Temporary-Permanent Pacemakers are Associated with Better Clinical and
Safety Outcomes Compared to Balloon-Tipped Temporary Pacemakers
Abstract
Background Balloon Tipped Temporary Pacemakers (BTTP) are the
most used temporary pacemakers; however, they are associated with a risk
of dislodgement and thromboembolism. Recently, Temporary Permanent
Pacemakers (TPPM) have become increasingly used. Evidence of better
outcomes with TPPM compared to BTTP is still scarce. Materials
and methods Retrospective, chart review study evaluating all patients
who underwent temporary pacemaker placement between 2014 and 2022
(N=126) in the cardiac catheterization laboratory (CCL) at a level 1
trauma center. Primary outcome of this study is to evaluate the safety
profile of TPPM vs BTTP. Secondary objectives include patient ambulation
and healthcare utilization in patients with temporary pacemakers.
Results Both groups had similar baseline characteristics
distribution including gender, race and age at temporary pacemaker
insertion (p>0.05). Subclavian vein was the most common
site of access for the TPPM cohort (89.0%) vs the femoral vein in the
BTTP group (65.1%). Ambulation was only possible in the TPPM group
(55.6%, p<0.001). Lead dislodgement, venous thromboembolism,
local hematoma, and access site infections were less frequently
encountered in the TPPM group (OR = 0.23 [95% CI (0.10-0.67),
P<0.001]). Within the subgroup of patients with TPPM, 36.6%
of the patients were monitored outside the ICU setting. There was no
significant difference in the pacemaker related adverse events among
patients with TPPM based on their in-hospital setting.
Conclusion TPPM are associated with more favorable safety
profile compared to BTTP. They are also associated with earlier patient
ambulation and reduced healthcare utilization.