Temporary-permanent pacemakers are associated with better clinical and safety outcomes compared to balloon-tipped temporary pacemakers.

active fixation ambulation intensive care unit passive fixation safety temporary pacemaker

Journal

Pacing and clinical electrophysiology : PACE
ISSN: 1540-8159
Titre abrégé: Pacing Clin Electrophysiol
Pays: United States
ID NLM: 7803944

Informations de publication

Date de publication:
02 2024
Historique:
revised: 18 12 2023
received: 03 11 2023
accepted: 21 12 2023
medline: 15 2 2024
pubmed: 19 1 2024
entrez: 19 1 2024
Statut: ppublish

Résumé

Balloon Tipped Temporary Pacemakers (BTTP) are the most used temporary pacemakers; however, they are associated with a risk of dislodgement and thromboembolism. Recently, Temporary Permanent Pacemakers (TPPM) have been increasingly used. Evidence of outcomes with TPPM compared to BTTP remains scarce. Retrospective, chart review study evaluating all patients who underwent temporary pacemaker placement between 2014 and 2022 (N = 126) in the cardiac catheterization laboratory (CCL) at a level 1 trauma center. Primary outcome of this study is to evaluate the safety profile of TPPM versus BTTP. Secondary objectives include patient ambulation and healthcare utilization in patients with temporary pacemakers. Both groups had similar baseline characteristics distribution including gender, race, and age at temporary pacemaker insertion (p > .05). Subclavian vein was the most common site of access for the TPPM cohort (89.0%) versus the femoral vein in the BTTP group (65.1%). Ambulation was only possible in the TPPM group (55.6%, p < .001). Lead dislodgement, venous thromboembolism, local hematoma, and access site infections were less frequently encountered in the TPPM group (OR = 0.23 [95% CI (0.10-0.67), p < .001]). Within the subgroup of patients with TPPM, 36.6% of the patients were monitored outside the ICU setting. There was no significant difference in the pacemaker-related adverse events among patients with TPPM based on their in-hospital setting. TPPM is associated with a more favorable safety profile compared to BTTP. They are also associated with earlier patient ambulation and reduced healthcare utilization.

Sections du résumé

BACKGROUND
Balloon Tipped Temporary Pacemakers (BTTP) are the most used temporary pacemakers; however, they are associated with a risk of dislodgement and thromboembolism. Recently, Temporary Permanent Pacemakers (TPPM) have been increasingly used. Evidence of outcomes with TPPM compared to BTTP remains scarce.
METHODS
Retrospective, chart review study evaluating all patients who underwent temporary pacemaker placement between 2014 and 2022 (N = 126) in the cardiac catheterization laboratory (CCL) at a level 1 trauma center. Primary outcome of this study is to evaluate the safety profile of TPPM versus BTTP. Secondary objectives include patient ambulation and healthcare utilization in patients with temporary pacemakers.
RESULTS
Both groups had similar baseline characteristics distribution including gender, race, and age at temporary pacemaker insertion (p > .05). Subclavian vein was the most common site of access for the TPPM cohort (89.0%) versus the femoral vein in the BTTP group (65.1%). Ambulation was only possible in the TPPM group (55.6%, p < .001). Lead dislodgement, venous thromboembolism, local hematoma, and access site infections were less frequently encountered in the TPPM group (OR = 0.23 [95% CI (0.10-0.67), p < .001]). Within the subgroup of patients with TPPM, 36.6% of the patients were monitored outside the ICU setting. There was no significant difference in the pacemaker-related adverse events among patients with TPPM based on their in-hospital setting.
CONCLUSION
TPPM is associated with a more favorable safety profile compared to BTTP. They are also associated with earlier patient ambulation and reduced healthcare utilization.

Identifiants

pubmed: 38240391
doi: 10.1111/pace.14918
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

203-210

Informations de copyright

© 2024 Wiley Periodicals LLC.

Références

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Auteurs

Maroun Chedid (M)

Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota, USA.

Gautam R Shroff (GR)

Division of Cardiology, Hennepin Healthcare, Minneapolis, Minnesota, USA.
Division of Cardiology, University of Minnesota Medical School, Minneapolis, Minnesota, USA.

Omer Iqbal (O)

Division of Cardiology, Hennepin Healthcare, Minneapolis, Minnesota, USA.
Division of Cardiology, University of Minnesota Medical School, Minneapolis, Minnesota, USA.

Selçuk Adabag (S)

Division of Cardiology, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
Veterans Affairs Medical Center, Division of Cardiology, Minneapolis, Minnesota, USA.

Rehan M Karim (RM)

Division of Cardiology, Hennepin Healthcare, Minneapolis, Minnesota, USA.
Division of Cardiology, University of Minnesota Medical School, Minneapolis, Minnesota, USA.

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