Clinical Profile of Patients Undergoing Temporary Transvenous Pacing in a Tertiary Cardiac Care Centre in Nepal

Abstract

Introduction Temporary transvenous pacemaker insertion is an emergency lifesaving procedure for patients with hemodynamically unstable and life-threatening bradyarrythmias. The aim of this study was to analyze demographics, indications, route of insertion and complications in patients undergoing temporary transvenous pacemaker implantation.
 MethodsThis was a retrospective observational study conducted at a tertiary-care center in Nepal. The hospital records of patients who had undergone temporary transvenous pacemaker implantation between July 2015 and June 2019 were reviewed.
 ResultsA total of 343 patients with mean age of 65.52±16.09 years received temporary transvenous pacing. Out of these 205 (59.8%) were males. Greater proportion of patients were between the age group of 70-80 years (n=76, 22.2%). Hypertension (n=97, 28.3%) was the most common comorbidity noted. The most common indication for temporary pacing was symptomatic complete heart block 165 (59.6%). Total of 288 (84%) patients received permanent pacemakers while 55(16%) had reversible cause so TPI was removed. Right Femoral vein was the most common (99%) venous access site. Among the 343 patients, complications were observed in 29 (8.4%) of cases during and after the temporary transvenous pacemaker insertion. The overall mortality stood low at 2% (n=7).
 ConclusionTemporary transvenous pacemaker insertion is required in elderly population presenting with bradyarrythmias and occasionally in acute myocardial infarction presenting with bradyarrythmias as complication. Temporary pacemaker insertion was overall a safe procedure with infrequent serious complications; however, strategies to avoid and alleviate such complications (RV perforation) should be sought and implemented.

Rate of various access sites for temporary transvenous pacing and different outcomes at Lady Reading Hospital, Peshawar Pakistan

“…10 - 12 The femoral vein in also a common venous access site for the purpose temporary trans-venous pacing, it is associated with high complication rate, which includes infection at the site of access and deep venous thrombosis, despite this femoral vein is a common access site in some centers around the worldwide. 13 , 14 …”

“…[10][11][12] The femoral vein in also a common venous access site for the purpose temporary trans-venous pacing, it is associated with high complication rate, which includes infection at the site of access and deep venous thrombosis, despite this femoral vein is a common access site in some centers around the worldwide. 13,14 The right internal jugular vein is the most preferred venous access site as it provides a relatively straightforward access to the right ventricle and has been associated with the least complication. 15 In contrast although our study utilized the same right internal jugular vein as the access site for temporary cardiac pacing, but it had more complications which might be because of the difference in the skills of the operators.…”