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Temporary transvenous cardiac pacing: a survey on current practice.

Igor Diemberger1, Giulia Massaro1, Antonio Rossillo2

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Temporary transvenous cardiac pacing (TTCP) practices vary widely among Italian cardiologists, with significant differences in infection prevention and patient management. Further research is needed to assess the impact on cardiac implantable electronic device infections.

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Temporary transvenous cardiac pacing (TTCP) is a common procedure despite limited guideline coverage.
  • Infections of cardiac implantable electronic devices (CIED) are a significant complication of TTCP.
  • Current TTCP practices lack a unified approach, necessitating a comprehensive survey.

Purpose of the Study:

  • To assess the current country-wide practices of temporary transvenous cardiac pacing (TTCP) in Italy.
  • To identify variations in TTCP procedures, complication management, and infection prophylaxis.
  • To provide a national overview of TTCP utilization and strategies.

Main Methods:

  • An online survey was distributed to members of the Italian Association of Arrhythmology and Cardiac Pacing.
  • Data were collected from 102 physicians across 81 Italian hospitals.
  • The survey focused on TTCP strategies, approaches, and post-procedure management.

Main Results:

  • Significant heterogeneity exists in TTCP strategies for acute bradycardia, with a trend towards limiting use to advanced atrioventricular block.
  • TTCP is primarily performed by electrophysiologists or interventional cardiologists, often via a femoral approach with non-floating catheters.
  • Inconsistent practices were observed in infection and thromboembolic complication prevention, as well as in post-TTCP management.

Conclusions:

  • Italian cardiologists exhibit considerable variability in their approaches to temporary transvenous cardiac pacing.
  • These practice variations may influence long-term outcomes, particularly the incidence of CIED-related infections.
  • Further investigation is required to correlate divergent TTCP practices with patient outcomes.