Outcomes of Supraclavicular Access in Temporary Pacemaker Implantation

Area of Science:

• Cardiology
• Vascular Access Techniques
• Medical Device Implantation

Background:

• Temporary pacemaker (TPM) implantation is crucial for managing symptomatic bradyarrhythmias.
• Infraclavicular venous access is standard, but supraclavicular access is a promising alternative.
• Limited comparative data exists, especially for resource-limited settings.

Purpose of the Study:

• To compare the safety and efficacy of supraclavicular versus infraclavicular venous access for TPM implantation.
• To identify predictors of complications associated with these procedures.

Main Methods:

• Retrospective observational study of 3569 patients undergoing TPM implantation.
• Comparison of supraclavicular (n=1644) and infraclavicular (n=1925) venous access.
• Analysis included procedural success, complications, and outcomes using multivariate and survival analyses.

Main Results:

• Supraclavicular access showed significantly lower complication rates (9.3% vs. 14.8%, p<0.001).
• Higher first-attempt success (89.4% vs. 83.2%) and shorter procedure times (24.6 vs. 29.1 min) were observed with supraclavicular access.
• Supraclavicular access was independently associated with fewer complications (aOR 0.59) and longer complication-free survival.

Conclusions:

• Supraclavicular venous access for TPM implantation is safer and more efficient than infraclavicular access.
• This approach leads to better patient outcomes and reduced complication rates.
• Wider adoption could enhance safety, particularly in high-volume or resource-limited environments.