Study Outcomes
Our study’s primary objective aimed to evaluate the safety of temporary
permanent pacemakers through the assessment of temporary pacing-related
adverse events compared to balloon-tipped temporary pacemakers.
Secondary clinical outcomes included: i) Comparison of healthcare
utilization between the 2 pacing modalities and ii) patient ambulation.
The pacemaker related adverse events were defined as the composite of
venous thromboembolic events (VTE), pneumothorax/ hemothorax, lead
access site hematoma or infection, and lead dislodgement or/and loss of
capture. A standardized approach was applied for the care of all
patients with temporary pacemaker at our institution, including hygiene
protocols for infection prevention, VTE prophylaxis (unless
contraindicated for specified reasons), and a routine post procedure
chest x-ray to identify any possible mechanical complication and to
evaluate lead position. Deep venous thromboses were diagnosed by Duplex
Ultrasonography as clinically indicated.
As a standard practice, patients with BTTP are admitted to ICU setting.
At our institution, patients with TPPM are monitored on telemetry or
step-down unit if their clinical status otherwise does not warrant an
ICU stay. This allowed us to further assess healthcare utilization in
terms of total number of days pacing was required, as well as number of
days spent in ICU versus outside of ICU. To assess safety of TPPM
outside of ICU setting, we also compared pacemaker related adverse
events between the subsets of this group who did not require ICU level
of care to those requiring ICU admission.