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Is transjugular insertion of a temporary pacemaker a safe and effective approach?
Kwang Jin Chun1, Hye Bin Gwag2, Jin Kyung Hwang3
1Division of Cardiology, Department of Internal Medicine, College of Medicine, Kangwon National University Hospital, Kangwon National University, Chuncheon, Korea.
Plos One
|May 13, 2020
Summary
The transjugular approach for temporary pacemakers (TPMs) is faster than the transfemoral route. Consider transjugular TPMs for durations exceeding three days to minimize repositioning risks.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Procedures
Background:
- Temporary pacemakers (TPMs) are crucial in emergencies, but optimal insertion routes remain unclear.
- Tertiary hospitals lack standardized preferred approaches for TPM placement.
- Evidence comparing transjugular and transfemoral temporary pacemaker insertion is limited.
Purpose of the Study:
- To compare procedure times between transjugular and transfemoral temporary pacemaker placement.
- To evaluate and contrast complication rates associated with both temporary pacemaker insertion approaches.
- To identify indications and risk factors for complications, specifically pacing wire repositioning.
Main Methods:
- A retrospective analysis of 732 patients undergoing temporary pacemaker placement.
- Comparison of procedure times, complication rates (infection, bleeding, repositioning), and indications.
- Stratification of data based on transjugular versus transfemoral access routes.
Main Results:
- The transjugular approach demonstrated significantly shorter procedure times (9.0 ± 8.0 min vs. 11.9 ± 9.7 min).
- Overall complication rates were comparable between the two groups.
- Temporary pacing duration exceeding 5 days (transjugular) or 3 days (transfemoral) increased repositioning risk.
Conclusions:
- The transjugular approach offers a faster method for temporary pacemaker insertion.
- For temporary pacing durations longer than three days, the transjugular route is recommended to reduce repositioning risks.
- Both approaches are viable, but duration of need influences the optimal choice for temporary pacemaker placement.
