What question did this study set out to answer?

To compare the short-term hospital morbidity, length of stay, and two-year failure rates of transvenous, transmediastinal, and transthoracic ventricular pacing electrode systems.

March 1, 1974CirculationOpen Access

Transvenous, Transmediastinal, and Transthoracic Ventricular Pacing:

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Why the study?

Does the approach to ventricular pacing (transvenous vs transmediastinal vs transthoracic) affect hospital morbidity, length of stay, and long-term electrode failure rates?

Population

205 patients receiving a total of 247 electrode systems for permanent ventricular pacing

Comparison

Transvenous ventricular pacing (n=129 systems) vs Transmediastinal and transthoracic ventricular…

Design

Cohort

Follow-up

24 months

Authors

ABAlan S. BrennerDuke University GWGalen S. WagnerElectrophysiology SAS. T. AndersonJohns Hopkins University

Discussion

Member takes

Implication

Transvenous pacing was associated with lower early morbidity but higher long-term failure; leaves open optimal approach without randomized data.

Key Points

To compare the short-term hospital morbidity, length of stay, and two-year failure rates of transvenous, transmediastinal, and transthoracic ventricular pacing electrode systems.
Evaluated 205 patients receiving a total of 247 ventricular pacing electrode systems across three surgical approaches.
Tracked 129 transvenous, 68 transmediastinal, and 50 transthoracic systems through a complete uniform 2-year follow-up.
Transvenous pacing showed lower hospital morbidity (19%) and shorter stays (75% ≤ 8 days) compared to transmediastinal (35% morbidity; 57% > 8 days) and transthoracic pacing (34% morbidity; 70% > 8 days).
Cumulative 24-month electrode failure was higher in transvenous systems (38%, primarily due to dislodgement) than in transmediastinal (16%) or transthoracic systems (11%).
Transmediastinal right epicardial leads uniquely exhibited threshold elevation, late failure, and elevated sudden death occurrences between 6 and 12 months post-implantation.

Structured PICO

Does the approach to ventricular pacing (transvenous vs transmediastinal vs transthoracic) affect hospital morbidity, length of stay, and long-term electrode failure rates?

Population

205 patients receiving a total of 247 electrode systems for permanent ventricular pacing

Intervention

Transvenous ventricular pacing (n=129 systems)

Comparator

Transmediastinal (n=68 systems) and transthoracic (n=50 systems) ventricular pacing

Outcome

Hospital morbidity, length of hospital stay, and electrode failure at 24 monthssafety

Transvenous pacing offers lower initial hospital morbidity but higher long-term failure rates compared to transmediastinal and transthoracic approaches, highlighting the need for improved electrode fixation technologies.

Cite This Study

Brenner et al. (1974) studied this question.

synapsesocial.com/papers/6a84811d7e95b97f4e73079a https://doi.org/10.1161/01.cir.49.3.407

Topics

Hypertension management

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Implication

Transvenous pacing was associated with lower early morbidity but higher long-term failure; leaves open optimal approach without randomized data.

Transvenous, Transmediastinal, and Transthoracic Ventricular Pacing:

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Transvenous, Transmediastinal, and Transthoracic Ventricular Pacing:

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider