Retained Temporary Epicardial Pacing Wires: A Systematic Review and Treatment Algorithm.

Area of Science:

• Cardiology
• Cardiac Surgery
• Medical Devices

Background:

• Temporary epicardial pacing wires (TEPW) are crucial for managing arrhythmias post-cardiac surgery.
• Retained TEPW, though rare, can lead to significant long-term complications.
• A systematic review was conducted to analyze complications and propose a management algorithm.

Observation:

• A systematic review identified 35 patients with retained TEPW over a median of 4.9 years post-placement.
• 77% of patients were symptomatic, with 74% experiencing wire migration into surrounding tissues or organs.
• Complications included chronic draining wounds and infection, necessitating surgical intervention.

Findings:

• Wire migration is common and associated with the need for surgical intervention.
• Most patients who underwent wire removal experienced complete recovery.
• Evidence level for existing literature is predominantly Level IV or V.

Implications:

• Surgical intervention and removal of retained TEPW should be strongly considered in symptomatic patients or those with migration.
• A novel treatment algorithm is proposed to minimize complications associated with retained TEPW.
• Early recognition and management are key to preventing severe outcomes.