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Published in: General Thoracic and Cardiovascular Surgery 7/2022

02-06-2022 | Heart Surgery | Review Article

Temporary epicardial pacing wires post-cardiac surgery: a literature review

Author: Lucy Manuel

Published in: General Thoracic and Cardiovascular Surgery | Issue 7/2022

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Abstract

Background

Although epicardial pacing wires are routinely inserted after cardiac surgical procedures, there is little in the medical literature to help standardise their use and identify associated risks and benefits. Much of the decision-making surrounding pacing wires are based on the surgeon’s preference and vary highly between centers.

Methods

A literature review was conducted exploring the evidence, indications, and current practice for temporary pacing wires. Risk factors for developing post-operative arrhythmias necessitating use of temporary pacing wires and complications were also reviewed.

Conclusions

Although temporary epicardial pacing wires have a crucial role to play in the post-operative recovery period, the current literature suggests that they should be considered on an individual basis in all high-risk patients including increased age, low ejection fraction, diabetes mellitus, elevated pulmonary artery pressures, prolonged cross clamp time, pacing required to wean from bypass, pre-operative arrhythmia, and multiple valvular and transplant operations. Although complications from pacing wires are low, this figure is likely underreported and further studies are required to focus on the risks and benefits of insertion.
Literature
1.
go back to reference AlWaqfi N, Ibrahim K, Khader Y, Baker A. Predictors of temporary epicardial pacing wires use after valve surgery. J Cardiothorac Surg. 2014;9(1):33.CrossRef AlWaqfi N, Ibrahim K, Khader Y, Baker A. Predictors of temporary epicardial pacing wires use after valve surgery. J Cardiothorac Surg. 2014;9(1):33.CrossRef
2.
go back to reference Chua J, Schwarzenberger J, Mahajan A. Optimization of pacing after cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 2012;26(2):291–301.CrossRef Chua J, Schwarzenberger J, Mahajan A. Optimization of pacing after cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 2012;26(2):291–301.CrossRef
3.
go back to reference Lazarescu C, Kara-Mostefa S, Parlanti JM, Clavey M, Mertes PM, Longrois D. Reassessment of the natural evolution and complications of temporary epicardial wires after cardiac surgery. J Cardiothorac Vasc Anesth. 2014;28(3):506–11.CrossRef Lazarescu C, Kara-Mostefa S, Parlanti JM, Clavey M, Mertes PM, Longrois D. Reassessment of the natural evolution and complications of temporary epicardial wires after cardiac surgery. J Cardiothorac Vasc Anesth. 2014;28(3):506–11.CrossRef
4.
go back to reference Peretto G, Durante A, Limite LR, Cianflone D. Postoperative arrhythmias after cardiac surgery: incidence, risk factors, and therapeutic management. Cardiol Res Pract. 2014;2014:615987.CrossRef Peretto G, Durante A, Limite LR, Cianflone D. Postoperative arrhythmias after cardiac surgery: incidence, risk factors, and therapeutic management. Cardiol Res Pract. 2014;2014:615987.CrossRef
5.
go back to reference Abu-Omar YG-WL, Taggart DP. Indications and positioning of temporary pacing wires. Multimed Man Cardio Thorac Surg. 2006;2006(0512):1248.CrossRef Abu-Omar YG-WL, Taggart DP. Indications and positioning of temporary pacing wires. Multimed Man Cardio Thorac Surg. 2006;2006(0512):1248.CrossRef
6.
go back to reference Dhonnchú TNGA, Walcot N. Postoperative care of adult cardiac surgery patients. Surgery. 2015;33(2):57–61. Dhonnchú TNGA, Walcot N. Postoperative care of adult cardiac surgery patients. Surgery. 2015;33(2):57–61.
7.
go back to reference Elmi F, Tullo NG, Khalighi K. Natural history and predictors of temporary epicardial pacemaker wire function in patients after open heart surgery. Cardiology. 2002;98(4):175–80.CrossRef Elmi F, Tullo NG, Khalighi K. Natural history and predictors of temporary epicardial pacemaker wire function in patients after open heart surgery. Cardiology. 2002;98(4):175–80.CrossRef
8.
go back to reference Bethea BT, Salazar JD, Grega MA, Doty JR, Fitton TP, Alejo DE, et al. Determining the utility of temporary pacing wires after coronary artery bypass surgery. Ann Thorac Surg. 2005;79(1):104–7.CrossRef Bethea BT, Salazar JD, Grega MA, Doty JR, Fitton TP, Alejo DE, et al. Determining the utility of temporary pacing wires after coronary artery bypass surgery. Ann Thorac Surg. 2005;79(1):104–7.CrossRef
9.
go back to reference Batra A, Balaji S. Post operative temporary epicardial pacing: when, how and why? Ann Pediatr Cardiol. 2008;1(2):120–5.CrossRef Batra A, Balaji S. Post operative temporary epicardial pacing: when, how and why? Ann Pediatr Cardiol. 2008;1(2):120–5.CrossRef
10.
go back to reference Reade MC. Temporary epicardial pacing after cardiac surgery: a practical review: part 1: general considerations in the management of epicardial pacing. Anaesthesia. 2007;62(3):264–71.CrossRef Reade MC. Temporary epicardial pacing after cardiac surgery: a practical review: part 1: general considerations in the management of epicardial pacing. Anaesthesia. 2007;62(3):264–71.CrossRef
11.
go back to reference Antal Dönmez ATS, Yayla Tunçer E, Adademir T, Yazıcı S, Köksal C, et al. Temporary epicardial pacing after adult cardiac surgery. Kosuyolu Kalp Dergisi. 2013;2013(2):133–8.CrossRef Antal Dönmez ATS, Yayla Tunçer E, Adademir T, Yazıcı S, Köksal C, et al. Temporary epicardial pacing after adult cardiac surgery. Kosuyolu Kalp Dergisi. 2013;2013(2):133–8.CrossRef
12.
go back to reference Tisdale JE, Patel R, Webb CR, Borzak S, Zarowitz BJ. Electrophysiologic and proarrhythmic effects of intravenous inotropic agents. Prog Cardiovasc Dis. 1995;38(2):167–80.CrossRef Tisdale JE, Patel R, Webb CR, Borzak S, Zarowitz BJ. Electrophysiologic and proarrhythmic effects of intravenous inotropic agents. Prog Cardiovasc Dis. 1995;38(2):167–80.CrossRef
13.
go back to reference Jowett V, Hayes N, Sridharan S, Rees P, Macrae D. Timing of removal of pacing wires following paediatric cardiac surgery. Cardiol Young. 2007;17(05):512–6.CrossRef Jowett V, Hayes N, Sridharan S, Rees P, Macrae D. Timing of removal of pacing wires following paediatric cardiac surgery. Cardiol Young. 2007;17(05):512–6.CrossRef
14.
go back to reference Merin O, Ilan M, Oren A, Fink D, Deeb M, Bitran D, et al. Permanent pacemaker implantation following cardiac surgery: indications and long-term follow-up. Pacing Clin Electrophysiol. 2009;32(1):7–12.CrossRef Merin O, Ilan M, Oren A, Fink D, Deeb M, Bitran D, et al. Permanent pacemaker implantation following cardiac surgery: indications and long-term follow-up. Pacing Clin Electrophysiol. 2009;32(1):7–12.CrossRef
15.
go back to reference Glikson M, Dearani JA, Hyberger LK, Schaff HV, Hammill SC, Hayes DL. Indications, effectiveness, and long-term dependency in permanent pacing after cardiac surgery. Am J Cardiol. 1997;80(10):1309–13.CrossRef Glikson M, Dearani JA, Hyberger LK, Schaff HV, Hammill SC, Hayes DL. Indications, effectiveness, and long-term dependency in permanent pacing after cardiac surgery. Am J Cardiol. 1997;80(10):1309–13.CrossRef
16.
go back to reference Bis J, Gościńska-Bis K, Gołba KS, Gocoł R, Zębalski M, Deja MA. Permanent pacemaker implantation after cardiac surgery: optimization of the decision making process. J Thorac Cardiovasc Surg. 2021;162(3):816-24.e3.CrossRef Bis J, Gościńska-Bis K, Gołba KS, Gocoł R, Zębalski M, Deja MA. Permanent pacemaker implantation after cardiac surgery: optimization of the decision making process. J Thorac Cardiovasc Surg. 2021;162(3):816-24.e3.CrossRef
17.
go back to reference Khorsandi M, Muhammad I, Shaikhrezai K, Pessotto R. Is it worth placing ventricular pacing wires in all patients post-coronary artery bypass grafting? Interact Cardiovasc Thorac Surg. 2012;15(3):489–93.CrossRef Khorsandi M, Muhammad I, Shaikhrezai K, Pessotto R. Is it worth placing ventricular pacing wires in all patients post-coronary artery bypass grafting? Interact Cardiovasc Thorac Surg. 2012;15(3):489–93.CrossRef
18.
go back to reference Ensminger S, Fujita B, Bauer T, Möllmann H, Beckmann A, Bekeredjian R, et al. Rapid deployment versus conventional bioprosthetic valve replacement for aortic stenosis. J Am Coll Cardiol. 2018;71(13):1417–28.CrossRef Ensminger S, Fujita B, Bauer T, Möllmann H, Beckmann A, Bekeredjian R, et al. Rapid deployment versus conventional bioprosthetic valve replacement for aortic stenosis. J Am Coll Cardiol. 2018;71(13):1417–28.CrossRef
19.
go back to reference Stecker EC, Strelich KR, Chugh SS, Crispell K, McAnulty JH. Arrhythmias after orthotopic heart transplantation. J Card Fail. 2005;11(6):464–72.CrossRef Stecker EC, Strelich KR, Chugh SS, Crispell K, McAnulty JH. Arrhythmias after orthotopic heart transplantation. J Card Fail. 2005;11(6):464–72.CrossRef
20.
go back to reference Hasan S, Lewis CT. A new method of temporary epicardial atrioventricular pacing utilizing bipolar pacing leads. Ann Thorac Surg. 2005;79(4):1384–7.CrossRef Hasan S, Lewis CT. A new method of temporary epicardial atrioventricular pacing utilizing bipolar pacing leads. Ann Thorac Surg. 2005;79(4):1384–7.CrossRef
21.
go back to reference Yiu P, Tansley P, Pepper JR. Improved reliability of post-operative ventricular pacing by use of bipolar temporary pacing leads. Cardiovasc Surg. 2001;9(4):391–5.CrossRef Yiu P, Tansley P, Pepper JR. Improved reliability of post-operative ventricular pacing by use of bipolar temporary pacing leads. Cardiovasc Surg. 2001;9(4):391–5.CrossRef
22.
go back to reference Saxena P, Konstantinov IE, Newman MA. Use of temporary epicardial pacing wires in cardiac surgery. Heart Lung Circ. 2007;16(1):60.CrossRef Saxena P, Konstantinov IE, Newman MA. Use of temporary epicardial pacing wires in cardiac surgery. Heart Lung Circ. 2007;16(1):60.CrossRef
23.
go back to reference Spotnitz HM. Optimizing temporary perioperative cardiac pacing. J Thorac Cardiovasc Surg. 2005;129(1):5–8.CrossRef Spotnitz HM. Optimizing temporary perioperative cardiac pacing. J Thorac Cardiovasc Surg. 2005;129(1):5–8.CrossRef
24.
go back to reference Cannesson M, Farhat F, Scarlata M, Cassar E, Lehot J-J. The impact of atrio-biventricular pacing on hemodynamics and left ventricular dyssynchrony compared with atrio–right ventricular pacing alone in the postoperative period after cardiac surgery. J Cardiothorac Vasc Anesth. 2009;23(3):306–11.CrossRef Cannesson M, Farhat F, Scarlata M, Cassar E, Lehot J-J. The impact of atrio-biventricular pacing on hemodynamics and left ventricular dyssynchrony compared with atrio–right ventricular pacing alone in the postoperative period after cardiac surgery. J Cardiothorac Vasc Anesth. 2009;23(3):306–11.CrossRef
25.
go back to reference Wang DY, Richmond ME, Quinn TA, Mirani AJ, Rusanov A, Yalamanchi V, et al. Optimized temporary biventricular pacing acutely improves intraoperative cardiac output after weaning from cardiopulmonary bypass: a substudy of a randomized clinical trial. J Thorac Cardiovasc Surg. 2011;141(4):1002–8.CrossRef Wang DY, Richmond ME, Quinn TA, Mirani AJ, Rusanov A, Yalamanchi V, et al. Optimized temporary biventricular pacing acutely improves intraoperative cardiac output after weaning from cardiopulmonary bypass: a substudy of a randomized clinical trial. J Thorac Cardiovasc Surg. 2011;141(4):1002–8.CrossRef
26.
go back to reference Wang W, Buehler D, Wang X, Yuan X. Effectiveness of biatrial pacing in reducing early postoperative atrial fibrillation after the maze procedure. Interact Cardiovasc Thorac Surg. 2013;16(5):589–93.CrossRef Wang W, Buehler D, Wang X, Yuan X. Effectiveness of biatrial pacing in reducing early postoperative atrial fibrillation after the maze procedure. Interact Cardiovasc Thorac Surg. 2013;16(5):589–93.CrossRef
27.
go back to reference Eberhardt F, Heringlake M, Massalme MS, Dyllus A, Misfeld M, Sievers HH, et al. The effect of biventricular pacing after coronary artery bypass grafting: a prospective randomized trial of different pacing modes in patients with reduced left ventricular function. J Thorac Cardiovasc Surg. 2009;137(6):1461–7.CrossRef Eberhardt F, Heringlake M, Massalme MS, Dyllus A, Misfeld M, Sievers HH, et al. The effect of biventricular pacing after coronary artery bypass grafting: a prospective randomized trial of different pacing modes in patients with reduced left ventricular function. J Thorac Cardiovasc Surg. 2009;137(6):1461–7.CrossRef
28.
go back to reference Cote CL, Baghaffar A, Tremblay P, Herman C. Incidence of tamponade following temporary epicardial pacing wire removal. J Card Surg. 2020;35(6):1247–52.CrossRef Cote CL, Baghaffar A, Tremblay P, Herman C. Incidence of tamponade following temporary epicardial pacing wire removal. J Card Surg. 2020;35(6):1247–52.CrossRef
29.
go back to reference Mahon L, Bena JF, Morrison SM, Albert NM. Cardiac tamponade after removal of temporary pacer wires. Am J Crit Care. 2012;21(6):432–40.CrossRef Mahon L, Bena JF, Morrison SM, Albert NM. Cardiac tamponade after removal of temporary pacer wires. Am J Crit Care. 2012;21(6):432–40.CrossRef
30.
go back to reference Bougioukas I, Jebran AF, Grossmann M, Friedrich M, Tirilomis T, Schoendube FA, et al. Is there a correlation between late re-exploration after cardiac surgery and removal of epicardial pacemaker wires? J Cardiothorac Surg. 2017;12(1):3.CrossRef Bougioukas I, Jebran AF, Grossmann M, Friedrich M, Tirilomis T, Schoendube FA, et al. Is there a correlation between late re-exploration after cardiac surgery and removal of epicardial pacemaker wires? J Cardiothorac Surg. 2017;12(1):3.CrossRef
31.
go back to reference Shaikhrezai K, Khorsandi M, Patronis M, Prasad S. Is it safe to cut pacing wires flush with the skin instead of removing them? Interact Cardiovasc Thorac Surg. 2012;15(6):1047–51.CrossRef Shaikhrezai K, Khorsandi M, Patronis M, Prasad S. Is it safe to cut pacing wires flush with the skin instead of removing them? Interact Cardiovasc Thorac Surg. 2012;15(6):1047–51.CrossRef
32.
go back to reference Maisel WH, Epstein AE. The role of cardiac pacing*: American college of chest physicians guidelines for the prevention and management of postoperative atrial fibrillation after cardiac surgery. Chest. 2005;128(2):S36–8.CrossRef Maisel WH, Epstein AE. The role of cardiac pacing*: American college of chest physicians guidelines for the prevention and management of postoperative atrial fibrillation after cardiac surgery. Chest. 2005;128(2):S36–8.CrossRef
33.
go back to reference Enevoldsen MS, Nielsen PH, Hasenkam JM. Risk and benefits of temporary pacemaker electrodes in adult open-heart surgery—a systematic review. Cardiothorac Surg. 2022;30(1):5.CrossRef Enevoldsen MS, Nielsen PH, Hasenkam JM. Risk and benefits of temporary pacemaker electrodes in adult open-heart surgery—a systematic review. Cardiothorac Surg. 2022;30(1):5.CrossRef
Metadata
Title
Temporary epicardial pacing wires post-cardiac surgery: a literature review
Author
Lucy Manuel
Publication date
02-06-2022
Publisher
Springer Nature Singapore
Published in
General Thoracic and Cardiovascular Surgery / Issue 7/2022
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-022-01831-5

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