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Use of balloon flotation pacing catheters for prophylactic temporary pacing during diagnostic and therapeutic

J R Harvey1, R M Wyman, R G McKay

  • 1Charles A. Dana Research Institute, Boston, Massachusetts.

The American Journal of Cardiology
|November 1, 1988
PubMed

Insights

Prophylactic temporary pacemakers are not recommended for diagnostic catheterization or coronary angioplasty due to low complication rates. Routine use is advised for balloon valvuloplasty, where pacing needs are higher.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Device Utilization

Background:

  • Prophylactic temporary pacemakers are sometimes used during cardiac procedures.
  • The necessity and cost-effectiveness of their use in various interventional settings remain debated.

Purpose of the Study:

  • To evaluate the incidence of bradycardia and conduction defects during cardiac procedures.
  • To determine the need for temporary pacing in patients undergoing diagnostic catheterization, coronary angioplasty, and balloon valvuloplasty.
  • To assess the cost-effectiveness of prophylactic temporary pacemaker use.

Main Methods:

  • Retrospective analysis of 1,033 patients over 18 months.
  • Pacemaker leads placed during diagnostic catheterization, coronary angioplasty, and valvuloplasty.
  • Documentation of complications, pacing requirements, and associated costs.

Main Results:

  • No major complications from pacemaker placement occurred.
  • Significant bradycardia or conduction defects occurred in 1%, 1%, and 10% of patients during catheterization, angioplasty, and valvuloplasty, respectively.
  • Only 0.06%, 0.4%, and 2.5% required pacing, with 5 patients needing support during valvuloplasty.

Conclusions:

  • Prophylactic temporary pacing is not indicated for diagnostic catheterization or coronary angioplasty.
  • Routine prophylactic temporary pacemaker use is recommended for balloon valvuloplasty.
  • Cost per actual use varied significantly, being highest for diagnostic cases and lowest for valvuloplasty.

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