The initial U.S. experience with the Tempo active fixation temporary pacing lead in structural heart interventions
- PMID: 31478304
- DOI: 10.1002/ccd.28476
The initial U.S. experience with the Tempo active fixation temporary pacing lead in structural heart interventions
Abstract
Objectives: This multicenter retrospective study of the initial U.S. experience evaluated the safety and efficacy of temporary cardiac pacing with the Tempo® Temporary Pacing Lead.
Background: Despite increasing use of temporary cardiac pacing with the rapid growth of structural heart procedures, temporary pacing leads have not significantly improved. The Tempo lead is a new temporary pacing lead with a soft tip intended to minimize the risk of perforation and a novel active fixation mechanism designed to enhance lead stability.
Methods: Data from 269 consecutive structural heart procedures were collected. Outcomes included device safety (absence of clinically significant cardiac perforation, new pericardial effusion, or sustained ventricular arrhythmia) and efficacy (clinically acceptable pacing thresholds with successful pace capture throughout the index procedure). Postprocedure practices and sustained lead performance were also analyzed.
Results: The Tempo lead was successfully positioned in the right ventricle and achieved pacing in 264 of 269 patients (98.1%). Two patients (0.8%) experienced loss of pace capture. Procedural mean pace capture threshold (PCT) was 0.7 ± 0.8 mA. There were no clinically significant perforations, pericardial effusions, or sustained device-related arrhythmias. The Tempo lead was left in place postprocedure in 189 patients (71.6%) for mean duration of 43.3 ± 0.7 hr (range 2.5-221.3 hr) with final PCT of 0.84 ± 1.04 mA (n = 80). Of these patients, 84.1% mobilized out of bed with no lead dislodgment.
Conclusion: The Tempo lead is safe and effective for temporary cardiac pacing for structural heart procedures, provides stable peri and postprocedural pacing and allows mobilization of patients who require temporary pacing leads.
Keywords: balloon valvuloplasty; electrophysiology; pacemaker; tamponade; temporary pacing; transcatheter aortic valve replacement.
© 2019 Wiley Periodicals, Inc.
Comment in
-
The new era of ventricular pacing during structural interventions.Catheter Cardiovasc Interv. 2020 Apr 1;95(5):1057-1058. doi: 10.1002/ccd.28868. Catheter Cardiovasc Interv. 2020. PMID: 32294324
References
REFERENCES
-
- Webb JG, Pasupati S, Achtem L, Thompson CR. Rapid pacing to facilitate transcatheter prosthetic heart valve implantation. Catheter Cardiovasc Interv. 2006;68:199-204.
-
- Auffret V, Puri R, Urena M, et al. Conduction disturbances after transcatheter aortic valve replacement: current status and future perspectives. Circulation. 2017;136:1049-1069.
-
- Siontis GC, Juni P, Pilgrim T, et al. Predictors of permanent pacemaker implantation in patients with severe aortic stenosis undergoing TAVR. A Meta-Anal J Am Coll Cardiol. 2014;64:129-140.
-
- Fitzgerald P, Kusumoto F. The effects of septal myectomy and alcohol septal ablation for hypertrophic cardiomyopathy on the cardiac conduction system. J Interv Card Electrophysiol. 2018;52:403-408.
-
- Metkus TS, Schulman SP, Marine JE, Eid SM. Complications and outcomes of temporary transvenous pacing: an analysis of >360,000 patients from the National Inpatient Sample. Chest. 2019;155:749-757.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical