TEMPORARY PACING DURING IMPLANTATION OF PERMANENT PACEMAKER: A REAPPRAISSAL OF REAL-WORLD BENEFITS AND OPERATOR RECOGNIZED COMPLICATIONS.
Authors & Affiliations
Kabirah Iyabode Edun1, Oluwaseye Michael Oladimeji1, Alaba Busola Oladimeji2, Esther Opeyemi Ijaola1, Ramon Moronkola1, Oluwadara Olanrewaju Oduwole3, Ajibola Yusuf Sanda1, Onomen Agnes Ehizojie1, Oluronke Tolulope Bamgboye1, Aishah Olawunmi Salaudeen1, Timilehin Esther Idowu1, Oluwaseun Oyeyemi Megbope1, Winnie_Wachiraphan Khlainoi4, Oluwafisayo Lizzy Owoeye5, Alaba Philip Adebola3, Ijeoma Ekeruo6, Oluwaseyi Bolorunduro7, Oladipupo Olafiranye8, Tayo Addo8, Obinnaya Emerole9, Departments of 1Medicine and 2Paediatric, Lagos State University Teaching Hospital, 3Department of Medicine, Lagos State University College of Medicine, Ikeja, Lagos State, 4Boston Scientific, 5Department of Nursing, Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria, 6Division of Cardiovascular Medicine, Arrhythmia Care Center, Houston, Texas, 7Division of Cardiovascular Medicine, NOVA Cardiovascular Care, INOVA Fairfax Hospital, Fairfax, Virginia, 8Division of Cardiovascular Medicine, UT Southwestern Medical Center, Dallas, Texas, 9Division of Cardiovascular Medicine, Georgia Heart Physicians, Macon, Georgia, USA
📖 Abstract Content
Temporary transvenous pacing (TVP) is an established safety measure for patients with high-degree atrioventricular block and hemodynamic instability undergoing permanent pacemaker (PPM) implantation. It provides a reliable escape rhythm during lead manipulation. However, beyond the well-documented complications, operators frequently encounter practical procedure-specific challenges that are often underreported despite their potential clinical significance.
This presentation reviews the role of TVP during PPM implantation, drawing on real-world clinical practice and operator experience to highlight both its benefits and procedure-related complications observed during implantation.
TVP provides a stable backup rhythm, minimizes the risk of transient asystole during lead testing, and allows safer implantation in unstable patients or where procedural delays occur. Two operator-recognized complications deserve attention. First, femoral temporary pacing leads, commonly used in Nigeria, remain accessible to sedated or agitated patients, increasing the risk of accidental lead displacement and loss of pacing support. Second, withdrawal of the temporary pacing lead may mechanically interact with the newly implanted right ventricular lead, potentially causing lead displacement, repositioning, or repeat venography. These practical complications are not commonly addressed in existing guidelines.
TVP remains an invaluable adjunct during PPM implantation but should be used selectively after weighing its benefits against both recognized and practical risks. Careful femoral lead securement, appropriate patient sedation, and fluoroscopy-guided withdrawal of the temporary lead can reduce procedure-related complications and improve patient outcomes, particularly in high-volume implanting centers.
