Key result
Transjugular temporary pacing is linked to ~3-minute shorter procedures vs transfemoral approach, with similar complications.
Why the study?
Few reports are available regarding which access route is best or preferred for emergency temporary pacemaker placement in tertiary hospitals.
Does the transjugular approach improve procedure times and complication rates compared to the transfemoral approach for temporary pacemaker placement?
Observational (n=732)
No
Does the transjugular approach improve procedure times and complication rates compared to the transfemoral approach for temporary pacemaker placement?
Absolute Event Rate: 9% vs 11.9%
p-value: p=<0.001
Transjugular insertion of temporary pacemakers is faster than transfemoral insertion and is preferable when pacing is required for more than 3 days due to a delayed risk of wire repositioning.
Transjugular temporary pacing was associated with shorter procedures and similar complications; leaves open preference for prolonged use pending randomized data.
Temporary pacemakers (TPMs) are usually inserted in an emergency situation. However, there are few reports available regarding which route of access is best or what the most preferred approach is currently in tertiary hospitals. This study aimed to compare procedure times, complication rates, and indications for temporary pacing between the transjugular and transfemoral approaches to TPM placement. We analyzed consecutive patients who underwent TPM placement. Indications; procedure times; and rates of complications including localized infection, any bleeding, and pacing wire repositioning rates were analyzed. A total of 732 patients (361 treated via the transjugular approach and 371 treated via the transfemoral approach) were included. Complete atrioventricular block was the most common cause of TPM placement in both groups, but sick sinus syndrome was especially common in the transjugular approach group. Separately, procedure time was significantly shorter in the transjugular approach group (9.0 ± 8.0 minutes vs. 11.9 ± 9.7 minutes; P < 0.001). Overall complication rates were not significantly different between the two groups, and longer duration of temporary pacing was a risk factor for repositioning. The risk of reposition was significantly increased when the temporary pacing was continued more than 5 days and 3 days in the transjugular approach group and the transfemoral approach group, respectively. The transjugular approach should be considered if the TPM is required for more than 3 days.
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Chun et al. (2020) conducted an observational in Temporary pacemaker placement (n=732). Transjugular approach vs. Transfemoral approach was evaluated on Procedure time (minutes) (p=<0.001). The transjugular approach for temporary pacemaker placement significantly reduced procedure time compared to the transfemoral approach (9.0 vs. 11.9 minutes, p<0.001), with no significant difference in overall complication rates.
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