Delays in Temporary and Permanent Pacemakers: Causes and In-Hospital Outcomes.
causes
delay
outcomes
permanent pacemaker
temporary pacemaker
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
11 Feb 2020
11 Feb 2020
Historique:
entrez:
20
3
2020
pubmed:
20
3
2020
medline:
20
3
2020
Statut:
epublish
Résumé
Background Temporary pacemakers frequently serve as a bridge to permanent pacemakers, but placement of the latter may be delayed. This study assessed the causes and in-hospital outcomes of patients with delayed placement of permanent pacemakers. Methods This retrospective study included all patients admitted to the Emergency Department who underwent temporary transvenous pacing in the Department of Cardiology, Lady Reading Hospital, Peshawar, Pakistan. The duration of hospitalization and the time from temporary to permanent placement were calculated in days. Asystole, infections, cardiac arrest, and death were recorded during the waiting period. Results Of the 260 patients who underwent temporary transvenous pacing, 136 (52.3%) were males and 124 (47.7%) were females, with an age range of 46-78 years. Coronary artery disease was prevalent in 34% of the patients. Only 5% of the patients were on arteriovenous (AV) nodal blocking agents, 44% had complete AV block, 22% had sinus node disease, and 14% had slow atrial fibrillation. The cause of high-degree AV block could not be determined in most patients. Most patients with ischemia- and hyperkalemia-induced AV block recovered. AV blocks induced by ischemia and with no known cause were not reversible, with most of these patients receiving permanent pacemakers. Of the 260 patients with high-degree AV block, 165 (63.5%) recovered. The mean waiting time for permanent pacemaker implantation was 8.7 ± 5.4 days. The waiting time was associated with increased infections and adverse hospital course. Conclusion A longer waiting period between permanent pacemaker indication and implantation is dangerous, as it is associated with an increased risk of adverse events such as infections, syncope, asystole, malignant arrhythmias, cardiac arrest, and death.
Identifiants
pubmed: 32190503
doi: 10.7759/cureus.6953
pmc: PMC7067517
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e6953Informations de copyright
Copyright © 2020, Irfan et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
QJM. 2008 Dec;101(12):955-60
pubmed: 18820315
Circulation. 2002 Oct 15;106(16):2145-61
pubmed: 12379588
Resuscitation. 2007 Apr;73(1):96-102
pubmed: 17212976
Br Heart J. 1975 Jun;37(6):583-92
pubmed: 1148056
QJM. 2009 Jul;102(7):485-90
pubmed: 19474111
Europace. 2012 Jul;14(7):975-80
pubmed: 22333242
Postgrad Med J. 2003 Aug;79(934):463-5
pubmed: 12954959
J Zhejiang Univ Sci B. 2010 Aug;11(8):634-8
pubmed: 20669355
Pacing Clin Electrophysiol. 2008 Apr;31(4):480-6
pubmed: 18373768
Europace. 2007 Oct;9(10):959-98
pubmed: 17726043
Pacing Clin Electrophysiol. 2006 Feb;29(2):142-5
pubmed: 16492298