Temporary transvenous pacing via the percutaneous femoral vein approach

Weinstein, Jerome; Gnoj, Julian; Mazzara, James T.; Ayres, Stephen M.; Grace, William J.

doi:10.1016/0002-8703(73)90178-6

Cited by 39 publications

(15 citation statements)

References 34 publications

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“…This reported high incidence of dislocations is likely related to the passive fixation of the leads used in these studies. Earlier studies are in concordance with these findings with a reported dislocation rate of 17–18% 7,8 . Hynes et al 8 reported a retrospective analysis of more than 1,000 patients with temporary pacing during a mean of 3.1 days and found a dislocation rate of 18%.…”

Section: Discussionsupporting

confidence: 69%

“…Hynes et al 8 reported a retrospective analysis of more than 1,000 patients with temporary pacing during a mean of 3.1 days and found a dislocation rate of 18%. Weinstein et al 7 studied prospectively 100 consecutive patients during a mean of 4.8 days of temporary pacing and reported a 17% dislocation rate. When a correction for the differences in follow‐up among these studies is made, the dislocation rate per pacing day ranges from 3.5% to 8% dislocation/day respectively 2 , 7 .…”

Section: Discussionmentioning

confidence: 99%

“…Weinstein et al 7 studied prospectively 100 consecutive patients during a mean of 4.8 days of temporary pacing and reported a 17% dislocation rate. When a correction for the differences in follow‐up among these studies is made, the dislocation rate per pacing day ranges from 3.5% to 8% dislocation/day respectively 2 , 7 . The present studies suggests that active fixation using a screw‐in lead is effective and safe, resulting in a low dislocation rate of 0.45% dislocation/day that compares favorably to the previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…Some limitations have to be acknowledged. The transfemoral route was exclusively used because of this perceived low incidence of complications 7,8 . In addition, no antibiotic therapy was routinely prescribed although some have advocated its use with prolonged transvenous pacing 1 .…”

Section: Study Limitationsmentioning

confidence: 99%

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Usefulness of a New Active‐Fixation Lead in Transvenous Temporary Pacing from the Femoral Approach

Cock

Campen

Visser

2003

Pacing Clinical Electrophis

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Temporary transvenous pacing is associated with a high incidence of complications with a substantial dislocation rate reported to occur in more than one-third of patients. This article describes a novel 3.5 Fr temporary pacing lead using active fixation in a consecutive series of 42 patients with prolonged (> or = 48 hours) temporary pacing. The dislocation rate was 4.8%, while in 7.1% of patients inappropriate pacing (more than a twofold increase of initial pacing threshold) was observed. The total procedural related complication rate (dislocation, inappropriate pacing, local infection, and/or thrombosis) was 31% during a mean duration of pacing of 5.96 +/- 2.6 days. Ambulatory pacing was performed in the vast majority (74%) of patients. Temporary transvenous pacing using an active-fixation lead is safe and permits long-term ambulatory pacing with a low dislocation rate.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Limitationsmentioning

confidence: 99%

See 2 more Smart Citations

Usefulness of a New Active‐Fixation Lead in Transvenous Temporary Pacing from the Femoral Approach

Cock

Campen

Visser

2003

Pacing Clinical Electrophis

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“…However, pulmonary emboli were clinically detected only in patients in whom the femoral vein was used. Weinstein et al 7 prospectively studied 100 consecutive patients who required temporary pacing and in whom the femoral vein was used. Thrombophlebitis and thromboembolism were not complications of the femoral route.…”

mentioning

confidence: 99%

Temporary transvenous pacing and femoral vein thrombosis.

Nolewajka¹,

Goddard²,

Brown³

1980

Circulation

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SUMMARY The true incidence of thrombosis and pulmonary embolism in patients requiring temporary transvenous pacing via the femoral vein is unknown. Twenty-nine patients, mean age 66.2 years (range 38-79 years) who required temporary pacing were studied by bilateral contrast venography and perfusion lung scanning after removal of the pacing catheter. The patients were subdivided into two subgroups based on hemodynamic status. There was no statistical difference between the two groups with respect to mean age or the time the pacer catheter was in place and all patients were placed on low-dose heparin therapy. Ten patients (34%) had venographic evidence of thrombosis; six of them (60%) showed lung scan evidence of pulmonary emboli. The hemodynamically compromised group consisted of seven patients, six (85%) of whom had thrombosis; three of these six (50%) had pulmonary emboli. Of the 22 patients in the hemodynamically stable group, four (18%) had thrombosis and two of these (50%) had pulmonary emboli. Venous thrombosis, with subsequent pulmonary emboli, is a serious complication of temporary transvenous pacing using the femoral approach, despite the use of prophylactic low-dose heparin.TEMPORARY TRANSVENOUS endocardial pacing is a simple, safe and effective means of treating both high-grade atrioventricular block' and selected cardiac dysrhythmias.2 9 Several venous routes are available for the insertion of the pacing electrode. These include both cutdown and percutaneous techniques using either the brachial, subclavian, internal jugular or femoral veins.Recently the percutaneous transfemoral venous technique has been advocated4 6 as a simple method that is free of significant complications. Lumia and Rios6 reported that the overall complication rates for the brachial and femoral approaches were statistically similar, 9.1% and 7.8%, respectively. In their series, phlebitis was clinically evident in 18.8% of patients in whom the brachial vein was used, while the femoral approach did not produce clinically evident phlebitis. However, pulmonary emboli were clinically detected only in patients in whom the femoral vein was used. Weinstein et al.7 prospectively studied 100 consecutive patients who required temporary pacing and in whom the femoral vein was used. Thrombophlebitis and thromboembolism were not complications of the femoral route.This study was designed to prospectively analyze the incidence of femoral vein thrombosis, with subsequent pulmonary embolization, in patients who required temporary transvenous pacing using the percutaneous femoral technique.

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