Comparison of Two Transvenous Temporary Pacemaker Fixation Methods

FIX-IT Trial

  • Raoni de Castro Galvão
  • Bruno Papelbaum
  • Raquel Almeida Lopes Neves
  • Fabricio Mantovani Cezar
  • Luciene Dias de Jesus
  • Jaqueline Correia Padilha
  • Carlos Eduardo Duarte
  • Jose Tarcísio Medeiros de Vasconcelos
  • Silas dos Santos Galvão-Filho
Keywords: Artificial pacemaker, Artificial heart stimulation, Sutures

Abstract

Introduction: the necessity for a temporary pacemaker (TP) goes through several scenarios. Some patients require the device to complete an infection treatment, regain the pace after myocardial infarction, or while awaiting the release of the definitive device by the health care provider. Regardless of the TP passage technique, good electrode fixation is essential, avoiding dislocation and the necessity for repositioning, among other complications. Objective: to compare two forms of TP fixation, one under direct fixation to the skin and the other keeping the venous introducer connected to the plastic protection through the pacemaker electrode lead. Methods: Forty patients were randomized, 20 in each group. Data regarding the procedure time, electrode lead position, command thresholds, sensitivity, and complications were recorded. The primary outcome considered was the necessity for repositioning or exchange of transvenous TP and secondary any complication without the necessity to reposition it. Results: There were no significant differences in the total duration of the procedure between the groups in the initial position of the electrode and the access route used. The group with plastic protection had a higher primary outcome (60%) than the direct fixation group (20%; p = 0.0098). There were no differences regarding the secondary outcome (p = 1.0). The group with plastic protection also had more total complications compared to the other group (p = 0.0262). Conclusion: Direct fixation of the pacemaker electrode lead was safer concerning the fixation with plastic protection, reducing complications such as electrode dislocation requiring repositioning or replacement without increasing the procedure time.

References

Pachón-Mateos JC, Pereira WL, Batista Junior WD, Mateos JCP, Mateo EIP, Vargas RNA, et al. Registro brasileiro de marcapassos, ressincronizadores e desfibriladores.

Relampa. 2013;26(1):39-49

Pachón-Mateos JC. Marcapasso cardíaco provisório: indicações e procedimentos empregados no controle de doentes graves. Rev Bras Marcapasso e Arritmia.

;3(3):94-9

Shah B, Awan ZA. Temporary pacemakers implantation: do we need fluoroscopy? J Ayub Med Coll Abbottabad. 2015;27(2):284-6

Maciąg A, Syska P, Oręziak A, Przybylski A, Broy B, Kołsut P, et al. Long-term temporary pacing with an active fixation lead. Kardiol Pol. 2015;73(12):1304-9. https://doi.org/ 10.5603/KP.a2015.0093

Kawata H, Pretorius V, Phan H, Mulpuru S, Gadiyaram V, Patel J, Steltzner D, et al. Utility and safety of temporary pacing using active fixation leads and externalized reusable

permanent pacemakers after lead extraction. Europace. 2013;15(9):1287-91. https://doi.org/10.1093/europace/eut045

Purohit M, Kaarne M. Sutureless fixation of temporary pacing wire. Asian Cardiovasc Thorac Ann. 2004;12(3):270-1. https://doi.org/10.1177/021849230401200321

Pinneri F, Frea S, Najd K, Panella S, Franco E, Conti V, et al. Echocardiography-guided versus fluoroscopy-guided temporary pacing in the emergency setting: an observational

study. J Cardiovasc Med. 2013;14(3):242-6. https://doi.org/10.2459/JCM.0b013e32834eecbf

Published
19-10-2019
Section
Artificial Heart Stimulation