Echo-guided insertion of temporary transvenous pacemakers significantly reduced median time to active pacing (22 vs. 43 minutes, p<0.01) and overall complication rates (15.0% vs. 28.8%, p=0.02).
Observational (n=203)
No
Does a fully echo-guided approach reduce time to active pacing and complication rates compared to standard fluoroscopic guidance in patients needing emergent temporary transvenous pacemaker placement?
Echo-guided insertion of temporary transvenous pacemakers through the jugular vein is a safe and feasible alternative that significantly reduces time to active pacing and complication rates compared to standard fluoroscopic guidance.
Absolute Event Rate: 22% vs 43%
p-value: p=<0.01
AIMS: To compare time to active pacing and complication rates associated with temporary transvenous pacemaker (TTVPM) insertion between a fully echo-guided approach of vein access and lead placement, and standard placement of TTVPM under fluoroscopic guidance. METHODS AND RESULTS: We performed a prospective single-center observational study enrolling all consecutive patients from 1 January 2008 to 31 December 2012 needing emergent TTVPM placement. According to personal experience and clinical setting, the operators could choose between a fully echo-guided approach of TTVPM placement through the jugular vein and a standard fluoro-guided approach through the femoral vein. Safety and efficacy endpoints were pre-specified, registered, and compared. A total of 113 patients were treated using the echo-guided approach, and 90 via the fluoro-guided approach. The two groups differed with regard to clinical setting at presentation: an acute coronary syndrome was more frequent in the fluoro-guided approach group (39.7% vs. 16.8%, p48 hours were observed less often in the echo-guided approach group (6.8 vs. 20.7%, p = 0.03). CONCLUSION: Echo-guided insertion of TTVPM through the jugular vein is a feasible and safe alternative to fluoroscopic guidance and may reduce complications and time to active pacing in patients who are not candidates for emergent cardiac catheterization.
Ferri et al. (Wed,) conducted a observational in Emergent temporary transvenous pacemaker (TTVPM) placement (n=203). Echo-guided TTVPM placement vs. Fluoroscopy-guided TTVPM placement was evaluated on Median time to active pacing (minutes) (p=<0.01). Echo-guided insertion of temporary transvenous pacemakers significantly reduced median time to active pacing (22 vs. 43 minutes, p<0.01) and overall complication rates (15.0% vs. 28.8%, p=0.02).
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