Cardiac transvenous pacing in the retrieval setting: A retrospective case series

Abstract

Objectives: To report on the safety and efficacy of transvenous cardiac pacing wire insertion outside a tertiary hospital by a medical retrieval service. Methods: SAAS MedSTAR Emergency Medical Retrieval Service transports symptomatic bradycardic patients in rural South Australia to Adelaide on transvenous pacing for ongoing management. This is a retrospective case review of all transvenous cardiac pacing wires inserted by SAAS MedSTAR between January 2015 and October 2017. Results: This study demonstrated successful insertion of cardiac transvenous pacing wires and cardiac capture in 10 of 11 cases (91%) by pre-hospital and retrieval doctors. There were no immediate or longterm complications from insertion. All of the patients were successfully transferred by helicopter or fixed wing to their receiving facility, with nine of the 11 patients (82%) surviving to hospital discharge. Conclusion: This paper demonstrates that transvenous cardiac pacing can be safely and successfully implemented for symptomatic patients by pre-hospital and retrieval physicians in the aeromedical retrieval setting.