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Bridge to Recovery or Permanent System Implantation: An Eight‐Year Single‐Center Experience in Transvenous Semipermanent Pacing
Author(s) -
KORNBERGER ANGELA,
SCHMID ECKHARD,
KALENDER GUENAY,
STOCK ULRICH ALFRED,
DOERNBERGER VOLKER,
KHALIL MAHMUD,
LISY MILAN
Publication year - 2013
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12175
Subject(s) - medicine , fixation (population genetics) , bridge (graph theory) , single center , cardiology , cardiac pacing , anesthesia , surgery , population , environmental health
Background To compare the risks, implications, and outcomes of transvenous semipermanent pacing as a bridge to permanent system implantation or recovery. Methods We investigated semipermanent transvenous pacing systems consisting of one (n = 57%) or two (n = 3%) bipolar active‐fixation pacing leads and an attached epicutaneous pulse generator implanted from 2000 to 2009. The study population comprised 60 patients aged 72.9 ± 10.5 years (44 [73.3%] male). Forty‐two (70%) were enrolled for complete system explantation for cardiac‐implanted electronic devices associated infection. Eighteen (30%) required temporary pacing in the context of a variety of mostly severe cardiac and noncardiac conditions. The semipermanent pacing systems were removed after implantation of permanent systems or recovery of a noncompromising heart rhythm, respectively. Results Transvenous semipermanent lead implantation was successful in 59 (98.3%) patients. Major and minor intraoperative complications occurred in one case (1.7%) each. The semipermanent systems were left in situ for a mean period of 14.6 ± 8.1 days). They served as a bridge to permanent system implantation in 68.3% (n = 41) and as a bridge to recovery of a noncompromising heart rhythm in 11.7% (n = 7). Four patients (8.3%) died with the semipermanent pacing system in situ, and seven (11.7%) were transferred to external hospitals with semipermanent pacing systems. Conclusions Transvenous semipermanent pacing with bipolar active‐fixation leads and epicutaneous pulse generators provide an important option for prolonged temporary pacing as a bridge to permanent system implantation or recovery.