Dataset Information

Inadvertent temporary pacemaker lead placement in aortic sinus.

ABSTRACT: Inadvertent placement of pacing leads into abnormal locations is potentially very dangerous. However, in emergency situations and without fluoroscopic guidance, these complications do occur. We report a case of an elderly male who underwent temporary pacemaker lead implantation without fluoroscopic guidance for cardiac arrest, but later the pacemaker lead was found to be in the non-coronary aortic sinus, but still capturing the myocardium. Interestingly, the post-pacing electrocardiography was mimicking atrial pacing.

SUBMITTER: Garg N

PROVIDER: S-EPMC3970375 | biostudies-literature | 2013 Oct

REPOSITORIES: biostudies-literature

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Inadvertent temporary pacemaker lead placement in aortic sinus.

Garg Naveen N Moorthy Nagaraja N

Heart views : the official journal of the Gulf Heart Association 20131001 4

Inadvertent placement of pacing leads into abnormal locations is potentially very dangerous. However, in emergency situations and without fluoroscopic guidance, these complications do occur. We report a case of an elderly male who underwent temporary pacemaker lead implantation without fluoroscopic guidance for cardiac arrest, but later the pacemaker lead was found to be in the non-coronary aortic sinus, but still capturing the myocardium. Interestingly, the post-pacing electrocardiography was m ...[more]

PMID: 24696761

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Project description:BackgroundFluoroscopic guidance is the traditional method for the implantation of transvenous temporary cardiac pacemakers (TVTPs). This study aimed to compare the time, effectiveness, and safety of real-time three-dimensional transesophageal echocardiography (3D TEE) with those of fluoroscopy in guiding TVTP implantation.MethodsThe records of patients who underwent transcatheter aortic valve implantation (TAVI) guided by real-time 3D TEE or fluoroscopy between July 1, 2016, and June 30, 2020, were retrospectively analyzed. TVTPs were implanted by anesthesiologists via the right internal jugular vein (IJV) in the real-time 3D TEE-guided group (3D TEE group), and by interventional cardiologists via the femoral vein in the fluoroscopy-guided group (fluoro group).ResultsA total of 143 patients (3D TEE-group n=79, and fluoro group n=64) were included. No statistical differences were observed in the baseline characteristics of the two groups. TVTPs were successfully implanted in all of the patients. The needle-to-pace time was significantly shorter in 3D TEE group than in fluoro group (5.2±2.9 vs. 8.5±4.6 min, P<0.001). Further, the incidence of access complications was significantly lower in 3D TEE group than in fluoro group (3.8% vs. 12.5%, P<0.05). One patient in fluoro group who suffered cardiac perforation underwent drainage via pericardiocentesis. No patients in either group died because of TVTP placement. The total complication rates were significantly lower in 3D TEE group than in fluoro group (19.0% vs. 39.1%, P<0.05). No statistically significant differences existed between groups in terms of pacing threshold, the incidence of permanent pacemaker insertion after surgery, the length of postoperative intensive care unit (ICU) stay, or the duration of postoperative hospitalization.ConclusionsReal-time 3D TEE-guided can be used to effectively, quickly, and safely guide TVTP implantation. The procedure can be performed by properly trained anesthesiologists. Therefore, real-time 3D TEE is a suitable option for guiding perioperative TVTP implantation in patients undergoing cardiac surgery.

Dataset Information

Inadvertent temporary pacemaker lead placement in aortic sinus.

Publications

Inadvertent temporary pacemaker lead placement in aortic sinus.

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