title: Outcomes of emergency department placement of transvenous pacemakers.
abstract: OBJECTIVE
  Placement of TVPs is a core EM procedure. Despite this, there is no specific outcome data on this procedure in the ED setting. This study examines the success of Emergency Physician (EP) attempted TVPs as well as their hospital courses and survivals.
  
  
  METHODS
  The charts of patients undergoing TVP placement in the ED of an urban community hospital were prospectively collected by a department billing abstractor and then underwent a structured review. All patients had a TVP placed by a board eligible or board certified EP or by a PGY2 EM resident under the direct supervision of an attending EP. All TVPs were placed utilizing a 5 Fr balloon tipped bi-polar pacer without fluoroscopic visualization.
  
  
  RESULTS
  Over a 36 month period, 43 patients met the study criteria. The mean age was 76.6 (+/- 1.49) years with 27 females (62.7%). Successful pacemaker capture was achieved in 41(95.4%) of TVP attempts. All of the patients were transferred from the ED with vital signs, 41 (95.4%) to a critical care unit and 2 (4.6%) to the electrophysiology laboratory. A total of 26 (60%) patients received permanent pacemakers. Four patients (9.3%) expired during their hospital stay. The remaining patients were discharged to the following: 31 (72%) to home, 5 (11.6%) to a subacute rehabilitation facility, 3 (7%) to a nursing home.
  
  
  CONCLUSIONS
  EP placed TVPs have a high rate of successful capture and patients undergoing this procedure have a good prognosis.
authors.affiliation: Department of Emergency, Medicine Our Lady of Lourdes Medical Center Camden, NJ; Department of Emergency, Medicine Thomas Jefferson University Philadelphia, PA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Piela
authors.affiliation: Department of Emergency, Medicine Thomas Jefferson University Philadelphia, PA. Electronic address: kornweiss@gmail.com.
authors.forename: Steven
authors.initials: S
authors.lastname: Kornweiss
authors.affiliation: Department of Emergency, Medicine Our Lady of Lourdes Medical Center Camden, NJ.
authors.forename: Alfred
authors.initials: A
authors.lastname: Sacchetti
authors.affiliation: Department of Emergency, Medicine Our Lady of Lourdes Medical Center Camden, NJ.
authors.forename: Amanda
authors.initials: A
authors.lastname: Gallagher
authors.affiliation: Department of Emergency, Medicine Our Lady of Lourdes Medical Center Camden, NJ.
authors.forename: Allen
authors.initials: A
authors.lastname: Abrams
mesh_terms: D000368:Aged; D002406:Catheterization, Peripheral / Q000379:methods*; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D010138:Pacemaker, Artificial; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology