Experience of Temporary Permanent Pacing: Indications, complications and outcomes

Abstract

Objective: Temporary permanent pacing (TPP) remains an underutilized yet crucial procedure involving active fixation leads connected to a pulse generator affixed to the patient's skin surface. We aim to conduct a retrospective study to examine the indications, duration, procedural complications, and outcomes of TPP interventions conducted at our center over a 2-year period.
Methods: This is a retrospective, single-centre observational study done in the Department of Cardiology & Electrophysiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research (SJICSR), a tertiary care medical centre in Bengaluru, Karnataka. This retrospective study examines the indications, duration, procedural complications, and outcomes of TPP interventions conducted at our centre over a 2-year period from December 2021 to December 2023.
Results: Seventeen patients underwent TPP, with 64.6% necessitating pacing during the postexplant/extraction period due to device-related infections. Additionally, 11.8% presented with complete heart block (CHB) and sepsis, while another 11.8% were post-aortic valve replacement patients experiencing sepsis with transient atrioventricular block. Singular cases comprised a CHB patient with stroke (5.9%) and a pre-operative CHB patient (5.9%). The mean TPP duration was 18.5±6.7 days (range: 10 to 30 days). Complications included superficial skin infection (11.9%) and lead dislodgment (5.8%), with no recorded mortalities.

Conclusion: Our findings, in conjunction with existing literature, affirm TPP as a safe and reliable pacing method for up to a one-month period. Encouraging education and broader adoption of TPP among emergency care providers and cardiologists is imperative.