Key result
Routine temporary epicardial pacing wires go unused in ~83% of patients after cardiac surgery.
Why the study?
Predictors for the need of temporary epicardial pacing wires after adult cardiac surgery and associated complications were not well defined to guide selective use.
What are the predictors for the need of temporary epicardial pacing wires after adult cardiac surgery?
Observational (n=112)
No
What are the predictors for the need of temporary epicardial pacing wires after adult cardiac surgery?
Routine placement of temporary epicardial pacing wires is not necessary after cardiac surgery, and selective use based on identified predictors is recommended.
Answers are grounded in this paper and cite their sources.
Supports selective use of temporary epicardial pacing wires; leaves open need for randomized confirmation before practice change.
Introduction: Temporary epicardial pacing wires (TEPW) have been routinely used in cardiac surgery in early postoperative period.Purpose of the study is to determine predictors for need of temporary pacing wires after surgery that will safely limit their usage and to document complications associated with the wires. Patients and Methods:This prospective study involved 112 patients operated at our institution from April 2010 to October 2010, who received TEPW following surgery.Surgical procedures included 34 isolated coronary revascularization, 51 valve replacement, 11 revascularization with valve replacement, 14 mitral reconstruction, 2 ascending aorta replacement.Results: Among 112 patients, 93 (83.1%) were never paced.Nineteen (16.9%) patients required pacing during weaning and 10 patients, required further pacing in intensive care unit.Indications for pacing included atrioventricular block in 7 (36.8%),sinus bradycardia in 2 (10.5%), junctional rhythm in 9 (47.4%) and low cardiac output in 1 (5.2%) patient.Atrioventricular block, junctional rhythm, postperfusion atrial fi brillation, inotropic agent requirement leaving the operating room, pacing requirement during weaning and mitral surgery are found to be the predictors for requirement of TEPWs.No complications were observed related with the use or removal of TEPWs.Conclusion: Routine placement of TEPWs is not necessary after cardiac surgery.Patients having rhythm disturbances after procedure and requiring pacemacer support during weaning of cardiopulmonary by-pass, require further pacemaker support in intensive care unit with higher probability.Depending on our data, because of potential complications related with use of wires, selective use of TEPWs for patients with identifi ed predictors can be recommended.
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Dönmez et al. (2013) conducted an observational in Adult cardiac surgery (n=112). Temporary epicardial pacing wires was evaluated on Requirement for temporary pacing during weaning from cardiopulmonary bypass or in the intensive care unit. Among patients receiving temporary epicardial pacing wires after cardiac surgery, 83.1% never required pacing, indicating that routine placement is unnecessary and can be selectively guided by clinical predictors.
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