Perioperative Application Of Epicardial Temporary Pacemaker Patients With Heart Valve Replacement

ObjectiveTo determine the clinical application of temporary epicardial pacing wires placed in patients undergoing surgery for cardiac valve replacement.MethodsA retrospective observational study was performed on 723 consecutive heart valve replacement surgery patients between January2013 and December 2017.Patients were grouped according to avoidance or insertion of temporary pacing wires,and were further subdivided according to temporary cardiac pacing need,which is divided into pacemaker dependent group and pacemaker non-dependent group.Logistic regression analysis was performed to identify independent predictors of temporary cardiac pacing.ResultsTemporary epicardial pacing wires were placed in 20 of 723(2.77%)patients undergoing surgery for cardiac valve replacement.Only 1 patient(1/20,5%)required temporary pacing died who were compared with the19(19/703,2.70%)died in patients did not have insertion of temporary pacing wires.ConclusionThe present results suggest that routine use of temporary epicardial pacing wires after valve replacement surgery is necessary for high risk patients including II-III° atrioventricular block,supraventricular bradycardia,heart rate still less than 100 beats / min after using atropine or isoproterenol is poor,fast and slow syndrome.Furthermore,the determinants of temporary cardiac pacing were as follows: age greater than65 years,I°AVB,and NYHA class III-IV,or PAP greater than 50 mmHg,or aortic block time greater than 60 minutes.These patients in whom wires were helpful postoperatively.