Abstract
Transvenous temporary cardiac pacing therapy (TV-TP) is widely used to treat life-threatening arrhythmias. Yet aggregated evidence on TV-TP is limited. We conducted a systematic scoping review to evaluate indications, access routes and complications of TV-TP, as well as permanent pacemaker therapy (PPM) following TV-TP. Clinical studies concerning TV-TP were identified in Ovid MEDLINE. Case studies and studies lacking complication rates were excluded. To assess complication incidence over time, differences in mean complication rates between 10-year intervals since the introduction of TV-TP were evaluated. We identified 1398 studies, of which 32 were included, effectively including 4546 patients. Indications varied considerably; however TV-TP was most commonly performed in atrioventricular block (62.7%). The preferred site of access was the femoral vein (47.2%). The mean complication rate was 36.7%, of which 10.2% were considered serious. The incidence of complications decreased significantly between 10-year interval groups, but remained high in the most recent time period (22.9%) (analysis of variance; p < 0.001). PPM was required in 64.2% of cases following TV-TP. Atrioventricular block was the primary indication for TV-TP; however indications varied widely. The femoral vein was the most frequent approach. Complications are common in patients undergoing TV-TP. Although a decrease has been observed since its introduction, the clinical burden remains significant. The majority of patients who underwent TV-TP required PPM therapy.Electronic supplementary materialThe online version of this article (10.1007/s12471-019-01307-x) contains supplementary material, which is available to authorized users.
Highlights
Transvenous temporary cardiac pacing (TV-TP) is a potentially life-saving therapy in patients with haemodynamically compromising arrhythmias [1]
We considered the following complications to warrantintervention: sepsis, cardiac perforation, excessive bleeding at access site and pulmonary embolism
In order to assess a trend in complication rates since the introduction of TV-TP therapy we reviewed mean complication rates over the years in 10-year intervals, based on year of publication
Summary
Transvenous temporary cardiac pacing (TV-TP) is a potentially life-saving therapy in patients with haemodynamically compromising arrhythmias [1]. TV-TP therapy may be used as a bridge to permanent cardiac pacing when permanent pacing is not immediately indicated or available, or when a permanent pacemaker cannot be implanted. Observed complications are related to the transvenous lead (e.g. lead dislodgement, lead malfunction, cardiac perforation) or related to the venous access and the necessity for immobilisation (e.g. bleeding, infection, thrombosis and delirium, especially in the elderly population) [6,7,8,9].
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