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Outcomes of Standard Permanent Active Fixation Leads for Temporary Pacing
Journal article   Open access   Peer reviewed

Outcomes of Standard Permanent Active Fixation Leads for Temporary Pacing

Ralph Cipriano, Ashwani Gupta, Faiz Subzposh, James A McCaffrey, Eduard Koman, David Fridman, Heath Saltzman and Steven P Kutalek
JACC. Clinical electrophysiology, v 6(3), pp 304-310
Mar 2020
DOI: https://doi.org/10.1016/j.jacep.2019.10.022
PMID: 32192681
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1016/j.jacep.2019.10.022View
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Abstract

Aged Aged, 80 and over Cardiac Pacing, Artificial - adverse effects Cardiac Pacing, Artificial - methods Cardiac Pacing, Artificial - statistics & numerical data Defibrillators, Implantable - adverse effects Defibrillators, Implantable - statistics & numerical data Device Removal - statistics & numerical data Female Humans Male Middle Aged Pacemaker, Artificial - adverse effects Pacemaker, Artificial - statistics & numerical data Treatment Outcome
This study investigated the performance of Temporary Pacing via an Externalized Active-Fixation (TPEAF) lead. The incidence of cardiac implantable electronic device infections is increasing, which necessitates the need for transvenous lead extraction (TLE). Pacemaker-dependent patients require temporary pacing during the guideline-recommended waiting period before reimplantation. Data regarding safety and efficacy of TPEAF leads are very limited. We evaluated patients implanted with TPEAF leads post-TLE at our center between April 2004 and December 2017. TPEAF leads were placed in 158 patients. The mean age was 74 ± 11 years. The median duration of the temporary lead was 6 days (range 1 to 29). There were 4 procedural complications (2.5% incidence): 1 patient had cardiac arrest from hyperkalemia, 2 developed cardiac tamponade, and 1 had profuse bleeding from the entry point of the leads. There were 13 complications post-implantation (8.2% incidence): 8 lead dislodgments, 1 elevated pacing threshold, 2 vegetations on the temporary lead, 1 pneumothorax, and 1 loss of capture due to the generator "safety switch." All dislodgements occurred within 24 h, except 1 on day 3. Sixteen patients died during the hospital stay: 10 due to septic shock, 2 due to hyperkalemic cardiac arrest, 3 due to ventricular tachycardia, and 1 due to a massive cerebrovascular accident. The use of TPEAF leads is safe and efficacious in pacemaker-dependent patients post-TLE. Dislodgement can occur within the first 24 h. The presence of persistent fever and positive blood cultures should raise concern for vegetation on the temporary lead.

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19 citations in Scopus

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Web of Science research areas
Cardiac & Cardiovascular Systems
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