Key result
Atrial spiral temporary pacing during LBBP links to ~0% electrode displacement risk and shorter procedures.
Why the study?
Temporary cardiac pacing is needed during left bundle branch pacemaker implantation, but the safety and efficiency of replacing femoral vein pacing with atrial spiral pacing in the right ventricle required evaluation.
Does atrial spiral pacing in the right ventricle improve procedural efficiency and safety compared to femoral vein pacing for temporary cardiac pacing during LBBP implantation?
Cohort (n=179)
Does atrial spiral pacing in the right ventricle improve procedural efficiency and safety compared to femoral vein pacing for temporary cardiac pacing during LBBP implantation?
Absolute Event Rate: 0% vs 4.85%
p-value: p=< 0.05
Using an atrial spiral pacing electrode in the right ventricle for temporary pacing during LBBP implantation is safe, reduces operation time and radiation dose, and avoids femoral puncture complications compared to traditional femoral vein pacing.
BACKGROUND: Left bundle branch pacemakers (LBBPs) can better maintain ventricular electrical synchronization than traditional right ventricular pacing (RVP). Temporary cardiac pacing (TCP) is needed to ensure the safety of the operation in patients undergoing LBBP. Currently, there are two methods of installing TCP in conventional permanent pacemaker implantation. HYPOTHESIS: To evaluate the safety and efficiency of replacing femoral vein pacing with atrial spiral pacing in the right ventricle for temporary cardiac pacing (TCP) during left bundle branch pacemaker (LBBP) implantation. METHOD: A total of 179 patients who underwent TCP during LBBP were selected for retrospective analysis from April 2019 to 2021 and divided into two groups: the atrial spiral electrode group (n = 76) and the femoral vein electrode group (n = 103). The following were observed: operation time; radiation dose; radiation time; operation expenses; hospitalization time; pacemaker parameters immediately after the operation and at 1 week, 1 month, 3 months, and 6 months after the operation; operation complications and femoral vein puncture point complications were observed in the two groups. RESULTS: Compared to the femoral vein electrode group, the atrial electrode group had significantly lower operation times ([116.86 ± 24.63] versus [128.94 ± 25.27] min, p < 0.05), radiation doses ([805.07 ± 132.94] versus [846.42 ± 87.37] mgy, p < 0.05), and decreased risk of a displaced or dislodged temporary pacing electrode during the operation ([0.00%] versus [4.85%], p < 0.05). The atrial electrode group did not have significant operation costs or material costs associated with femoral vein temporary pacing electrode implantation. In addition, the atrial electrode group did not have an increased risk of pacemaker-related infections, and the parameters of the pacemaker were unaffected. However, some puncture point complications appeared in the femoral vein electrode group (8 cases of local subcutaneous hematoma, 3 cases of pseudoaneurysms, 3 cases of arteriovenous fistula). CONCLUSION: The replacement of the femoral vein pacing electrode with an atrial spiral pacing electrode in the right ventricle for TCP during LBBP implantation was safe and effective.
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Li et al. (2023) conducted a cohort in Patients undergoing left bundle branch pacemaker (LBBP) implantation requiring temporary cardiac pacing (n=179). Atrial spiral pacing with electrodes placed at the right ventricle vs. Femoral vein pacing was evaluated on Displaced or dislodged temporary pacing electrode during the operation (p=< 0.05). Atrial spiral pacing for temporary cardiac pacing during LBBP implantation significantly reduced operation time (116.86 vs 128.94 min, p<0.05) and electrode displacement risk (0.00% vs 4.85%, p<0.05).
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