Temporary Endocavitary Pacemakers and their Use and Misuse: the Least is Better

Temporary pacemakers are classically indicated for severe bradydysrhythmia, especially when the clinical settings require prompt intervention. Implantation of a temporary pacemaker is not a benign procedure since it may be associated with serious adverse events such as infection, cardiac perforation, and lead dislodgment. Accordingly, we recommend, when the clinical condition allows, to proceed directly with permanent pacemaker implantation without prior use of a temporary pacemaker. However, if a temporary pacemaker is required, it should be maintained for the shortest time possible. This policy allows avoiding or decreasing the potential complications associated with temporary pacemaker implantation.