Temporary cardiac pacing : Experience in Prapokklao Hospital.

Abstract

Background : Temporary cardiac pacing is a life saving maneuver from malignant Bradycardia resultion from several causes, such as acute myocardial infarction, cardiovascular drugs usage, etc . The bradycardia from each cause may be appropriately treated with cardiac pacing at different time.

Objective : To study indications and complications of temporary cardiac pacings.

Method : This is a descriptive retrospective study of patients admitted in internal medicine wards of Prapokklao Hospital form July 2002 to August 2006. Their medical records were reviewed and data of temporary cardiac pacings were analysed.

Results : There were 101 attempts of temporary cardiac pacing among 100 patients (51 male, 49 female) Their causes of bradycardia consisted of acute coronary syndrome (ACS 45 percent), sick sinus syndrome (32 percent), cardiovascular drug usage (18 percent), hyperkalemia (2 percent) and others (3 percent). The pacing catheters were inserted through internal jugular veins 97 attempts and subclavian viens 4 attempts. Complications comprised Pneumothorax (1 percent),catheter- related bacteremia (2 percent), infection of incision wound (4 percent),exit site bleeding 19 percent, pacemaker malfunction 40.6 percent. of pacemaker malfunction requiring readjustment of the pacing catheters.

Conclusion : Temporary cardiac pacing for bradycardia,which may result from different causes, should be performed only when there is definite indication and the pacing catheter should be removed as soon as possible when the indication no longer exists, in order to reduce subsequent complications.

Key words : Temporary cardiac pacing, Pacemaker, pacemaker malfuncetion