a reduction in pacing related adverse events.
de Cock
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CC
Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands. cc.dcock@vumc.nl
Van Campen
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CM
In't Veld
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JA
Visser
C A
CA
D000368:Aged; D001919:Bradycardia / Q000628:therapy; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects / Q000379:methods*; D004868:Equipment Failure; D005260:Female; D005268:Femoral Vein; D006323:Heart Arrest / Q000628:therapy; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial / Q000009:adverse effects; D018709:Statistics, Nonparametric