title: Reassessment of the natural evolution and complications of temporary epicardial wires after cardiac surgery.
abstract: OBJECTIVE
  The aim of this study was to prospectively reassess the natural evolution and complications of temporary epicardial wires (TEW) after cardiac surgery.
  
  
  METHODS
  Observational prospective study.
  
  
  METHODS
  Monocentric.
  
  
  METHODS
  All adult patients having cardiac surgery with TEW insertion, except for those undergoing cardiac transplantation or having permanent pacemakers.
  
  
  METHODS
  Thresholds were measured daily until wire removal or permanent device insertion. Descriptive statistics and analysis of variance (ANOVA) were performed with p<0.05 as the significance threshold.
  
  
  RESULTS
  Two hundred thirty-six patients were enrolled. All had ventricular and only 142 (60%) both ventricular and atrial unipolar FEP15, Ethicon TEW. In most TEW (74%), capture thresholds increased significantly by the first (atrial wires) and by the second (ventricular wires) postoperative day and continued to increase until the fifth day, followed by a plateau. For the others, 2 opposite profiles were noticed: 10% of the total TEW lost their capture function before the fourth postoperative day, whereas 16% remained functional beyond the seventh postoperative day. Both atrial and ventricular sensitivity degraded significantly by the second day. The median energy output used for pacing was 17.5 mA (atrial) and 20 mA (ventricular), regardless of the capture thresholds. Major complications related to TEW were noted in 0.8% of cases.
  
  
  CONCLUSIONS
  Despite widespread use, the natural history of TEW is still a major concern. Pacing with high-energy output is a possible factor leading to capture dysfunction that must be avoided. Education of all operators is needed.
authors.affiliation: Department of Anesthesia and Intensive Care, General Hospital of Metz, Metz, France. Electronic address: chrisetcris@gmail.com.
authors.forename: Cristina
authors.initials: C
authors.lastname: Lazarescu
authors.affiliation: Department of Anesthesia and Intensive Care, Nancy University Hospital, Nancy, France.
authors.forename: Samia
authors.initials: S
authors.lastname: Kara-Mostefa
authors.affiliation: Department of Anesthesia and Intensive Care, Nancy University Hospital, Nancy, France.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Parlanti
authors.affiliation: Department of Anesthesia and Intensive Care, Nancy University Hospital, Nancy, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Clavey
authors.affiliation: Department of Anesthesia and Intensive Care, Strasbourg University Hospital, Strasbourg, France.
authors.forename: Paul-Michel
authors.initials: PM
authors.lastname: Mertes
authors.affiliation: Department of Anesthesia and Intensive Care, Hospital of Bichat-Claude Bernard, Public Assistance-Hospitals of Paris, Paris, France.
authors.forename: Dan
authors.initials: D
authors.lastname: Longrois
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects / Q000379:methods; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods*; D001026:Coronary Artery Bypass; D020878:Device Removal; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D010496:Pericardium / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011446:Prospective Studies; D055815:Young Adult
keywords: cardiac surgery; complications; temporary epicardial wires; temporary pacing; thresholds