Perfecting temporary pacemakers in a developing country

ABSTRACT

Introduction

Transvenous pacemakers are used to temporarily pace heart in emergent situations. This study was conducted to analyze the current success rate of temporary pacemaker insertion in our institution and discover causes for failure to improve the technique.

Methodology

A retrospective cohort study was conducted of 263 patients from 2006 to 2016 who underwent TPM insertion at Aga Khan University Hospital, Karachi.

Results

The success rate for the procedure was 97.7%, with one mortality caused by the pacemaker. No significant risk factor was found for the failure of TPM.

Conclusion

There was no significant effect of anatomical site or technique on the failure of TPM insertion. However, with better training and higher experience of the residents, the complications and rate of failures can be reduced.

KEYWORDS:

• Temporary pacing
• cardiac pacemakers
• artificial
• arrhythmias
• atrioventricular block
• femoral line
• jugular line

Article highlights

• The jugular line with fluoroscopic method has been proven to be safe; however, the femoral site showed no increase in complication, and no venous thromboembolism was reported.

• The complication rate and procedure failure rate are inversely proportional to the experience of the person performing the procedure, regardless of the technique.

• There was no significant evidence for any pre, intra, or post cause to increase the risk of TPM failure.

• Our TPM procedure success rate is 97.7%

• The mortality rate due to pacemaker causes was 0.4% (1 patient).

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Disclosures statement

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.