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(Chest. 1973;64:604-608.)
© 1973 American College of Chest Physicians

Temporary Transvenous Pacemaker Therapy: An Analysis of Complications

Francis J. Lumia M.D.1 and Jorge C. Rios M.D.2

1 George Washington University Medical Center, Washington, D.C.
2 Associate Professor of Medicine and Director, ECG Laboratory

A systematic study of the complications resulting from temporary transvenous endocardial pacing was conducted. One hundred thirteen patients requiring insertion of 142 temporary transvenous pacemaker catheters were evaluated. On 61 occasions the pacemakers were introduced through the brachial vein, and on 81 the femoral vein approach was utillized. Evidence of pacemaker malfuction, manifested as failure to capture or to sense spontaneous QRS, was encountered in 95 seprate episodes or 43 percent of the total instances of insertion. Malfunction occurred in 45.9 percent of catheter pacemakers inserted through the arm vein and 40.7 percen of catheter pacemakers inserted through the femoral vein. Complications from transvenous endocardial pacing consisted primarily of ventrucular tachycardia-fibrillation, myocardial perforation, pulmonary emboli, hematoma or absess at the insertion sit. Thiry-two complications were encountered in 24 instances of pacemaker therapy or 16.9 percent of the total. No deaths could be directly attrubutable to the complications of cardiac pacing. The high incidece of malfuncitons detected during constant electrocardiographic surveillance indiacate that, although temporary transvenous pacing is a safe technique, the availbility of continuous electrocardiographic monitoring must be considered a prerequisite for the extensive use of temporary pacing. No significant difference could be demonstrated in the incidence of malfunction or complications from the two most commonly used sites of pacemaker insertion.

Submitted on March 27, 1973
Accepted on May 7, 1973




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[Abstract] [Full Text] [PDF]


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Copyright © 1973 by the American College of Chest Physicians.