Temporary‐permanent pacemakers are associated with better clinical and safety outcomes compared to balloon‐tipped temporary pacemakers

• Published in: Pacing and clinical electrophysiology Vol. 47; no. 2; pp. 203 - 210
• Main Authors: Chedid, Maroun, Shroff, Gautam R., Iqbal, Omer, Adabag, Selçuk, Karim, Rehan M.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-02-2024
• Subjects: active fixation; ambulation; Balloon treatment; Health care; Health services utilization; Hematoma; Humans; intensive care unit; Pacemaker, Artificial; Pacemakers; passive fixation; Patients; Retrospective Studies; Safety; temporary pacemaker; Thromboembolism; passive fixation; intensive care unit; temporary pacemaker; active fixation; ambulation; safety
• ISSN: 0147-8389; 1540-8159
• DOI: 10.1111/pace.14918

Background
Balloon Tipped Temporary Pacemakers (BTTP) are the most used temporary pacemakers; however, they are associated with a risk of dislodgement and thromboembolism. Recently, Temporary Permanent Pacemakers (TPPM) have been increasingly used. Evidence of outcomes with TPPM compared to BTTP remains scarce.
Methods
Retrospective, chart review study evaluating all patients who underwent temporary pacemaker placement between 2014 and 2022 (N = 126) in the cardiac catheterization laboratory (CCL) at a level 1 trauma center. Primary outcome of this study is to evaluate the safety profile of TPPM versus BTTP. Secondary objectives include patient ambulation and healthcare utilization in patients with temporary pacemakers.
Results
Both groups had similar baseline characteristics distribution including gender, race, and age at temporary pacemaker insertion (p > .05). Subclavian vein was the most common site of access for the TPPM cohort (89.0%) versus the femoral vein in the BTTP group (65.1%). Ambulation was only possible in the TPPM group (55.6%, p < .001). Lead dislodgement, venous thromboembolism, local hematoma, and access site infections were less frequently encountered in the TPPM group (OR = 0.23 [95% CI (0.10‐0.67), p < .001]). Within the subgroup of patients with TPPM, 36.6% of the patients were monitored outside the ICU setting. There was no significant difference in the pacemaker‐related adverse events among patients with TPPM based on their in‐hospital setting.
Conclusion
TPPM is associated with a more favorable safety profile compared to BTTP. They are also associated with earlier patient ambulation and reduced healthcare utilization.