Key result
Temporary pacemaker strategy reduces the composite outcome of death and complications versus epicardial pacing.
Why the study?
Pacemaker-dependent patients with CIED infection require temporary pacing and delayed endocardial reimplantation or epicardial pacing before device extraction, but the optimal strategy remained to be compared.
Does temporary-pacemaker (TP) and delayed endocardial reimplantation reduce the composite outcome of all-cause death and complications compared to epicardial-pacing-system (EPI) in pacemaker-dependent patients after device extraction?
Meta-Analysis
Does temporary-pacemaker (TP) and delayed endocardial reimplantation reduce the composite outcome of all-cause death and complications compared to epicardial-pacing-system (EPI) in pacemaker-dependent patients after device extraction?
In pacemaker-dependent patients undergoing CIED extraction, a temporary pacemaker strategy with delayed endocardial reimplantation reduces death and complications compared to an epicardial pacing strategy, albeit with longer discharge times.
Answers are grounded in this paper and cite their sources.
Supports temporary-pacemaker strategy with delayed reimplantation post-extraction; extends meta-analytic evidence for fewer composite adverse events in pacemaker-dependent patients.
INTRODUCTION: Pacemaker-dependent (PM) patients with cardiac implantable electronic device (CIED) infection require implantation of a temporary-pacemaker (TP) and delayed endocardial reimplantation or implantation of an epicardial-pacing-system (EPI) before device extraction. Our aim was to compare the TP and EPI-strategy after CIED extraction through a meta-analysis. METHODS: We searched electronic databases up to 25 March 2022, for observational studies that reported clinical outcomes of PM-dependent patients implanted with TP or EPI-strategy after device extraction. CONCLUSION: TP-strategy led to a reduction of the composite outcome of all-cause death and complications, upgrading, reintervention on reimplanted CIED, and risk of increase in pacing threshold compared to EPI-strategy, with longer discharge time.
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Parlavecchio et al. (2023) conducted a meta-analysis in Cardiac implantable electronic device (CIED) infection in pacemaker-dependent patients. Temporary-pacemaker (TP) strategy vs. Epicardial-pacing-system (EPI) strategy was evaluated on Composite outcome of all-cause death and complications, upgrading, reintervention on reimplanted CIED, and risk of increase in pacing threshold (p== 0.01). Temporary-pacemaker strategy reduced the composite outcome of death, complications, upgrading, reintervention, and pacing threshold increase compared to epicardial pacing (P=0.01).
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