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Background/Objectives: The use of temporary pacemakers is increasing every year. Conventional temporary pacemakers are connected to the myocardium via a passive-fixation lead (temporary pacing with passive fixation leads; TPPF), which compromises their effectiveness and safety. Off-label active-fixation systems (temporary pacing with active fixation leads; TPAF) are a safer alternative. The main objective of this study was to assess the clinical and economic impact of TPAF versus TPPF. Methods: We conducted a literature search based on the clinical outcomes of both pacing techniques. We then carried out a descriptive comparative analysis and extrapolated the results to the Spanish, European, and global populations. Results: Of the 1015 articles located, the analysis included five articles from ECTSF and eight from ECTEFA, prospective and focused on the recording of complications. It is estimated that the implementation of ECTEFA as the first option for ECT would lead to a 94.7% reduction in complications. In economic terms, it would mean a 55.72% reduction in the cost of the procedure. Conclusions: TPAF leads to considerable clinical improvement compared with TPPF. Furthermore, while the price of TPAF doubles the procedural cost, the reduced cost of hospital stays and treating complications means the active-fixation systems could substantially reduce the overall cost of temporary pacing for healthcare systems.

Background Patients with a temporary pacemaker (TPM) for bradycardias are required to maintain bedrest until permanent pacemakers (PPMs) are implanted because of the development of Adams–Stokes syndrome, worsening heart failure, or complications associated with TPMs is anticipated. However, bedrest may be detrimental in patients because it leads to disuse syndrome. This study examined whether bedrest could decrease the incidence of cardiovascular events or complications associated with TPMs in patients waiting for PPM implantation. Methods We conducted a retrospective cohort study on 88 patients who had emergency hospitalization for the treatment of bradycardias, and a TPM was inserted during the waiting period before PPM implantation. We divided patients into two groups according to whether they underwent bedrest (Bedrest Group) or not (Ambulation Group) during the period that patients were supported with TPM. We evaluated whether bedrest was a predictor of adverse events using a logistic regression analysis. Results Adverse events occurred in 31 patients (35%). In the univariate analysis, there was no significant difference in the incidence of adverse events between the Bedrest and Ambulation Groups (39% vs. 29%). In the logistic regression analysis, bedrest was not a predictor of adverse events (odds ratio, 1.40; 95% confidence interval, 0.53‐3.68, P = .497). Conclusions In patients with TPMs for bradyarrhythmias during the waiting period for PPM implantations, bedrest might not prevent adverse events, such as cardiovascular events and complications associated with TPMs. Bedrest might not prevent cardiovascular events or device complications in patients with a temporary pacemaker for bradyarrhythmias during the waiting period for permanent pacemaker implantation.

Transvenous temporary cardiac pacing (TTCP) is a lifesaving procedure, but the incidence of complications and prognosis depends on the underlying cause. The aim of this study was to compare the characteristics, complications, and prognosis in patients with myocardial infarction (MI) requiring TTCP vs. patients with TTCP due to other causes. The present analysis involved 244 cases in whom TTCP was performed between 2017 and 2021 in a high-volume cathlab. All the procedures were performed by an interventional cardiologist. MI constituted 46.3% of the patients (n = 113), including 63 ST-segment elevation MI patients (55.75%). Non-MI patients (control group) consisted of patients with any cause of bradycardia requiring TTCP. Myocardial infarction patients requiring TTCP are younger and have a higher prevalence of hypertension and heart failure. The pacing lead is more frequently inserted during asystole/resuscitation, and pacing was needed for a longer time. MI patients required cardiac implantable electronic device implantation less frequently than in other causes (22% vs. 82%, p < 0.01). The incidence of TTCP complications did not differ. The incidence of in-hospital death was 6.5-fold higher in TTCP patients with MI. Logistic regression showed MI to be a strong predictor of in-hospital death (odds ratio: 8.1; 95% confidence interval: 1.3-57.9). In-hospital mortality in MI patients requiring TTCP is 6.5-fold higher than in other patients with bradycardia. The complication rate of TTCP is similar in MI and non-MI patients. It is not TTCP but the severity of MI itself and the fact that a pacing lead is frequently implanted in asystole or during resuscitation that is responsible for the higher mortality rate.

Introduction Prolonged sinus pause (PSP) after atrial fibrillation (AF) termination shortly after catheter ablation seems to be a reversible phenomenon without further need for pacemaker implantation (PMI). However, no mature management strategy has been established. Methods In this prospective observational study, we included consecutive patients who developed PSP ≥ 3 s upon AF termination during hospitalization following AF ablation at our center between October 2020 and October 2022. Regular follow‐up was conducted. Results Twelve patients (mean age 66.3 ± 8.5 years; 7 females) were included. PSP ≥ 3 s upon AF termination initiated at a median of 2.0 days (IQR: 1.3–3.8) post‐ablation and resolved by 5.0 days (IQR: 3.5–7.5). Three patients received temporary PMI, all of which were removed before discharge without further pacing. One patient underwent permanent PMI during hospitalization due to Adams‐Stokes syndrome. After discharge, one patient received permanent pacing for symptomatic sinus arrest at 3 months, and another underwent atrioventricular node ablation followed by permanent pacing due to recurrent arrhythmia. The remaining patients had no related symptoms or need for pacing during follow‐up. Conclusion PSP ≥ 3 s upon AF termination shortly after catheter ablation appears to be reversible. A watch‐and‐wait strategy was practical. Management may involve discontinuation of antiarrhythmic drugs or temporary pacing support. A small proportion of patients may ultimately require permanent PMI. Twelve of the 1330 patients who underwent AF catheter ablation showed PSP ≥ 3 s after AF termination post ablation. The temporal characteristics of PSP were described. Nine of the 12 patients had no need for permanent pacing. We concluded that a ‘watch‐and‐wait’ strategy could be adopted in these patients.

Abstract Background Temporary pacemaker lead implantation is a common low-risk procedure, but can occasionally get complicated by infections, arrhythmias, thromboembolic events, and perforation of the vessel or the heart. However, intracardiac knotting of the temporary pacemaker lead has been rarely reported. This could lead to vascular or valvular injury, pneumothorax, symptomatic loss of pacing or haemodynamic compromise, and difficult lead removal. Case summary We are reporting a case of twice twice-knotted temporary pacemaker lead, which to our knowledge has not been reported before. The two knots in the transjugularly inserted temporary pacemaker lead, via a 6F venous sheath made it difficult to retrieve it. Discussion We decided to snare the knotted TPI into the inferior vena cava, and then retrieve it via a large-size femoral sheath, thus avoiding the need for a venotomy or any surgical intervention.

Background There is little literature on the use of temporary pacemakers in children with fulminant myocarditis. Therefore, we summarized the use of temporary cardiac pacemakers in children with fulminant myocarditis in our hospital. Methods The clinical data of children with fulminant myocarditis treated with temporary pacemakers in Wuhan Children’s Hospital from January 2017 to May 2022 were retrospectively analyzed. Results A total of 6 children were enrolled in the study, including 4 boys and 2 girls, with a median age of 50 months and a median weight of 15 kg. The average time from admission to pacemaker placement was 2.75 ± 0.4 h. The electrocardiogram showed that all 6 children had third-degree atrioventricular block (III°AVB). The initial pacing voltage, the sensory sensitivity of the ventricle and the pacing frequency were set to 5–10 mV, 5 V and 100–120 bpm respectively. The sinus rhythm was recovered in 5 patients within 61 h (17–134) h, and the median time of using temporary pacemaker was 132 h (63–445) h. One of the children had persistent III°AVB after the temporary pacemaker. With parental consent, the child was fitted with a permanent pacemaker on the 12th day of his illness. Conclusions When fulminant myocarditis leads to severe bradycardia or atrioventricular block in children, temporary pacemakers have the characteristics of high safety to improve the heart function.

Background Temporary pacemaker (TPM) implantation is a critical intervention for managing symptomatic bradyarrhythmias. While infraclavicular access via subclavian or internal jugular veins is commonly used, the supraclavicular approach has emerged as a promising alternative with potential benefits in safety and procedural efficiency. However, data comparing these approaches, particularly in resource‐limited settings, remain limited. Methods We conducted a retrospective observational study at a tertiary care center, evaluating all patients who underwent TPM implantation via either supraclavicular or infraclavicular venous access between January 2020 and December 2024. Baseline characteristics, procedural success, complications, and outcomes were compared. Multivariate logistic regression identified predictors of complications. A ROC curve and Kaplan–Meier analysis were used to evaluate model performance and complication‐free survival. Results Of 3569 patients, 1644 received supraclavicular access and 1925 received infraclavicular access. The supraclavicular group had a significantly lower overall complication rate (9.3% vs. 14.8%, p < 0.001), including fewer arterial punctures, pneumothoraces, lead dislodgements, and hematomas. First‐attempt success (89.4% vs. 83.2%, p < 0.001) and mean procedure time (24.6 ± 7.8 min vs. 29.1 ± 9.4 min, p < 0.001) were also better with supraclavicular access. On multivariate analysis, supraclavicular access was independently associated with fewer complications (adjusted OR 0.59, p < 0.001). Kaplan–Meier analysis showed longer complication‐free survival in the supraclavicular group (log‐rank p = 0.01). Conclusions Supraclavicular venous access for TPM implantation is associated with fewer complications, greater procedural efficiency, and improved patient outcomes compared to infraclavicular access. Wider adoption may improve safety in high‐volume or resource‐limited settings. This study compared supraclavicular versus infraclavicular venous access for temporary pacemaker implantation in 3569 patients. Supraclavicular access showed fewer complications, higher first‐attempt success, shorter procedure time, and improved complication‐free survival. Findings suggest supraclavicular access is a safer, more efficient approach, particularly beneficial in high‐volume and resource‐limited healthcare settings.

Background and objectivesAtrioventricular block (AVB) is a serious complication following coronary artery bypass grafting (CABG) surgery, and its high-grade form may necessitate the implantation of a permanent pacemaker (PPM). AVB is associated with increased morbidity and mortality rates. This study aims to estimate the incidence of AVB and subsequent PPM implantation after isolated CABG surgery.Material and methodsWe searched electronic databases of PubMed, Embase, and Scopus from inception to 18 November 2022. Clinical trials and observational studies reporting the incidence of post-CABG AVB or subsequent PPM implantation in adult patients were included. The total incidence for all included outcomes was calculated using the inverse variance method, and the I 2 statistic was reported to evaluate the heterogeneity of studies.ResultsA total of 28 studies met the inclusion criteria. Four studies [3 cohorts, 1 randomized controlled trial (RCT)] reported AVB without specifying its type; one (cohort) reported different degrees of AVB, 20 (12 cohorts, 8 RCTs) reported complete heart block (CHB) (or AVB requiring temporary pacing), and nine (8 cohorts, 1 RCT) reported the number of PPM inserted due to AVB. The pooled incidence of AVB, CHB (or AVB requiring temporary pacing), and PPM due to AVB was 1.16%, 1.73%, and 0.58%, respectively. Meta-regression analysis revealed that age, gender, diabetes, hypertension, hyperlipidemia, or smoking were not significantly associated with AVB, CHB, or PPM implantation.ConclusionThis study highlights the incidence of AVB and the need for PPM implantation following CABG surgery. The findings emphasize the importance of postoperative monitoring and surveillance to improve patient outcomes.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022377181, identifier PROSPERO CRD42022377181.

BackgroundDamage to the cardiac conduction system requiring permanent pacemaker (PPM) implantation is a known adverse outcome of transcatheter aortic valve replacement (TAVR). A permanent-temporary pacemaker (PTPM) is a device that involves an active-fixation lead attached to an external pulse generator taped to the skin. We reviewed the utility of PTPMs as a temporary bridge measure after TAVR in patients with conduction abnormalities that do not meet conventional criteria for PPM placement.MethodsBetween January 01, 2013 and December 31, 2015, we analyzed 67 patients who received PTPM after TAVR. Baseline demographics, comorbidities, type and size of the valve, pre-TAVR electrocardiograms (ECGs), post-TAVR ECGs at 1 day, 1 month, and 6 months, and pacemaker interrogation results were reviewed for each patient if available.ResultsThe mean age of patients was 80.5 ± 9.1 years. PTPM were placed for 2.3 ± 2.4 days. Among these patients, 44.8% (n = 30) received a PPM prior to discharge. Male gender (OR 2.84, 95% CI 1.05–7.69, p = 0.05) and an increase in QRS duration post-TAVR (p = 0.01) were associated with PPM placement. Pacemaker interrogation data of 11 patients with PPM revealed that 27% (n = 3) had < 1% V-pacing requirements and < 10% A-pacing requirements.ConclusionsIn post-TAVR patients who develop conduction abnormalities that do not meet conventional PPM implantation indications, PTPM safely provides a time period for further assessment and may prevent unnecessary PPM implantation. Male gender and an increase in QRS duration post-TAVR are associated with PPM implantation. Additionally, some patients may recover from their conduction disturbances and demonstrate low pacemaker utilization.