title: Percutaneous lead implantation connected to an external device in stimulation-dependent patients with systemic infection--a prospective and controlled study.
abstract: BACKGROUND
  Permanent pacemaker implantation usually is contraindicated in patients with systemic infection. The aim of the present study was to compare two different techniques of transvenous temporary pacing to bridge the infectious situation until permanent pacemaker implantation under infection-free conditions is possible.
  
  
  RESULTS
  Forty-nine patients with systemic infection and hemodynamic-relevant bradyarrhythmia/asystole were temporarily paced using either a conventional pacing wire/catheter (n = 26, reference group) or a permanent bipolar active pacing lead, which was placed transcutaneously in the right ventricle and connected to an external pacing generator (n = 23, external lead group). In both groups, there were no significant differences in patient characteristics. Whereas the sensing values were almost identical, the median pacing threshold was significantly higher in the reference group (1.0 V vs 0.6 V, P < 0.05). Within comparable duration of pacing (median: 8.2 vs 7.7 days), there were 24 pacing-related adverse events (including dislocation, resuscitation due to severe bradycardia, or local infection) in the reference group as compared to one event in the external lead group (P < 0.01). None of these complications resulted in cardiac death.
  
  
  CONCLUSIONS
  Thus, transvenous pacing with active fixation is safe and associated with a significantly lower rate of pacing-related adverse events as compared to the standard technique of transvenous pacing using a passive external pacing catheter.
authors.affiliation: Medical Clinic II, Department of Internal Medicine and Cardiology, University of Technology Dresden, Dresden, Germany.
authors.forename: Martin U
authors.initials: MU
authors.lastname: Braun
authors.forename: Thomas
authors.initials: T
authors.lastname: Rauwolf
authors.forename: Mania
authors.initials: M
authors.lastname: Bock
authors.forename: Utz
authors.initials: U
authors.lastname: Kappert
authors.forename: Alessandra
authors.initials: A
authors.lastname: Boscheri
authors.forename: Andreas
authors.initials: A
authors.lastname: Schnabel
authors.forename: Ruth H
authors.initials: RH
authors.lastname: Strasser
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications* / Q000517:prevention & control*; D001424:Bacterial Infections / Q000150:complications* / Q000517:prevention & control*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D011446:Prospective Studies; D016896:Treatment Outcome