Key result
Temporary transvenous pacing is linked to myocardial injury in ~91% of patients.
Why the study?
Temporary transvenous cardiac pacing leads can penetrate or perforate the right ventricular wall, but the extent of associated myocardial injury was not well evaluated.
Does temporary transvenous cardiac pacing cause myocardial injury in patients undergoing non-cardiac procedures?
Observational (n=22)
Does temporary transvenous cardiac pacing cause myocardial injury in patients undergoing non-cardiac procedures?
Temporary transvenous cardiac pacing is associated with a high incidence of myocardial injury as evidenced by significant troponin elevation.
Suggests caution with temporary pacing in non-cardiac procedures; leaves open effects on outcomes and need for prospective confirmation.
Introduction: It is not unusual for temporary transvenous cardiac pacing (TVCP) leads to penetrate and occasionally perforate the right ventricular wall, which generally is asymptomatic. The definition of myocardial injury is evidence of elevated cardiac troponin (cTn) values above the 99th percentile upper reference limit (URL). Myocardial injury is associated with an adverse prognosis. The present study was designed to evaluating myocardial injury complicated by TVCP. Methods: Retrospective study from August 2018 to March 2020, 33 consecutive patients undergo elective TVCP support for non-cardiac procedures, 22 of them had cardiac biomarkers assays before and after TVCP. These 22 eligible patients had a median age of 66 (50-83) years, 6 (27.3%) were women, and all baseline cTn <1 URL. Compare cardiac biomarkers before and after TVCP. Results: 20 (91%, N=22) patients detect cTn >1 URL after pacing. Paired t-test compare before and after pacing leads insertion showed a mean cTn elevation of 3.599 (95% CI, 1.566 to 5.632, P<0.01）URL, and no significantly creatine kinase-MB elevation of 0.1550 (95% CI, -0.01239 to 0.3224, P>0.05 ) URL. Conclusion: This study demonstrates a high incidence of substantial myocardial injury by TVCP, which should be concerned.
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Liu et al. (2020) conducted an observational in Patients requiring elective temporary transvenous cardiac pacing for non-cardiac procedures (n=22). Temporary transvenous cardiac pacing (TVCP) vs. Baseline (before TVCP) was evaluated on Myocardial injury (elevated cardiac troponin >1 URL) (Mean difference 3.599 URL, 95% CI 1.566-5.632, p=<0.01). Temporary transvenous cardiac pacing caused myocardial injury in 91% of patients, with a mean cardiac troponin elevation of 3.599 URL compared to baseline (95% CI 1.566-5.632; P<0.01).
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