title: [Efficacy and safety of non-permanent transvenous pacemaker implantation in an intensive care unit].
abstract: OBJECTIVE
  To analyze the clinical indications for use, morbidity and mortality associated with a non-permanent transvenous pacemaker.
  
  
  METHODS
  Prospective and observational study.
  
  
  METHODS
  Cardiac intensive care unit.
  
  
  METHODS
  One hundred and eighty-two patients with non-permanent pacemakers implanted consecutively over a period of four years.
  
  
  METHODS
  Main variables of interest were demographic data, clinical indications, access route, length of stay and complications.
  
  
  RESULTS
  A total of 63% were men, with a median age of 78 ± 9.5 years and with symptomatic third-degree atrioventricular block in 76.9% of the cases. Femoral vein access was preferred in 92.3% of the cases. Complications appeared in 40.11% of the patients, the most frequent being hematoma at the site of vascular access (13.19%). Restlessness was associated to the need for repositioning the pacemaker due to a shift in the electrode (p=0.059) and to hematoma (p=0.07). Subclavian or jugular vein lead insertion (p=0.012; OR=0.16; 95%CI, 0.04-0.66), restlessness during admission to ICU (p=0.006; OR=3.2; 95%CI, 1.4-7.3), and the presence of cardiovascular risk factors (p=0.042; OR=5; 95%CI, 1.06-14.2) were identified by multivariate analysis as being predictors of complications. Length of stay in ICU was significantly longer when lead insertion was carried out by specialized staff (p=0.0001), and in the presence of complications (p=0.05).
  
  
  CONCLUSIONS
  Predictfurors of complications were restlessness, cardiovascular risk factors, and insertion through the jugular or subclavian vein. Complications prolonged ICU stay and were not related to the professionals involved.
authors.affiliation: Servicio de Cuidados Críticos y Urgencias, Hospital Regional Universitario Carlos Haya, Málaga, España. javibono@hotmail.com
authors.forename: J
authors.initials: J
authors.lastname: Muñoz Bono
authors.forename: M A
authors.initials: MA
authors.lastname: Prieto Palomino
authors.forename: I
authors.initials: I
authors.lastname: Macías Guarasa
authors.forename: B
authors.initials: B
authors.lastname: Hernández Sierra
authors.forename: G
authors.initials: G
authors.lastname: Jiménez Pérez
authors.forename: E
authors.initials: E
authors.lastname: Curiel Balsera
authors.forename: G
authors.initials: G
authors.lastname: Quesada García
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D054537:Atrioventricular Block / Q000628:therapy; D002983:Clinical Competence; D015897:Comorbidity; D003422:Critical Care / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D005268:Femoral Vein; D006341:Heart Rupture / Q000453:epidemiology / Q000209:etiology; D006406:Hematoma / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D011446:Prospective Studies; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D011595:Psychomotor Agitation / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors