Comparison of efficacy and safety of temporary pacing using active-fixation rersus traditional leads after extraction of infected leads / 中国介入心脏病学杂志

ABSTRACT

Objective To evaluate the efficacy and safety of the new active-fitation right ventricular lead temporary-permanent pacemaker (TPPM) rersus the traditional temporary transvenous pacing system .Methods Between January 2011 and June 2013, 234 patients had their infected leads removed at our center. A total of 105 (44.9%) patients were pacemaker dependent. Thirty-five patients underwent TPPM implantation and 70 patients had implanted with traditional temporary transvenous pacing system. For traditional temporary pacing, the quadrupole catheter was implanted into the right ventricle through the femoral vein to connect the temporary pacemaker. In TPPM, an active-fixation electrode was implanted into the right ventricular septum through the subclavian and internal jugular veins to connect to the reused permanent pacemaker. parameters from the pacemakers,time for the procedure,the occurance of complications and rates of infection and mortality during the 2 years of follow up were compared between the 2 groups. Results There were more patients with infectious endocarditis in the TPPM group than in the traditional temporary pacing group(22.9% vs. 5.7%,P=0.019). Therefore,the electrode retention time in the TPPM group was longer[2(2,7)d vs.2(2,3)d,P=0.032]and the hospital stay was slightly prolonged[15(14,21)d vs.17(15,25)d,P=0.05]compared with the traditional temporary pacing group.The pacing threshold in the TPPM group was lower than that in the traditional temporary pacing group[(0.7±0.2)V vs.(1.0±0.3)V, P=0.035)].There was no difference in X-ray exposure time between the groups[(24.7±15.4)min vs.(27.5±17.7)min,P=0.242].There were no complications related to bridging in the TPPM group, but 11 patients in the traditional temporary pacing group had developed complications (P=0.009). Conclusions TPPM is effective and safer as compared to traditional temporary pacing for pacemaker-dependent patients with device infection. The operation time does not increase in patients with TPPM implantation.