title: Bridge to recovery or permanent system implantation: an eight-year single-center experience in transvenous semipermanent pacing.
abstract: BACKGROUND
  To compare the risks, implications, and outcomes of transvenous semipermanent pacing as a bridge to permanent system implantation or recovery.
  
  
  METHODS
  We investigated semipermanent transvenous pacing systems consisting of one (n = 57%) or two (n = 3%) bipolar active-fixation pacing leads and an attached epicutaneous pulse generator implanted from 2000 to 2009. The study population comprised 60 patients aged 72.9 ± 10.5 years (44 [73.3%] male). Forty-two (70%) were enrolled for complete system explantation for cardiac-implanted electronic devices associated infection. Eighteen (30%) required temporary pacing in the context of a variety of mostly severe cardiac and noncardiac conditions. The semipermanent pacing systems were removed after implantation of permanent systems or recovery of a noncompromising heart rhythm, respectively.
  
  
  RESULTS
  Transvenous semipermanent lead implantation was successful in 59 (98.3%) patients. Major and minor intraoperative complications occurred in one case (1.7%) each. The semipermanent systems were left in situ for a mean period of 14.6 ± 8.1 days). They served as a bridge to permanent system implantation in 68.3% (n = 41) and as a bridge to recovery of a noncompromising heart rhythm in 11.7% (n = 7). Four patients (8.3%) died with the semipermanent pacing system in situ, and seven (11.7%) were transferred to external hospitals with semipermanent pacing systems.
  
  
  CONCLUSIONS
  Transvenous semipermanent pacing with bipolar active-fixation leads and epicutaneous pulse generators provide an important option for prolonged temporary pacing as a bridge to permanent system implantation or recovery.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Germany.
authors.forename: Angela
authors.initials: A
authors.lastname: Kornberger
authors.forename: Eckhard
authors.initials: E
authors.lastname: Schmid
authors.forename: Guenay
authors.initials: G
authors.lastname: Kalender
authors.forename: Ulrich Alfred
authors.initials: UA
authors.lastname: Stock
authors.forename: Volker
authors.initials: V
authors.lastname: Doernberger
authors.forename: Mahmud
authors.initials: M
authors.lastname: Khalil
authors.forename: Milan
authors.initials: M
authors.lastname: Lisy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000706:statistics & numerical data*; D015995:Prevalence; D019919:Prosthesis Implantation; D016459:Prosthesis-Related Infections / Q000453:epidemiology*; D020127:Recovery of Function; D012307:Risk Factors; D016896:Treatment Outcome
keywords: implantable cardioverter defibrillator; infection; lead failure; temporary pacing