Regional survey of temporary transvenous pacing procedures and complications.
Postgrad Med J
; 79(934): 463-5, 2003 Aug.
Article
em En
| MEDLINE
| ID: mdl-12954959
ABSTRACT
OBJECTIVE:
A prospective regional survey was carried out to describe the current practice of temporary transvenous pacing in five hospitals in the Wessex region and identify factors that predispose to complications.METHODS:
Data were collected on patient characteristics, pacing indication and setting, operator grade, training, experience and supervision, venous access, procedure time, duration of pacing, complications, and eventual outcome.RESULTS:
A total of 144 procedures were performed on 111 patients (age 75 (12) years). Median procedure time was 30 (1-150) min. Trainees performed 129 (91.5%) procedures. The senior physician present was a cardiologist/cardiology trainee for 65/144 (45.1%), and had experience of >20 procedures for 81/144 (57.9%). Venous access was by the subclavian in 52 (46.8%), internal jugular in 37 (33.3%) and femoral in 22 (19.8%), requiring multiple stabs or multiple sites in 41(33.1%). Pacing wires remained in place for a median of 2 (0.04-20) days. Overall procedure times were shorter for cardiologists/cardiology trainees (24[1-90] v 45[10-150] min, p<0.0001), and experienced physicians (30[1-150] v 40[10-120] min, p<0.01). There were 50 complications in 46/144 (31.9%) procedures, affecting 31/111 (27.9%) patients. Immediate complications were less common with experienced physicians (1/81 v 5/59, p<0.05). Infection occurred more often with wires left in situ for >48 hours (17/86 v 2/55, p<0.01) and with longer procedure times (55[8-150] v 30[1-120] min, p<0.005). No factors predicted displacement, which occurred at a median time of 1 (0.04-8) day. Complications delayed permanent pacemaker insertion in 19/63 (22.9%) patients.CONCLUSIONS:
Temporary pacemaker insertion is performed by physicians with variable experience and training. The presence of an experienced cardiologist/cardiology trainee and decreasing the time that pacing wires remain in situ may reduce complications.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Marca-Passo Artificial
/
Arritmias Cardíacas
/
Estimulação Cardíaca Artificial
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2003
Tipo de documento:
Article