Temporary transvenous cardiac pacing in cathlab - myocardial infarction versus other causes - differences, complications, and prognosis. Data from a single-center retrospective analysis.

BACKGROUND: Transvenous temporary cardiac pacing (TTCP) is a lifesaving procedure, but the incidence of complications and prognosis depends on the underlying cause. The aim of this study was to compare the characteristics, complications, and prognosis in patients with myocardial infarction (MI) requiring TTCP vs. patients with TTCP due to other causes. METHODS: The present analysis involved 244 cases in whom TTCP was performed between 2017 and 2021 in a high-volume cathlab. All the procedures were performed by an interventional cardiologist. MI constituted 46.3% of the patients (n = 113), including 63 ST-segment elevation MI patients (55.75%). Non-MI patients (control group) consisted of patients with any cause of bradycardia requiring TTCP. RESULTS: Myocardial infarction patients requiring TTCP are younger and have a higher prevalence of hypertension and heart failure. The pacing lead is more frequently inserted during asystole/resuscitation, and pacing was needed for a longer time. MI patients required cardiac implantable electronic device implantation less frequently than in other causes (22% vs. 82%, p < 0.01). The incidence of TTCP complications did not differ. The incidence of in-hospital death was 6.5-fold higher in TTCP patients with MI. Logistic regression showed MI to be a strong predictor of in-hospital death (odds ratio: 8.1; 95% confidence interval: 1.3-57.9). CONCLUSIONS: In-hospital mortality in MI patients requiring TTCP is 6.5-fold higher than in other patients with bradycardia. The complication rate of TTCP is similar in MI and non-MI patients. It is not TTCP but the severity of MI itself and the fact that a pacing lead is frequently implanted in asystole or during resuscitation that is responsible for the higher mortality rate.

Pacing Over the Guidewire in Cardiac Structural Intervention: A Practical Guide.

Left ventricular access for aortic valve intervention provides the opportunity to deliver rapid pacing over the guidewire for device positioning and deployment. Temporary pacing delivered via the left ventricle can obviate the need for venous access and has been shown to be a safe alternative to temporary right ventricular pacing. The technique requires some basic knowledge and experience in temporary cardiac pacing. We outline safe practical steps and common pitfalls in using this technique.

Wandering Atrial Pacemaker Wire: Migration of a Temporary Epicardial Pacing Wire Into the Left Heart.

Temporary epicardial pacing, routinely used after cardiac surgery, employs wires anchored to the epicardium allowing removal via traction. In cases of resistance, the temporary wires are cut flush at the skin. We present a rare noninfectious case of a migrated retained temporary pacing wire into the left heart. (Level of Difficulty: Beginner.).

The incidence, indications and predictors of acute pacemaker implantation after ablation of persistent atrial fibrillation.

INTRODUCTION: Patients with persistent atrial fibrillation (AF) may additionally suffer from a concealed sinus node disease. We sought to determine the incidence, indications and predictors of acute pacemaker [PM] implantation within 1 week after the ablation of persistent AF. METHODS AND RESULTS: We performed a retrospective analysis of patients, who had had an ablation of persistent AF at our center. Between 01/2011 and 08/2016, 1234 patients (mean age 65 ± 10 years, 66.7% male) without prior PM implantation underwent an ablation of persistent AF. Pulmonary vein isolation (PVI) was performed in 1158 (93.8%), the additional ablation of complex fractionated atrial electrograms (CFAE) in 1109 (89.9%) and linear ablation in 524 (42.5%) patients. Temporary cardiac pacing was necessary in 27 (2.2%) patients. The temporary PM was removed in 15 patients (1.2%) because sinus node recovered after a median of 1.0 (minimum 0.1-maximum 2.0) day. The remaining 12 (1.0%) patients required the implantation of a permanent PM. Another 13 (1.1%) patients required permanent PM implantation without prior temporary pacing. In a multivariable regression model, age [OR 1.07 (1.02-1.12), p = 0.006], sinus pauses prior to ablation [OR 7.97 (2.36-26.88), p = 0.001] and atria with low voltage [OR 2.83 (1.31-6.11), p = 0.008] were identified as significant predictors for acute cardiac pacing. CONCLUSION: Acute cardiac pacing within 1 week after the ablation of persistent AF was necessary in 40 (3.2%) patients. Age, sinus pauses in history prior to ablation and the existence of low-voltage areas in the atria were identified as relevant risk factors.

Application analysis of temporary pacing for children with bradyarrhythmia / 中国实用儿科杂志

OBJECTIVE: To explore the effects and results of temporary cardiac pacing in children with bradyarrhythmia.METHODS: The clinical data of 55 children with bradyarrhythmia who received temporary cardiac pacing between June2007 and May 2018 in Children's Hospital of Chongqing Medical University were analyzed retrospectively. The clinical characteristics and curative effects were summarized and statistically analyzed. RESULTS: A total of 55 cases of bradyarrhythmia included 29 cases of severe atrioventricular block(AVB),sinus bradycardia or cardiac arrest caused by myocarditis,5 cases of Ⅲ°AVB or sick sinus syndrome caused by cardiomyopathy,6 cases of Ⅲ°AVB caused by congenital heart disease after surgery,5 cases of congenital Ⅲ°AVB,and 10 cases of perioperative temporary pacing Ⅲ°AVB.Among them,39 cases were compared in Adams-Stokes syndrome(P=0.003),34 cases were compared in ejection fraction and fractional shortening(P=0.000,P=0.001),and 26 patients were compared in left ventricular end diastolic diameter(P=0.001)before and after temporary pacing,and there were statistically differences. After treatment,18 cases were clinically cured,36 cases were improved,and 1 case died,among which 45% arrhythmia were improved or recovered,and 10 cases of perioperative children all passed through the anesthesia period. Kruskal-Wallis H(K)test showed that the clinical and arrhythmia prognosis of different basic cardiovascular diseases were not completely the same(P=0.001,P=0.000);Mann-Whitney U test indicated a better prognosis in the myocarditis group(P=0.001,P=0.000).CONCLUSION: Temporary cardiac pacing can effectively relieve the clinical symptoms of severe bradyarrhythmia caused by various etiologies,promote the recovery of acute conduction system injury,and reduce Ⅲ°AVB perioperative risk.Temporary cardiac pacing is a safe and effective prevention and first-aid technique.

Reversible atrioventricular block and the importance of close follow-up: Two cases of Lyme carditis.

Lyme carditis is an uncommon presentation of the early-disseminated phase of Lyme disease, although it is recognizable and often curable. Because of its rarity, diagnosing Lyme carditis requires a high level of suspicion, especially when young patients in certain endemic areas present with symptoms of bradycardia and/or evidence of high-degree atrioventricular (AV) block. Temporary cardiac pacing along with antibiotic therapy has been shown to aid in the management of Lyme carditis until symptoms and conduction blocks have resolved. Herein, we report two cases of Lyme carditis-induced AV block that were successfully managed and reversed with temporary cardiac pacing and antibiotics. In order to monitor for any late sequela that may arise, we also recommend close follow-up for patients treated for Lyme carditis with high-degree AV block. .

Application of temporary electrotherapy for acute intractable tachyarrhythmia in children / 临床儿科杂志

Objective To explore the value of transesophageal atrial pacing (TEAP) and temporary cardiac pacing in the treatment of acute intractable tachyarrhythmia in children. Method The clinical data of children with acute intractable tachyarrhythmia treated with TEAP (48 cases) or temporary cardiac pacing (6 cases) from January 2014 to December 2017 were retrospectively analyzed. Results In the 48 cases aged 1 day to 13 years (28 males and 20 females) treated with TEAP, 25 cases had paroxysmal supraventricular tachycardia, in which there were 15 cases of rapid atrial flutter, 5 cases of atrial tachycardia and 3 cases of left ventricular idiopathic bundle branch reentrant tachycardia. The rates of successful cardioversion to sinus rhythm through TEAP were 84％, 80％, 20％ and 100％ respectively. In the 6 cases aged 2 to 10 years (1 male and 5 females) treated with temporary cardiac pacing, there were 5 cases of fulminant myocarditis and 1 case of noncompaction of the ventricular myocardium and their conditions were well controlled after treatment. Conclusion TEAP and temporary cardiac pacing have good curative effect in the treatment of acute intractable tachyarrhythmia in children. However, temporary electricity therapy can only temporarily rectify the hemodynamic abnormality threatening the life of children, and active comprehensive treatment for the primary diseases should be carried out simultaneously.

Effects of preventive cardiac pacing on hemodynamic and major adverse cardiovascular events during hospitalization in patients with acute inferior wall myocardiac infarction during emergency percutaneous coronary intervention / 实用医学杂志

Objective To evaluate the effects of preventive cardiac pacing on acute inferior wall myocardiac infarction ( AIMI ) . Methods A total of 52 patients were given preventive cardiac pacing before Percutaneous coronary intervention (PCI) (group T),while another 68 patients were not (group N).Heart rate and average blood pressure level before reperfusion, average blood pressure level after reperfusion,TIMI flow grade before and after reperfusion,the incidence of malignant ventricular arrhythmia after reperfusion and adverse cardiovascular events during hospitalization were compared in two groups. Results There were no significant differences in heart rate before reperfusion , average blood pressure levels before and after reperfusion , and the TIMI flow grade before and after reperfusion between two groups. The malignant ventricular arrhythmia after reperfusion in group T was significantly higher than that in group N while heart failure and nonfatal myocardial infarction were no significantly different between them. Mortality rate and mortality rate of cardiovascular disease in group T were higher than those in group N, but there were no significant differences between them. Conclusions The temporary cardiac pacing has no additional preventive effect on hemodynamic , but increases the occurrence of malignant ventricular arrhythmia , and the risk of death and cardiovascular events.

Study of emergency temporary cardiac pacing / 中国医师进修杂志

Objective To assess the feasibility and the reliability of emergency temporary cardiac pacing under fluoroscopy and nofluoroscopy,and compare to the superiority and inferiority between two groups.Methods Fifty-seven patients were temporarily paced under fluoroscopy and nofluoroscopy by the way which the common bi-pole temporary endocardium pacing electrode was introduced into the right ventricle by the bi-subclavian vein and right internal jugular.Result Twenty-six patients were successfully paced under fluoroscopy,and 27 patients of 31 were successfully paced without fluoroscopy,the other 4 patients were not paced successfully.Besides,there was no any complication in all patients.Conclusion Emergency temporary cardiac pacing without fluoroscopy is utility,saving time and safety,Compared to other method,the effect is proximity and even superior than the way under fluoroscopy.The way of the emergency temporary cardiac pacing without fluoroscopy is applied widespreadly in the work of clinical first aid.

The Application of Emergent Bedside Temporary Cardiac Pacing in ICU / 医学研究杂志

Objective To observe the success rate, complications of bedside pacing using ordinary electrodes lead guided by pacing signal in intensive care unit (ICU) and to summarize the procedure techniques.Methods 38 cases of temporary beside pacing conducted from June of 2004 to June of 2006 in our hospital from ICU were analysed retrospectively.Results 38 cases all achieved successful pacing within 15 minutes, non-sustainable ventricular tachycardia occurred in 2 patients; measuring electrodes were used successfully within 20 minutes to 2 cases with unstable pacing ;Electrodes lead micro-dislocation occurred 8 times in 6 cases. All patients recovered after prompt management. No serious complications such as thrombosis, embolism, pneumohemothorax or my ocardium perforation happened.Conclusion Bedside temporary cardiac pacing using ordinary electrodes lead guided by pacing signal is convenient, rapid, effective and safe. It is feasible in emergency cases and to prepare the measuring electrodes is necessary indeed in ICU.

Indications of Temporary Cardiac Pacing during Perioperative Period of Non-Cardiac Operations / 中国微创外科杂志

Objective To evaluate the indications of temporary cardiac pacing during perioperative period of non-cardiac operations.Methods Temporary cardiac pacemakers were installed preoperatively in 102 patients with bradyarrhythmia.The patients were divided into paced and no-paced groups according to the ECG monitoring during perioperative period.Clinical data were compared between the two groups.Results Totally 37 patients needed pacing during perioperative period.They were older than the no-paced patients [(61?17)y vs(52?14)y,t=2.885,P=0.005].In the paced group,more patients had history of myocardial infarction [54%(20/37)vs 14%(9/65),?2=18.733,P=0.000],cardiomyopathy [8%(3/37)vs 0%(0/65),P=0.045],and syncope [11%(4/37)vs 0%(0/65),P=0.030],abnormal findings in Holter [97%(36/37)vs 48%(31/65),?2=25.741,P=0.000] and UCG [97%(36/37)vs 45%(29/65),?2=26.076,P=0.000].Conclusions Temporary cardiac pacemaker can enhance the perioperative safety and reduce the incidence of cardiovascular complications in patients with bradyarrhythmia.Overall assessments of clinical setting were needed before implantation.The indications for temporary cardiac pacing include bradyarrhythmia with myocardium disorder,which is confirmed by UCG,advanced age,as well as history of syncope.Positive result of atropine test is not one of the significant indications.