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Pacing Clin Electrophysiol. 2013 Sep;36(9):1096-103. doi: 10.1111/pace.12175. Epub 2013 May 29.

Bridge to recovery or permanent system implantation: an eight-year single-center experience in transvenous semipermanent pacing.

Author information

1
Department of Thoracic and Cardiovascular Surgery, Germany.

Abstract

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.

KEYWORDS:

implantable cardioverter defibrillator; infection; lead failure; temporary pacing

PMID:
23718817
DOI:
10.1111/pace.12175
[Indexed for MEDLINE]

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