Epicardial pacing wires after cardiac surgery: an Irish cross-sectional study.

BACKGROUND Temporary epicardial pacing wires are inserted after cardiac surgery. However, there are no international guidelines on which to base best practice regarding wire insertion or removal. METHODS Data were collected on patients following cardiopulmonary bypass and analysed in terms of use, duration of use and complications of pacing wires after surgery. RESULTS Wires were inserted in 164 of the 167 patients. Most (74%) did not require pacing. Patients were categorised into those who had aortic valve replacement (AVR) (n=42) and those who did not (n=122). Of the AVR group, 26% (n=11) were pacemaker dependent after surgery and 10% (n=4) required permanent pacemakers. Most pacing wires were removed by day 4. The only noted complication was delayed discharge. CONCLUSION Unused pacing wires are normally removed on day 4, but for 77 (47%) of patients they remained in place longer. Forty patients (24%) had delayed wire removal because of a policy of wire removal during business hours only. Of these 40 patients, 27 (17% of the 77 with delayed removal) had delayed discharge as a result of our wire removal policy.

[1]  James Thomas,et al.  Impact and experiences of delayed discharge: A mixed‐studies systematic review , 2017, Health expectations : an international journal of public participation in health care and health policy.

[2]  L. Siciliani,et al.  Delayed discharges and hospital type: Evidence from the English NHS , 2017 .

[3]  I. Bougioukas,et al.  Is there a correlation between late re-exploration after cardiac surgery and removal of epicardial pacemaker wires? , 2017, Journal of Cardiothoracic Surgery.

[4]  K. Giakoumidakis,et al.  The formation of bronchocutaneous fistulae due to retained epicardial pacing wires: A literature review , 2016, Annals of cardiac anaesthesia.

[5]  M. Lemay,et al.  Clinical and mechanical factors associated with the removal of temporary epicardial pacemaker wires after cardiac surgery , 2016, Journal of Cardiothoracic Surgery.

[6]  M. Rosman,et al.  Prolonged patients’ In-Hospital Waiting Period after discharge eligibility is associated with increased risk of infection, morbidity and mortality: a retrospective cohort analysis , 2015, BMC Health Services Research.

[7]  D. Longrois,et al.  Reassessment of the natural evolution and complications of temporary epicardial wires after cardiac surgery. , 2014, Journal of cardiothoracic and vascular anesthesia.

[8]  Y. Khader,et al.  Predictors of temporary epicardial pacing wires use after valve surgery , 2014, Journal of Cardiothoracic Surgery.

[9]  Domenico Cianflone,et al.  Postoperative Arrhythmias after Cardiac Surgery: Incidence, Risk Factors, and Therapeutic Management , 2014, Cardiology research and practice.

[10]  A. McNaughton Indications for postoperative (transthoracic) epicardial pacing , 2013 .

[11]  N. Albert,et al.  Cardiac tamponade after removal of temporary pacer wires. , 2012, American journal of critical care : an official publication, American Association of Critical-Care Nurses.

[12]  F. Hanley,et al.  Predictors for use of temporary epicardial pacing wires after pediatric cardiac surgery. , 2012, The Journal of thoracic and cardiovascular surgery.

[13]  Ishaq Muhammad,et al.  Is it worth placing ventricular pacing wires in all patients post-coronary artery bypass grafting? , 2012, Interactive cardiovascular and thoracic surgery.

[14]  John S. Green,et al.  Effects of delays in transfer on independence outcomes for older people requiring postacute care in community hospitals in England , 2010 .

[15]  H. Luckraz,et al.  Temporary epicardial pacing wire removal: is it an innocuous procedure? , 2010, Interactive cardiovascular and thoracic surgery.

[16]  P. Myint,et al.  Delayed transfer of care from NHS secondary care to primary care in England: its determinants, effect on hospital bed days, prevalence of acute medical conditions and deaths during delay, in older adults aged 65 years and over , 2009, BMC geriatrics.

[17]  O. Merin,et al.  Permanent Pacemaker Implantation Following Cardiac Surgery: Indications and Long‐Term Follow‐Up , 2009, Pacing and clinical electrophysiology : PACE.

[18]  M. Reade,et al.  Temporary epicardial pacing after cardiac surgery: a practical review , 2007, Anaesthesia.

[19]  M. Alligood,et al.  Complications of epicardial pacing wire removal. , 1993, The Journal of cardiovascular nursing.