Application of modified temporary cardiac pacing in lead extraction patients

Abstract

Objective To explore the efficiency and safety of modified temporary cardiac pacing in lead extraction patients. Methods The patients who were with indications of pacing system removal and received treatment in Nanjing Drum Tower Hospital from Jan. 2012 to Sep. 2016 were chosen and divided into modified temporary pacing group and conventional temporary pacing group in accordance to pathways of temporary pacing. Active electrode temporary pacemaker was implanted from jugular vein pathway in modified temporary pacing group and passive electrode temporary pacemaker was implanted through femoral artery in conventional temporary pacing group. Difference regarding safety, efficiency, economy and well-being of patients in the two groups were analyzed and compared. Results In total 76 patients were enrolled, among whom 40 in conventional temporary pacing group and 36 in modified temporary pacing group. In terms of safety, there were five total complications in modified temporary pacing group and 24 in conventional temporary pacing group. Safety in modified temporary pacing group was obviously better than that in conventional temporary pacing group (P<0.001) . Pacing dysfunction, poor sensing and number of wire adjustment in modified temporary pacing group were zero. While in conventional temporary pacing group, there were 8 times of pacing dysfunction, 10 times of poor sensing and 16 times of wire adjustment. Comparison of the two groups was statistically different (P<0.05) . Subjective well-being in modified temporary pacing group was higher than that in conventional pacing group (87.72±5.11 vs. 66.98±13.74, P<0.001) . Costs of surgical materials in modified temporary pacing group were higher than those in conventional pacing group[￥ (2 030±146) vs. ￥ (1 369±224) , P<0.001] but general expenses were lower than those in conventional temporary pacing group[￥ (87 482±18 617) vs.￥ (104 521±36 872) , P<0.001]. Conclusions Compared with conventional temporary pacing, modified temporary pacing is significantly safe, efficient and well-being, and is helpful for reducing medical costs for patients. Key words: Pacemaker, artificial; Infection; Jugular veins