Long-term temporary pacing with an active fixation lead

Maciąg, Aleksander; Syska, Paweł; Oręziak, Artur; Przybylski, Andrzej; Broy, Beata; Kołsut, Piotr; Zając, Dariusz; Bilińska, Maria; Sterliński, Maciej; Szwed, Hanna

doi:10.5603/kp.a2015.0093

Cited by 9 publications

(8 citation statements)

References 16 publications

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“…50 The use of temporary pacing allows for the safe removal of an infected device, particularly in patients who are pacemaker-dependent. 51 After the infected device has been explanted, there needs to be a delay for implanting a new device starting from the first set of negative blood cultures, and this period of time is subjected to the presence of valvular endocarditis and extracardiac bacterial seeding. 52 Although small studies have shown good outcomes with the removal of an infected device and simultaneous placement of a new one, the availability of reliable temporary pacing using TPPMs does not justify managing patients in such a manner.…”

Section: Discussionmentioning

confidence: 99%

“…24 Unintended dislodgement of the temporary lead could be prevented by positioning it at a certain distance from the leads to be extracted. 51 Most of the deaths documented were related to patient comorbidities. As an example, one study revealed that death was more frequent in patients who had a TPPM placed for an indication that was one other than infection of a CIED.…”

Section: Discussionmentioning

confidence: 99%

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A Review of Temporary Permanent Pacemakers and a Comparison with Conventional Temporary Pacemakers

Suarez

Banchs

2019

J Innov Cardiac Rhythm Manage.

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Temporary cardiac pacing is commonly used in patients with life-threatening bradycardia and serves as a bridge to implantation of a permanent pacemaker (PPM). For years, passive fixation leads have been used for this purpose, offering the advantage of that they can be placed at bedside. The downside, however, is that patients must remain on telemetry and bed rest until lead removal due to the risk of displacement and failure to capture. Even then, the latter cannot always be prevented. Temporary cardiac pacing with passive fixation leads has also been related to a higher incidence of infection and venous thrombosis, delayed recovery, and increased length of stay. Thus, over the last couple of decades, pacemaker leads with an active fixation mechanism have become increasingly used. This is known as a temporary PPM (TPPM) approach, which carries a very low risk of lead dislodgement and allows patients to ambulate, among other advantages. Here, we performed a review of the literature on the use of TPPMs and their advantages over temporary pacemakers with passive fixation leads and in order to evaluate the advantages and disadvantages of active and passive fixation leads in temporary cardiac pacing. Most articles found were case reports and case series, with few prospective studies. We excluded documents such as editorials and image case reports that provided little to no useful information for the final analysis. The literature search was performed in PubMed, Google Scholar, and other databases and articles written in English and Spanish were considered. Articles were screened up to January 2017. The search keywords used were "temporary permanent pacemaker," "external permanent pacemaker," "active fixation lead," "explantable pacemaker," "hybrid pacing," "temporary permanent generator," "prolonged temporary transvenous pacing," and "semipermanent pacemaker." A total of 24 studies with 770 patients were ultimately included in our review. The age group was primarily above the sixth decade of life, with the exception of one that included pediatric patients. Indications for pacing included device infection, sick sinus syndrome, atrioventricular block, ventricular tachycardia, and bradyarrhythmias associated with systemic illness. The duration of TPPM usage varied from a few days up to 336 days. A total of 18 (2.3%) TPPM-related infections were reported, in which the duration of TPPM use was less than 30 days in at least 15 patients. Loss of capture was documented in only eight patients (1.0%). Complication rates varied from 0% to 30%, with the highest event rates being present in studies that used femoral venous access. In conclusion, although no high-quality studies were identified in our literature search, we found the data retrieved suggest the association of overall favorable outcomes with the use of TPPMs. Device placement and removal typically involve a simple procedure, although fluoroscopy, usually applied in the cardiac catheterization laboratory, is necessary for implantation, which could represent an addition...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Review of Temporary Permanent Pacemakers and a Comparison with Conventional Temporary Pacemakers

Suarez

Banchs

2019

J Innov Cardiac Rhythm Manage.

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“…Promising short‐term outcomes with no early infection recurrences were reported by Maciąg et al in a retrospective analysis of 34 pacemaker‐dependent patients. The patients were bridged with externalized active‐fixation pacing lead for 4‐26 days following TLE due to infection . Amraoui et al in a retrospective analysis of 80 consecutive pacemaker‐dependent patients bridged with externalized pacing lead for 4‐14 days reported excellent short‐ and long‐term effects with no early lead dislodgement and no infection recurrence at 1 year follow‐up .…”

Section: Discussionmentioning

confidence: 99%

“…Undoubtedly, a prospective study would be required to fully assess the long‐term safety of temporary lead bridging. Importantly, in the above‐mentioned studies by Maciąg et al and Perrin et al, up to 20% of patients had an infected ICD system, whereas in the study by Amraoui et al, ICD patients were excluded from analysis …”

Section: Discussionmentioning

confidence: 99%

Temporary external implantable cardioverter‐defibrillator as a bridge to reimplantation after infected device extraction

Dębski

Ząbek

Boczar

et al. 2017

Journal of Arrhythmia

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Patients with cardiac implantable electronic devices (CIED) and endovascular infection represent a difficult management group. The explantation of an implantable cardioverter‐defibrillator (ICD) system deprives the patient of the protection against life‐threatening ventricular tachyarrhythmias. In this study, we describe feasibility and clinical outcomes of bridging with temporary dual‐coil ICD lead and external ICD following the extraction of a CIED due to endovascular infection and compare the performance of this approach to other available options.

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“…A standard approach involves insertion of a temporary endocardial bipolar lead into the right ventricle and connecting it to an external pacemaker. It has been recently reported that active bipolar leads designed for permanent cardiac stimulation may also be used with a pacemaker in VVI mode [2]. Such a solution usually ensures satisfactory pacing support but does not provide atrioventricular synchrony in case of complete heart block.…”

Section: Discussionmentioning

confidence: 99%

Temporary synchronous ventricular pacing as a bridge therapy after CRT-D removal due to lead-related infective endocarditis

Blicharz¹,

Michalak²,

Cacko³

et al. 2017

Heart Beat

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We present a case of single-lead temporary synchronous pacing in a patient after cardiovascular implantable electronic device (CIED) removal.A 60-year-old stimulation-dependent patient implanted with cardiac resynchronization therapy and defibrillator (CRT-D) was admitted to the hospital due to heart failure decompensation. Past medical history included chronic heart failure with low ejection fraction (EF), dilated cardiomyopathy, episodes of ventricular arrhythmia, paroxysmal atrial fibrillation (AF) and decompensated mitral regurgitation. The patient developed lead-related infective endocarditis which necessitated complete removal of the implanted system. A spontaneous sinus rhythm (rate ~ 80-100 BPM) was present, but due to complete heart block and ventricular dyssynchrony significant heart failure (HF) decompensation would have occurred without an intervention. Temporary ventricular stimulation was introduced as a bridge therapy until the eradication of the infective endocarditis. Taking advantage of the sinus rhythm, the patient was provided with a Medtronic SEDR01 Sensia DR pacemaker set to VDD mode and connected to the Biotronik Linox Smart ProMRI S DX 65/15, which resulted in single-lead atrial-synchronized ventricular pacing. The lead was introduced through the left subclavian vein into the right ventricular apex. The pacemaker and the proximal part of the lead were externalized outside of the infected pocket in the left subclavian area (Figure 1). Peri-procedure lead parameters Figure 1 Medtronic SEDR01 Sensia DR as a temporary pacemaker connected to Biotronik Linox Smart ProMRI S DX 65/15 lead tunneled in the skin and emerging outside of the infected pocket.

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Long-term temporary pacing with an active fixation lead

Cited by 9 publications

References 16 publications

A Review of Temporary Permanent Pacemakers and a Comparison with Conventional Temporary Pacemakers

A Review of Temporary Permanent Pacemakers and a Comparison with Conventional Temporary Pacemakers

Temporary external implantable cardioverter‐defibrillator as a bridge to reimplantation after infected device extraction

Temporary synchronous ventricular pacing as a bridge therapy after CRT-D removal due to lead-related infective endocarditis

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