Feasibility and safety of exclusive echocardiography-guided intravenous temporary pacemaker implantation

Nasasra, Aref El; Alnsasra, Hilmi; Zahger, Doron; Lerman, Tsahi T.; Kobal, Sergio; Cafri, Carlos; Haim, Moti; Fuchs, Lior; Shimony, Avi

doi:10.1007/s12574-018-0406-4

Cited by 9 publications

(13 citation statements)

References 19 publications

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“…As a portable imaging modality, echocardiography could also be employed to facilitate temporary and permanent pacemaker implantation in intensive care units and reduce in‐hospital transfer. 4 , 6 Furthermore, the use of non‐fluoroscopic lead implantation for temporary pacemakers has been reported using ultrasound, computed tomography (CT), and echocardiography. 4 , 5 , 6 , 7 Subcostal echocardiograph views have been utilized in the acute, perioperative setting to guide insertion of a RV temporary transvenous pacemaker.…”

Section: Discussionmentioning

confidence: 99%

“… 4 , 6 Furthermore, the use of non‐fluoroscopic lead implantation for temporary pacemakers has been reported using ultrasound, computed tomography (CT), and echocardiography. 4 , 5 , 6 , 7 Subcostal echocardiograph views have been utilized in the acute, perioperative setting to guide insertion of a RV temporary transvenous pacemaker. 13 Intracardiac echocardiography and electroanatomic mapping have been reported in a permanent pacemaker placement of a pregnant patient.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the use of fluoroscopy is a limiting factor to widespread implantation of CIED in resource‐limited settings. Prior studies have explored non‐fluoroscopic alternatives for temporary device insertion, including electromagnetic mapping systems, ultrasound, and echocardiography in device implantation 4–7 …”

Section: Introductionmentioning

confidence: 99%

“…Prior studies have explored non‐fluoroscopic alternatives for temporary device insertion, including electromagnetic mapping systems, ultrasound, and echocardiography in device implantation. 4 , 5 , 6 , 7 …”

Section: Introductionmentioning

confidence: 99%

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Feasibility study for echocardiography‐guided lead insertion for permanent cardiac implantable electronic devices

Sogade

Aben

Eyituoyo

et al. 2021

Pacing Clinical Electrophis

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Background Permanent cardiac implantable electronic devices (CIEDs) are traditionally implanted with the assistance of fluoroscopy. While clinically effective, this technique exposes both patients and providers to radiation which is associated with adverse health effects and represents an occupational hazard. In this study, we investigate the safety and feasibility of permanent CIED placement under the guidance of transthoracic echocardiography (TTE). There is also increasing interest in use of non‐fluoroscopic options for noninvasive cardiac electrophysiologic procedures. Methods Fifteen patients consecutively consented for initial implant of CIEDs, specifically dual chamber pacemakers (DCPM) and dual chamber implantable cardioverter defibrillators (DCICDs). Patients were excluded if they had previous implants, abandoned leads, or anatomic anomalies including congenital and known persistent left superior vena cava (PLSVC). We used TTE to guide and implant atrial and ventricular leads. Results Eleven patients received DCPMs and four patients received DCICDs. The procedure duration was 49.3 min for DCICD and 52.3 min for DCPM, p = .807. The average number of right atrial lead attempts was 1.6 for DCPMs and 1.8 for DCICD, p = .860. The average number of right ventricular lead attempts for DCPMs was 2.2 and 1.0 attempt for DCICDs, p = .044. There were no complications at 90‐day follow‐up. Conclusion We demonstrate the feasibility of TTE‐guided DCPM/DCICD implantation without use of fluoroscopy. We present this method as a safe alternative for permanent CIED placement that may reduce risk of radiation exposure and cost while maintaining safety and efficacy. No operators wore lead aprons during the procedure.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Feasibility study for echocardiography‐guided lead insertion for permanent cardiac implantable electronic devices

Sogade

Aben

Eyituoyo

et al. 2021

Pacing Clinical Electrophis

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“…Echography-guided implantation of TV-TP leads could result in shorter times to therapy and avoid the risks of an emergency transfer. Two observational studies reported the feasibility of using echographic guidance in temporary transvenous pacemaker placement in a total of 130 patients [45, 46] and showed a significant reduction in total complications in the larger study (6.8% vs 20.7%, p  = 0.03) [45]. Also, the median time from decision to active pacing was significantly shorter for the echography-guided group (22 vs 43 min, p  < 0.01).…”

Section: Discussionmentioning

confidence: 99%

A comprehensive scoping review on transvenous temporary pacing therapy

et al. 2019

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Transvenous temporary cardiac pacing therapy (TV-TP) is widely used to treat life-threatening arrhythmias. Yet aggregated evidence on TV-TP is limited. We conducted a systematic scoping review to evaluate indications, access routes and complications of TV-TP, as well as permanent pacemaker therapy (PPM) following TV-TP. Clinical studies concerning TV-TP were identified in Ovid MEDLINE. Case studies and studies lacking complication rates were excluded. To assess complication incidence over time, differences in mean complication rates between 10-year intervals since the introduction of TV-TP were evaluated. We identified 1398 studies, of which 32 were included, effectively including 4546 patients. Indications varied considerably; however TV-TP was most commonly performed in atrioventricular block (62.7%). The preferred site of access was the femoral vein (47.2%). The mean complication rate was 36.7%, of which 10.2% were considered serious. The incidence of complications decreased significantly between 10-year interval groups, but remained high in the most recent time period (22.9%) (analysis of variance; p < 0.001). PPM was required in 64.2% of cases following TV-TP. Atrioventricular block was the primary indication for TV-TP; however indications varied widely. The femoral vein was the most frequent approach. Complications are common in patients undergoing TV-TP. Although a decrease has been observed since its introduction, the clinical burden remains significant. The majority of patients who underwent TV-TP required PPM therapy.Electronic supplementary materialThe online version of this article (10.1007/s12471-019-01307-x) contains supplementary material, which is available to authorized users.

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Zero to minimal fluoroscopy for cardiac electronic device implantation: A systematic review and meta‐analysis

Luke,

Milla,

Tandi

et al. 2023

Journal of Arrhythmia

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BackgroundFluoroscopy is conventionally performed for cardiac implantable electronic device (CIED) therapy and carries radiation drawback for both patients and medical workers. Recently, zero to minimal fluoroscopy (ZMF) approach is introduced to reduce radiation exposure of fluoroscopy. This study compares the feasibility and safety of ZMF approach to fluoroscopy for CIEDs therapy in adults.MethodA systematic literature search was conducted on PubMed, ScienceDirect, and Web of Science in March 2023. All observational or experimental studies comparing ZMF approach to fluoroscopy for adult CIEDs therapy were included. Reviews, case report/series, animal studies, and non‐English articles were excluded. The success rate, procedural time, fluoroscopy time, radiation dose, and complications rate were compared for each approach.ResultsSeven articles for permanent and three articles for temporary CIEDs were included for analysis. The success rate of ZMF for permanent CIEDs was similar to fluoroscopy method (OR: 0.77, 95% CI: 0.33–4.15). The procedural time of ZMF was similar to fluoroscopy for both permanent and temporary CIEDs (standardized mean difference [SMD]: 0.10, 95% CI: −0.35 to 0.55 and SMD: −0.71, 95% CI: −1.87–0.44, respectively). However, ZMF approach markedly reduced the fluoroscopy time and radiation exposure for permanent CIEDs (SMD: −1.80, 95% CI: −2.49 to −1.12 and SMD: −1.26, 95% CI: −2.24 to −0.29). The complication rate was similar for permanent CIEDs (OR: 1.08, 95% CI: 0.41–2.84), yet lowered for temporary CIEDs (OR: 0.34, 95% CI: 0.20–0.59).ConclusionZMF had similar success rate, procedural time, and sum complication rate for permanent CIEDs implantation with a significant reduction of fluoroscopy time and radiation exposure.

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Feasibility and safety of exclusive echocardiography-guided intravenous temporary pacemaker implantation

Cited by 9 publications

References 19 publications

Feasibility study for echocardiography‐guided lead insertion for permanent cardiac implantable electronic devices

Feasibility study for echocardiography‐guided lead insertion for permanent cardiac implantable electronic devices

A comprehensive scoping review on transvenous temporary pacing therapy

Zero to minimal fluoroscopy for cardiac electronic device implantation: A systematic review and meta‐analysis

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