Outcomes of Standard Permanent Active Fixation Leads for Temporary Pacing

Cipriano, Ralph; Gupta, Ashwani; Subzposh, Faiz A.; McCaffrey, James A.; Koman, Eduard; Fridman, David; Saltzman, Heath; Kutalek, Steven P.

doi:10.1016/j.jacep.2019.10.022

Cited by 16 publications

(22 citation statements)

References 17 publications

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“…As for systemic infection, no patients in our cohort presented antibiotic-resistant bacteremia or persistent fever. In contrast to our findings, Cipriano et al observed two patients (3.1%) developed vegetations on the temporary lead of a total of 65 patients with bacteremia 10. Persistent bacteremia or recurrent high-grade fever should raise the suspicion of vegetations on the temporary lead.Over the years, many studies have suggested that pacemaker reuse may be safe and effective.…”

contrasting

confidence: 99%

“…In our cohort, 70 patients (21.1%) had new lead implanted through the right internal jugular vein and no local infection was observed. Cipriano et al reported that the right internal jugular vein was the most common access site for TPAFL (153 patients, 96.8%) and no local infections were observed 10. As for systemic infection, no patients in our cohort presented antibiotic-resistant bacteremia or persistent fever.…”

mentioning

confidence: 54%

“…reported a dislodgment rate of 5.1% in 158 patients. 10 However, three of the all the eight dislodgments were caused by delirious patients pulling out their temporary leads. In our study, one of two dislodgments were also caused by the same reason.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have evaluated the utility and safety of this approach. [8][9][10] In this study, we investigated the efficacy and safety of temporary pacing via an active fixation lead (TPAFL) after transvenous lead extraction (TLE) in a high-volume center.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of temporary pacing using active fixation leads and externalized permanent pacemakers in patients with cardiovascular implantable electronic device infection and pacemaker dependency

Zhou

et al. 2021

Cardiovasc electrophysiol

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Introduction:The incidence of cardiac implantable electronic device (CIED) infections is increasing. Complete device and lead removal are recommended for all patients with definite CIED system infection. In patients with pacemaker dependency, temporary pacing before reimplantation is necessary. In this study, temporary pacing using active fixation leads (TPAFL) was evaluated. Methods: We reviewed data from consecutive patients implanted with TPAFL after transvenous lead extraction at our center between November 2014 and October 2020. Results: TPAFL were placed in 334 patients. The mean age was 64.5 ± 16.4 years and 76.3% were males. Two hundred and forty (72%) were treated due to local pocket infection and 94 (28%) systemic infection. The indication for temporary pacing was sick sinus syndrome in 135 (40.4%) patients and complete or high-grade atrioventricular (AV) block in 199 (59.6%) patients. The most common access site for lead implantation was the ipsilateral subclavian or axillary vein (78.9%). A new permanent CIED was reimplanted at 10.3 ± 9.2 days (median 10, range: 2-70) after implantation of the temporary pacing. There were five (1.5%) adverse events related to the temporary pacing during hospitalization. The median follow-up duration was 23.1 months (interquartile range [IQR], 7.2-43.4 months). Only one patient (0.3%) developed recurrent CIED infection. Conclusion: TPAFL is safe and effective in pacemaker-dependent patients after infected CIED removal. The rate of temporary pacing-related complications, including lead dislodgment and reinfection of CIED is relatively low.

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confidence: 99%

mentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Outcomes of temporary pacing using active fixation leads and externalized permanent pacemakers in patients with cardiovascular implantable electronic device infection and pacemaker dependency

Zhou

et al. 2021

Cardiovasc electrophysiol

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“…of 23 patients who had EPTP for a mean of 19 days, for CIED related infection, half of their study cohort was discharged home or to a nursing facility with EPTP in situ, until completion of antibiotic treatment, and then re‐admitted for a new permanent pacemaker. In a more recent study, Cipriano et al 10 . reported 158 patients who needed EPTP post extraction of infected transvenous pacing leads.…”

Section: Discussionmentioning

confidence: 99%

The indications and safety of prolonged temporary pacing using active‐fixation leads and externalized pulse generator

Shah

Elsayed

et al. 2021

Pacing Clinical Electrophis

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Background Temporary cardiac pacing, conventionally achieved using a passive transvenous pacing wire, can be life‐saving for unstable arrhythmias. However, they run the risk of complications, the longer they remain in‐situ. Externalized prolonged temporary pacing (EPTP), using active‐fixation lead and an externalized pulse generator; may be an alternative for transient pacing indications, concurrent illness or sepsis that precludes permanent pacing. Methods Sixty‐seven patients (mean age 69 ± 14 years; 82% male) underwent EPTP between November 2011 and April 2019. EPTP was performed in a sterile facility, under fluoroscopy, using active‐fixation leads anchored to the right ventricle septum. Externalized lead was connected to a re‐sterilized pulse generator and secured to anterior chest wall with transparent dressings. EPTP indications and patient outcomes were evaluated. Results Pacing indications were high‐grade atrio‐ventricular (AV) block (73.2%), sinus arrest (14.9%), overdrive suppression of VT (5.9%) and pause‐dependent VT (4.5%). Reasons for ETPT rather than permanent pacing included: sepsis (38.8%), CIED‐related infection (8.9%), transient pacing indication (25%), to allow further investigations prior to decision on CIED type (22%), and over‐drive arrhythmia suppression (6%). Sixty three percent patients were severely ill in an ICU. Mean duration of pacing was 16 ± 12 days. Sixty seven percent patients subsequently received a CIED and had no evidence of device‐related infection at 1‐year post‐implant. There were three non‐fatal complications during EPTP while no deaths were attributed to EPTP. Conclusion EPTP is a safe and useful method of prolonged temporary pacing for patients who require chronotropic support, but in whom immediate permanent pacemaker implantation is contraindicated.

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Graphene Biointerface for Cardiac Arrhythmia Diagnosis and Treatment

et al. 2023

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Heart rhythm disorders, known as arrhythmias, cause signi cant morbidity and are one of the leading causes of mortality. Cardiac arrhythmias are primarily treated by implantable devices, such as pacemakers and de brillators, or by ablation therapy guided by electroanatomical mapping.Pharmacological treatments are mostly ineffective. Both implantable and ablation therapies require sophisticated biointerfaces for electrophysiological measurements of electrograms and delivery of therapeutic stimulation or ablation energy. In this work, we report for the rst time on graphene biointerface for in vivo cardiac electrophysiology. Leveraging sub-micrometer thick tissue-conformable graphene arrays, we demonstrate sensing and stimulation of the open mammalian heart both in vitro and in vivo. Furthermore, we demonstrate graphene pacemaker treatment of a pharmacologically-induced arrhythmia, AV block. The arrays show effective electrochemical properties, namely interface impedance down to 40 Ohm×cm 2 , charge storage capacity up to 63.7 mC/cm 2 , and charge injection capacity up to 704 µC/cm 2 . Transparency of the graphene structures allows for simultaneous optical mapping of cardiac action potentials and calcium transients while performing electrical measurements and stimulation. Our report presents evidence of the signi cant potential of graphene biointerfaces for the future clinical device-and catheter-based cardiac arrhythmias therapies.

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Outcomes of Standard Permanent Active Fixation Leads for Temporary Pacing

Cited by 16 publications

References 17 publications

Outcomes of temporary pacing using active fixation leads and externalized permanent pacemakers in patients with cardiovascular implantable electronic device infection and pacemaker dependency

Outcomes of temporary pacing using active fixation leads and externalized permanent pacemakers in patients with cardiovascular implantable electronic device infection and pacemaker dependency

The indications and safety of prolonged temporary pacing using active‐fixation leads and externalized pulse generator

Graphene Biointerface for Cardiac Arrhythmia Diagnosis and Treatment

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