Efficacy and safety of temporary permanent pacemaker: A single-center experience

Abstract

Temporary cardiac pacing is commonly indicated for the treatment of symptomatic bradycardia and various types of reversible symptomatic heart block. Conventional transvenous temporary cardiac pacing therapy is widely used. This technique is associated with a number of limitations and complications, compared to permanent pacing system. The aim of our study was to identify the indications, complications and outcomes of transvenous semi-permanent pacing. A retrospective study was conducted in our cardiology department from 2017 to 2019. We investigated semi-permanent transvenous pacing system. Were included all patients presenting symptomatic heart block potentially reversible or in a context of severe infection, and patients hospitalized for alcohol septal ablation. A total of 18 patients were implanted, aged between 47 and 92 years. Seven were enrolled for STEMI with symptomatic atrioventricular block, 4 for alcohol septal ablation for hypertrophic cardiomyopathy, 1 for hyperkaliemia, 1 for myocarditis with atrioventricular block and 5 for symptomatic sinus bradycardia or atrioventricular block with infection circumstances. The venous access was sub clavicular in 17 patients (94%) and internal jugular in just 1 patient. After a median follow-up of 14.5 ± 9.63 months, the total duration of hospital stay was 13.5 ± 10.14 days. The duration of temporary pacing was 10 ± 6.27 days. A total of 12 patients (67%) were definitely implanted of dual chamber pacemaker (75%), cardio resynchronization therapy pacemaker (17%) or defibrillator (8%). One patient died with the semi-permanent pacing system in situ. No major or minor intra-operative or postoperative complication occurred. Temporary permanent pacemaker with bipolar active fixation leads and epicutaneous pulse generators provide a cost effectiveness option for prolonged temporary pacing as a bridge to permanent system implantation or recovery.