Temporary Pacemakers: Current Use and Complications

• Published in: Revista española de cardiologia 2004-11, Vol.57 (11), p.1045-1052
• Main Authors: López Ayerbe, Jorge, Villuendas Sabaté, Roger, García García, Cosme, Rodríguez Leor, Oriol, Gómez Pérez, Miquel, Curós Abadal, Antoni, Serra Flores, Jordi, Larrousse, Eduardo, Valle, Vicente
• Format: Article
• Language: eng ; spa
• Subjects: acute myocardial infarction; Adolescent; Adult; Aged; Aged, 80 and over; AMI; Arrhythmias, Cardiac - etiology; Arrhythmias, Cardiac - mortality; Arrhythmias, Cardiac - therapy; atrioventricular block; AVB; Complicaciones; Complications; Coronary Disease - complications; Coronary Disease - diagnosis; Coronary Disease - therapy; Echocardiography; Female; Humans; Indicaciones; Indications; Male; Marcapasos temporales; Middle Aged; Pacemaker, Artificial - adverse effects; Pacemaker, Artificial - statistics & numerical data; Temporary pacemakers
• ISSN: 1885-5857; 0300-8932; 1885-5857
• DOI: 10.1016/S1885-5857(06)60190-4

Temporary pacemakers (TP) are used in the emergency treatment of patients with severe bradyarrhythmia. They are often used in emergency situations and for older patients in poor general condition who are hemodynamically unstable and uncooperative. The aim of this study was to review and analyze the indications, incidence, and type of complications associated with TP implanted in our center during a 6-year period. We analyzed significant clinical variables, indication, route of insertion, follow-up, complications, and duration of temporary pacing. A total of 568 TP were implanted, and 530 cases were available for review (mean age 74.8 [11] years). The main indications were symptomatic complete AV block (51%), prophylaxis for replacement with a definitive pacemaker (14.7%), blockage in the acute phase of myo-cardial infarction (12.6%), bradyarrhythmia due to drug intoxication (12.2%), symptomatic sick sinus syndrome (7.5%), and long QT interval or ventricular tachycardia (2.5%). The route of insertion was via the femoral vein in 99% of the cases. The duration of TP use was 4.2 days (range, 1 to 31 days). A total of 369 patients (69.6%) required a permanent pacemaker. Complications: 34 patients died (6.4%), but only 3 deaths were attributable to TP implantation. Other severe complications were seen in 98 patients (18.5%). Malfunction of the TP occurred in 48 patients (9%) because of electrode displacement. Temporary pacemakers are used in older patients with extreme bradyarrhythmia and occasionally with acute myocardial infarction. Serious complications are not uncommon (22% of all patients), and can range from femoral hematoma to cardiac tamponade and even death (6%). In 9% of the patients the electrode needed to be repositioned because of failure of sensing or loss of ventricular capture. Los marcapasos temporales (MT) permiten el tratamiento urgente de pacientes con bradiarritmias severas. Se los utiliza en las situaciones urgentes y con frecuencia en ancianos con estado general deteriorado, inestabilidad hemodinámica y escasa colaboración. El objetivo es revisar los MT implantados en nuestro centro en los últimos 6 años y analizar sus indicaciones, incidencia y tipo de complicaciones. Se han analizado las variables clínicas significativas, la indicación, la vía de acceso, el seguimiento, las complicaciones y los días de manteni-miento del MT. Se implantó un total de 568 MT y se pudo revisar 530 casos (edad, 74,8 ± 11 años). Las indicaciones para su implan