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2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. Translation of the document prepared by the Czech Society of Cardiology. COR ET VASA 2022. [DOI: 10.33678/cor.2022.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Glikson M, Nielsen JC, Kronborg MB, Michowitz Y, Auricchio A, Barbash IM, Barrabés JA, Boriani G, Braunschweig F, Brignole M, Burri H, Coats AJ, Deharo JC, Delgado V, Diller GP, Israel CW, Keren A, Knops RE, Kotecha D, Leclercq C, Merkely B, Starck C, Thylén I, Tolosana JM. Grupo de trabajo sobre estimulación cardiaca y terapia de resincronización cardiaca de la Sociedad Europea de Cardiología (ESC). Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2021.10.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Glikson M, Nielsen JC, Kronborg MB, Michowitz Y, Auricchio A, Barbash IM, Barrabés JA, Boriani G, Braunschweig F, Brignole M, Burri H, Coats AJS, Deharo JC, Delgado V, Diller GP, Israel CW, Keren A, Knops RE, Kotecha D, Leclercq C, Merkely B, Starck C, Thylén I, Tolosana JM, Leyva F, Linde C, Abdelhamid M, Aboyans V, Arbelo E, Asteggiano R, Barón-Esquivias G, Bauersachs J, Biffi M, Birgersdotter-Green U, Bongiorni MG, Borger MA, Čelutkienė J, Cikes M, Daubert JC, Drossart I, Ellenbogen K, Elliott PM, Fabritz L, Falk V, Fauchier L, Fernández-Avilés F, Foldager D, Gadler F, De Vinuesa PGG, Gorenek B, Guerra JM, Hermann Haugaa K, Hendriks J, Kahan T, Katus HA, Konradi A, Koskinas KC, Law H, Lewis BS, Linker NJ, Løchen ML, Lumens J, Mascherbauer J, Mullens W, Nagy KV, Prescott E, Raatikainen P, Rakisheva A, Reichlin T, Ricci RP, Shlyakhto E, Sitges M, Sousa-Uva M, Sutton R, Suwalski P, Svendsen JH, Touyz RM, Van Gelder IC, Vernooy K, Waltenberger J, Whinnett Z, Witte KK. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. Europace 2022; 24:71-164. [PMID: 34455427 DOI: 10.1093/europace/euab232] [Citation(s) in RCA: 140] [Impact Index Per Article: 70.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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Elaziz MEA, Saleh EG, Elsayed MG, Hafez BA. The Need for Cardiac Pacing after Isolated Coronary Artery Bypass Graft Surgery. OPEN JOURNAL OF THORACIC SURGERY 2022; 12:21-32. [DOI: 10.4236/ojts.2022.122003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Glikson M, Nielsen JC, Kronborg MB, Michowitz Y, Auricchio A, Barbash IM, Barrabés JA, Boriani G, Braunschweig F, Brignole M, Burri H, Coats AJS, Deharo JC, Delgado V, Diller GP, Israel CW, Keren A, Knops RE, Kotecha D, Leclercq C, Merkely B, Starck C, Thylén I, Tolosana JM. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. Eur Heart J 2021; 42:3427-3520. [PMID: 34455430 DOI: 10.1093/eurheartj/ehab364] [Citation(s) in RCA: 893] [Impact Index Per Article: 297.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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A novel technique to avoid perforation of the right ventricle by the temporary pacing lead during transcatheter aortic valve implantation. Cardiovasc Interv Ther 2020; 36:347-354. [PMID: 32474841 DOI: 10.1007/s12928-020-00676-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 05/20/2020] [Indexed: 10/24/2022]
Abstract
Cardiac tamponade is a life-threatening complication during transcatheter aortic valve implantation (TAVI), often caused by perforation of the right ventricle (RV) by the temporary pacemaker used for rapid pacing during valve deployment. We aimed to assess the feasibility of performing rapid pacing while maintaining inflation of the pacing lead balloon in the RV during TAVI. Among 749 consecutive patients who underwent TAVI with SAPIEN XT valves between October 2013 and July 2015, 726 treated using rapid pacing with a transvenous balloon-tip lead were enrolled in our study, and were stratified into three groups according to the extent of balloon inflation in the RV as follows: full inflation (n = 100), partial inflation (n = 196), and deflation (n = 430). We compared the following clinical outcomes: pacing lead-related RV perforation, rapid pacing failure, valve malpositioning due to rapid pacing failure, device success, and 30-day mortality. Pacing lead-related RV perforation occurred only in patients in the deflation group (6 cases, 1.4%), but the differences among the groups were not statistically significant (p = 0.13). Rapid pacing failure, but no valve malpositioning, occurred most frequently in patients in the full inflation group (4.0% vs. 0.5% in the other groups, p = 0.004). The rate of device success (> 94%) and the 30-day mortality (2.0%) were similar among the three groups. Partial inflation of the balloon of the pacing lead may reduce the risk of RV perforation without increasing the risk of pacing failure or valve malpositioning.
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Temporary transvenous pacer placement under transesophageal echocardiogram guidance in the Emergency Department. Am J Emerg Med 2019; 38:1044.e3-1044.e4. [PMID: 31870671 DOI: 10.1016/j.ajem.2019.12.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 12/12/2019] [Accepted: 12/14/2019] [Indexed: 11/21/2022] Open
Abstract
Placement of a transvenous pacer is an important procedure mainly used to treat hemodynamically unstable brady-arrhythmias. In the Emergency Department (ED), wire placement into the right ventricle is typically performed blindly, or in some cases, under transthoracic ultrasound guidance. This case report describes a patient with extensive cardiac history who presented after a witnessed arrest, and after return of spontaneous circulation, sustained an unstable bradycardia requiring emergent transvenous pacer placement while in the ED. A temporary pacer wire was placed transvenously without successful capture. Transesophageal echocardiography was then utilized to guide and adjust the pacer wire placement helping to successfully achieve capture. To our knowledge, this is the first report to describe transesophageal echocardiogram-assisted placement of a transvenous pacer wire while in the ED.
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Bougioukas I, Jebran AF, Grossmann M, Friedrich M, Tirilomis T, Schoendube FA, Danner BC. Is there a correlation between late re-exploration after cardiac surgery and removal of epicardial pacemaker wires? J Cardiothorac Surg 2017; 12:3. [PMID: 28122567 PMCID: PMC5264443 DOI: 10.1186/s13019-017-0569-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 01/19/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Re-exploration for bleeding accounts for increased morbidity and mortality after major cardiac operations. The use of temporary epicardial pacemaker wires is a common procedure at many departments. The removal of these wires postoperatively can potentially lead to a serious bleeding necessitating intervention. METHODS From Jan 2011 till Dec 2015 a total of 4244 major cardiac procedures were carried out at our department. We used temporary epicardial pacemaker wires in all cases. We collected all re-explorations for bleeding and pericardial tamponade from our surgical database and then we focused on the late re-explorations, meaning on the 4th postoperative day and thereafter, trying to identify the removal of the temporary pacemaker wires as the definite cause of bleeding. Patients' records and medication were examined. RESULTS Thirty-nine late re-explorations for bleeding, consisting of repeat sternotomies, thoracotomies and subxiphoid pericardial drainages, were gathered. Eight patients had an acute bleeding incidence after removal of the temporary wires (0.18%). In four of these patients, a pericardial drainage was inserted, whereas the remaining patients were re-explorated through a repeat sternotomy. Two patients died of the acute pericardial tamponade, three had a blood transfusion and one had a wound infection. Seven out of eight patients were either on dual antiplatelet therapy or on combination of aspirin and vitamin K antagonist. CONCLUSIONS A need for re-exploration due to removal of the temporary pacemaker wires is a very rare complication, which however increases morbidity and mortality. Adjustment of the postoperative anticoagulation therapy at the time of removal of the wires could further minimize or even prevent this serious complication.
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Affiliation(s)
- Ioannis Bougioukas
- Department of Thoracic and Cardiovascular Surgery, University Medical Center, Robert-Koch 40 Str, 37075, Goettingen, Germany.
| | - Ahmad Fawad Jebran
- Department of Thoracic and Cardiovascular Surgery, University Medical Center, Robert-Koch 40 Str, 37075, Goettingen, Germany
| | - Marius Grossmann
- Department of Thoracic and Cardiovascular Surgery, University Medical Center, Robert-Koch 40 Str, 37075, Goettingen, Germany
| | - Martin Friedrich
- Department of Thoracic and Cardiovascular Surgery, University Medical Center, Robert-Koch 40 Str, 37075, Goettingen, Germany
| | - Theodor Tirilomis
- Department of Thoracic and Cardiovascular Surgery, University Medical Center, Robert-Koch 40 Str, 37075, Goettingen, Germany
| | - Friedrich A Schoendube
- Department of Thoracic and Cardiovascular Surgery, University Medical Center, Robert-Koch 40 Str, 37075, Goettingen, Germany
| | - Bernhard Christoph Danner
- Department of Thoracic and Cardiovascular Surgery, University Medical Center, Robert-Koch 40 Str, 37075, Goettingen, Germany
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Outcomes of emergency department placement of transvenous pacemakers. Am J Emerg Med 2016; 34:1411-4. [PMID: 27133534 DOI: 10.1016/j.ajem.2016.04.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 03/29/2016] [Accepted: 04/07/2016] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Placement of TVPs is a core EM procedure. Despite this, there is no specific outcome data on this procedure in the ED setting. This study examines the success of Emergency Physician (EP) attempted TVPs as well as their hospital courses and survivals. METHODS The charts of patients undergoing TVP placement in the ED of an urban community hospital were prospectively collected by a department billing abstractor and then underwent a structured review. All patients had a TVP placed by a board eligible or board certified EP or by a PGY2 EM resident under the direct supervision of an attending EP. All TVPs were placed utilizing a 5 Fr balloon tipped bi-polar pacer without fluoroscopic visualization. RESULTS Over a 36 month period, 43 patients met the study criteria. The mean age was 76.6 (+/- 1.49) years with 27 females (62.7%). Successful pacemaker capture was achieved in 41(95.4%) of TVP attempts. All of the patients were transferred from the ED with vital signs, 41 (95.4%) to a critical care unit and 2 (4.6%) to the electrophysiology laboratory. A total of 26 (60%) patients received permanent pacemakers. Four patients (9.3%) expired during their hospital stay. The remaining patients were discharged to the following: 31 (72%) to home, 5 (11.6%) to a subacute rehabilitation facility, 3 (7%) to a nursing home. CONCLUSION EP placed TVPs have a high rate of successful capture and patients undergoing this procedure have a good prognosis.
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Kossaify A. Temporary Endocavitary Pacemakers and their Use and Misuse: the Least is Better. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2014; 8:9-11. [PMID: 24453502 PMCID: PMC3891625 DOI: 10.4137/cmc.s13272] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Revised: 11/11/2013] [Accepted: 11/19/2013] [Indexed: 11/11/2022]
Abstract
Temporary pacemakers are classically indicated for severe bradydysrhythmia, especially when the clinical settings require prompt intervention. Implantation of a temporary pacemaker is not a benign procedure since it may be associated with serious adverse events such as infection, cardiac perforation, and lead dislodgment. Accordingly, we recommend, when the clinical condition allows, to proceed directly with permanent pacemaker implantation without prior use of a temporary pacemaker. However, if a temporary pacemaker is required, it should be maintained for the shortest time possible. This policy allows avoiding or decreasing the potential complications associated with temporary pacemaker implantation.
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Affiliation(s)
- Antoine Kossaify
- Electrophysiology Unit, Cardiology division, USEK-University Hospital Notre Dame de Secours, St Charbel Street, Byblos, Lebanon
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Lazarescu C, Mertes PM, Longrois D. [Temporary epicardial pacing following cardiac surgery: practical aspects]. ACTA ACUST UNITED AC 2013; 32:592-601. [PMID: 23972516 DOI: 10.1016/j.annfar.2013.07.805] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 07/17/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To review the practical aspects of temporary epicardial pacing following open heart surgery. METHODS Review of articles published in English or French within the last five years and investigating temporary epicardial pacing (indications, pacing modes, epicardial wires and temporary generators). The studies were extracted from the databases ScienceDirect and Pubmed. RESULTS Temporary epicardial pacing is used to treat severe conduction and/or rhythm disorders, but also to improve hemodynamics by optimizing selected temporary pacing settings. Temporary epicardial pacing consists in choosing the most suitable pacing mode according to the situation (surgery, patient, conduction and/or rhythm abnormalities) and setting its parameters that ensure : i) optimal pacemaker functioning; ii) epicardial electrodes longevity; iii) the most favorable hemodynamic profiles. Management of temporary pacing settings and their regular adjustment, at least daily and based on thresholds, are part of good clinical practices. Nevertheless, the French literature lacks official recommendations for temporary epicardial pacing. CONCLUSION Temporary epicardial pacing following cardiac surgery is a simple method, more effective than transcutaneous pacing and easier to implement than transvenous pacing. Its practical management should be known by all physicians (anesthetists, cardiac surgeons) as well as paramedical personnel in order to avoid the risks of suboptimal functioning. A good practice protocol is proposed at the end of the manuscript.
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Affiliation(s)
- C Lazarescu
- Service d'anesthésie-réanimation cardiovasculaire, CHR de Metz, 1, allée du Château, 57085 Metz cedex, France.
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