Temporary Epicardial Pacing Post Congenital Cardiac Surgery; Frequency and its Associated Outcomes
DOI:
https://doi.org/10.51253/pafmj.v75iSUPPL-3.12872Keywords:
Congenital Heart block, Congenital heart disease, Temporary epicardial pacing, Pediatric cardiology, Permanent pacemaker.Abstract
Objective: To determine the frequency and outcomes of Temporary Epicardial Pacing (TEP) after congenital cardiac surgery in pediatric patients.
Study Design: Analytical Cross Sectional study.
Place and Duration of Study: Armed Forces Institute of Cardiology/ National Institute of Heart Diseases, Rawalpindi Pakistan, from Jan to Jun 2024.
Methodology: Total one hundred and ten patients having the age of <12 years who underwent cardiac surgery for congenital heart diseases were recruited. Frequency of patients requiring TEP was calculated and the pacing duration was noted for intervals of less than 12 hours, 12-24 hours, 25-48 hours, 49-72 hours and >3-15 days respectively. Patients were monitored post operatively to assess outcomes, including mortality and infection rate.
Results: Overall, 110 patients (27.7%) required TEP, including 62(56.4%) males and 48(43.6%) females. Out of total, 31(28.2%) patients required pacing for <12 hours, 51(46.4%) for 12-24 hours, 20(18.2%) for 25-48 hours, 6(5.5%) for 49-72 hours and 2(1.8%) patients were shifted to permanent pacing later on. Statistically significant difference was observed between pacing in terms of duration (p=0.02) with mortality. Statistically significant association was found between mortality and post procedural infections (p<0.001).
Conclusion: This study demonstrated that TEP was a common intervention following congenital cardiac surgery in pediatric patients with VSD and ASD, whereas majority required short-term pacing. Though most of the patients recovered without major complications, a small percentage may require permanent pacemakers due to prolonged pacing needs.
Downloads
References
Khokhar RA, Gowa MA, Bangash SK, Tahir A. The spectrum of pediatric cardiac procedures and their outcomes: a six-month report from the largest cardiac facility in Sindh, Pakistan. Cureus 2019; 11(8). https://doi.org/10.7759/cureus.5339
Adil DM, Khan DSB, Khan DMS, Hassan DZ. Rate of various access sites for temporary transvenous pacing and different outcomes at Lady Reading Hospital, Peshawar Pakistan. Pak J Med Sci 2023; 39(4). https://doi.org/10.12669/pjms.39.4.7467
Rodriguez-Cruz E, Berul CI, McElhinney DB. Long-term Outcomes of Pediatric Patients with Temporary Epicardial Pacing After Congenital Heart Surgery. Heart Rhythm 2019; 16(7): 1012-1018. https://doi.org/10.1016/j.hrthm.2019.04.022
Ibrahim LA, Soliman M, Gad Elkarim AH, El Tantawy A. Frequency and Risk Factors of Early Complete Heart Block Post Cardiac Surgery in Children: A Multicenter Prospective Study. Pediatr Sci J 2023; 3(1): 44-49.
https://doi.org/10.21608/cupsj.2022.175068.1081
Nady MM, Amrousy DM, Lotfy WM, Zoair AM. Risk Factors and Outcomes of Complete Heart Block in Children after Surgical Closure of Ventricular Septal Defects: The Role of Pacemaker Therapy. J Adv Med Med Res 2023; 35(19): 34-44.
https://doi.org/10.9734/jammr/2023/v35i195138
Van Blarcom AG, Wojack CA, Casida J. Cardiac tamponade following the removal of epicardial pacing wires: Critical care APRN toolkit. AACN Adv Crit Care 2020; 31(4): 410-415.
https://doi.org/10.4037/aacnacc2020324
AlWaqfi NR, Ibrahim KS, Khader YS, Baker AA. Predictors of temporary epicardial pacing wires use after valve surgery. J Thorac Cardiovasc Surg 2014; 9: 1-7.
https://doi.org/10.1186/1749-8090-9-33
Gupta P, Jines P, Gossett JM, Maurille M, Hanley FL, Reddy VM, et al. Predictors for use of temporary epicardial pacing wires after pediatric cardiac surgery. J Thorac Cardiovasc Surg 2012; 144(3): 557-562. https://doi.org/10.1016/j.jtcvs.2011.12.060
Mikulski MF, Well A, Shmorhun D, Fraser Jr CD, Mery CM, Fenrich Jr AL, et al. Pacemaker management and in-hospital outcomes in neonatal congenital atrioventricular block. JACC Clin Electrophysiol 2023; 9(9): 1977-1986.
https://doi.org/10.1016/j.jacep.2023.05.003
Li TT, Cheng J. Clinical analysis of temporary pacemaker implantation in 13 children. Transl Pediatr 2022; 11(2): 174.
https://doi.org/10.21037/tp-21-586
Puskas JD, Sharoni E, Williams WH, Petersen R, Duke P, Guyton RA, et al. Is routine use of temporary epicardial pacing wires necessary after either OPCAB or conventional CABG/CPB? Heart Surg Forum 2003; 6(6): 103-106.
https://doi.org/10.1532/hsf.1061
Asynchronous to synchronous pacing in pediatric cardiac surgery. Pediatr Cardiol J 2023; 45: 123-135.
https://doi.org/10.1016/j.pcad.2023.07.009
Risk 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: 1-4.
https://doi.org/10.1186/s43057-021-00064-1
Murray LE, Kogon B, Bichell D, Kanter K, Kirshbom P, McCrindle BW, et al. Genotypic and phenotypic predictors of complete heart block after congenital heart surgery. Heart Rhythm 2017; 14(3): 402-409.
https://doi.org/10.1016/j.hrthm.2016.12.020
Niu MC, Marchant MH, Saarel EV, Berul CI. Pediatric patients with pacemakers implanted for atrioventricular block: Risk factors and outcomes. J Cardiovasc Electrophysiol 2016; 27(4): 471-479. https://doi.org/10.1111/jce.12969
Temporary epicardial pacing wires post-cardiac surgery: a literature review. Gen Thorac Cardiovasc Surg 2022; 70: 595-601.
https://doi.org/10.1007/s11748-022-01831-5
Batra AS, Balaji S. Post operative temporary epicardial pacing: when, how and why?. Ann Pediatr Cardiol 2008; 1(2): 120-125.
https://doi.org/10.4103/0974-2069.43877
Cronin B, Dalia A, Goh R, Essandoh M, O'Brien E. Temporary Epicardial Pacing After Cardiac Surgery. J Cardiothorac Vasc Anesth 2022; 36: 4427-4439.
https://doi.org/10.1053/j.jvca.2022.08.017
Baruteau AE, Abrams DJ, Ho SY, Thambo JB, McLeod CJ, Khairy P, et al. Cardiac conduction in transposition of the great arteries. J Am Heart Assoc 2017; 6(3).
https://doi.org/10.1161/JAHA.117.007759
Elshal AM, Abd Elsatar MI, Abd Elsalam SN. Knowledge and Practice of Nurses Regarding Safety of Patients with Temporary Cardiac Pacemakers in the Critical Care Units. Egypt J Health Care. 2020; 11(4): 1275-1293.
https://doi.org/10.21608/ejhc.2020.274027
Waqanivavalagi SWFR. Temporary pacing following cardiac surgery - a reference guide for surgical teams. J Cardiothorac Surg 2024; 19: 115.
Downloads
Published
License
Copyright (c) 2025 Sadia Noreen, Kaleem Ahmed, Maryam Nazir, Hira Mubeen

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.