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Routine Versus Selective Temporary Epicardial Pacing Wire Placement: A Scoping Review.

Oluwakorede Akele1, Evans Osuji2, Vaishvik Patel3

  • 1Department of Medicine, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, 06030, CT, USA. oakele@uchc.edu.

Surgery Today
|June 15, 2026
PubMed
Summary

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This summary is machine-generated.

Routine placement of temporary epicardial pacing wires (TEPWs) in cardiac surgery often leads to underutilization. Selective TEPW strategies improve use and reduce unnecessary procedures.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Electrophysiology

Background:

  • Temporary epicardial pacing wires (TEPWs) are commonly used for rhythm management post-cardiac surgery.
  • Debate exists regarding routine versus selective TEPW placement due to low utilization and potential risks.

Purpose of the Study:

  • To compare routine and selective TEPW placement strategies.
  • To assess TEPW utilization, associated complications, and predictors for pacing necessity.

Main Methods:

  • A scoping review was conducted following PRISMA-ScR guidelines.
  • Searched major databases (PubMed, Embase, Scopus, Cochrane Library) until June 2025.
  • Included 11 studies (16,874 patients) examining TEPW strategies in adult and pediatric cardiac surgery.

Main Results:

Keywords:
Cardiac surgeryPostoperative arrhythmiasPredictors of pacing needRoutine placementSelective placementTemporary epicardial pacing wires

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  • Routine TEPW placement rates were high (73.5%-89.9%), but actual utilization was low (2.9%-29.6%).
  • Selective strategies demonstrated higher utilization (30%-100%) with fewer unused wires.
  • Predictors for TEPW need included intraoperative arrhythmias, prolonged cardiopulmonary bypass (CPB), and complex procedures; complications were infrequent.

Conclusions:

  • Routine TEPW placement frequently results in unnecessary wire use.
  • Selective TEPW strategies, guided by clinical and intraoperative predictors, can optimize patient care.
  • A risk-based decision tool could improve TEPW management and reduce procedural burden.