Table 2 Significant factors associated with temporary postoperative cardiac pacing
From: Risk and benefits of temporary pacemaker electrodes in adult open-heart surgery—a systematic review
Type of surgery | Article | Factors significantly associated with temporary cardiac pacing (P value ≤ 0.05) | P value | Odds ratio |
|---|---|---|---|---|
CABGa, valve surgery | Cote CL, Baghaffar A, Tremblay P, Herman CR., “Prediction of temporary epicardial pacing wire use in cardiac surgery”, 2020 | CABG: - Age (71–80+ years) - Preoperative renal failure - Low ejection fraction - Preoperative arrhythmia - Preoperative use of calcium channel blockers - COPDb - Aortic cross-clamp time > 90 min Aortic valve replacement: - Age (61–80+ years) - Male sex - Dyslipidemia - Preoperative renal failure - Low ejection fraction - Preoperative arrhythmia - Preoperative use of calcium channel blockers - Aortic cross-clamp time > 90 min Mitral valve repair: - Age > 80 - Obesity - Smoking history - COPD Mitral valve replacement: - Preoperative arrhythmia | CABG: - < 0.01 - < 0.02 - < 0.01 - < 0.01 - < 0.01 - 0.04 - < 0.01 - < 0.01 - < 0.01 - < 0.01 - < 0.01 - < 0.01 - < 0.01 - < 0.01 - < 0.01 - < 0.01 - 0.05 - 0.04 - 0.01 - 0.02 | CABG: - 2.4 - 1.5 - 2.7 - 1.7 - 1.4 - 1.1 - 1.4 - 1.7 - 0.7 - 0.8 - 1.5 - 2.5 - 2.1 - 1.2 - 1.7 - 61.6 - 5.6 - 0.3 - 10.7 - 3.3 |
CABG, valve surgery, and other procedures | Kiely N, O'Brien F, Mooney M., “Epicardial pacing wires after cardiac surgery: an Irish cross-sectional study”, 2020 | - Not reported | - | - |
Valve surgery | Abd Elaziz ME, “Temporary epicardial pacing after valve replacement: incidence and predictors”, 2018 | - Age > 65 - Diabetes Mellitus - NYHAc class III-IV - Preoperative digoxin use - PAPd > 45 mmHg - Type of surgery (multiple valve surgery) - Valve annulus calcification - Aortic cross-clamp time > 65 min | - 0.004 - 0.005 - < 0.001 - < 0.001 - < 0.001 - 0.01 - 0.01 0.006 | - 11 - 47.6 - 6 - 115 - 141 - 6 - 7 - 19 |
Valve surgery | Alwaqfi, Nizar R, “Predictors of temporary epicardial pacing wires use after valve surgery”, 2014 | - Age - NYHA class III–IV - PAP > 50 mmHg - Preoperative digoxin use - Type of surgery (multiple valve surgery) - Aortic cross-clamp time > 60 min - Valve annulus calcification | - 0.002 - 0.008 - 0.001 - 0.024 - 0.021 - 0.010 - 0.003 | - 1.1 - 5.6 - 22.0 - 8.0 - 13.5 - 7.8 - 7.9 |
CABG | Khorsandi M., Ishaq M, “Is it worth placing ventricular pacing wires in all patients post-coronary artery bypass grafting?”, 2012 | - Number of coronary arteries bypassed - CPBe time - Aortic cross-clamp time | - - - | - - - |
Valve replacement, valve replacement + CABG surgery | Ferrari AD, “Atrioventricular block in the postoperative period of heart valve surgery: incidence, risk factors and hospital evolution”, 2011 | - Age > 60 | - < 0.001 | - 1.99 |
- Preoperative use of antiarrhythmic drugs | - 0.026 | - 1.86 | ||
- Preoperative use of beta-blocker | - 0.002 | - 1.76 | ||
- Biological prosthesis | - 0.039 | - 1.59 | ||
- Mitral valve surgery | - 0.002 | - 1.76 | ||
- Length of hospital admission | - < 0.0001 | - 1.03 | ||
CABG | Asghar M. I., “Placing epicardial pacing wires in isolated coronary artery bypass graft surgery - A procedure routinely done but rarely beneficial”, 2009 | - Age | - 0.019 | - |
- Bundle branch block - Preoperative arrhythmias (especially bundle branch block) - Pacing required to come off CPB - Use of antiarrhythmic drugs on leaving the operating room | - 0.00 - - 0.00 - 0.00 - 0.015 | - - - - | ||
CABG | Imren Y., Benson AA, “Is the use of temporary pacing wires following coronary bypass surgery really necessary?”, 2008 | ONCAPf (multivariate analysis) Preoperative: - History of arrhythmia - Use of antiarrhythmic drugs - Age - Previous CABG Intraoperative: - Mean CPB - Mean aorta cross clamp time - Pacing to come off CPB | - 0.002 - 0.01 - 0.05 - 0.02 - 0.02 - 0.01 - 0.02 | - 6.9 - 3.1 - 1.9 - 2.1 - 2.4 - 2.9 - 2.7 |
CABG | Bethea BT, Salazar JD, “Determining the utility of temporary pacing wires after coronary artery bypass surgery”, 2005 | - Preoperative arrhythmias - Pacing required to come off CPB - Diabetes mellitus | - 0.001 - 0.01 - 0.04 | - 8.7 - 4.7 - 3.7 |
CABG | JD Puskas, “Is routine use of temporary epicardial pacing wires necessary after either OPCAB or conventional CABG/CPB”, 2003 | - Age - Gender (female) - Hypertension | - 0.05 - < 0.001 - 0.013 | - - 4.39 - 3.12 |
CABG, valve surgery and other procedures | Takeda, M.; Furuse, A.; “Use of temporary atrial pacing in management of patients after cardiac surgery”, 1996 | - Not reported | - - | - |
CABG, valve surgery and other procedures | Morin JE., “Temporary cardiac pacing following open-heart surgery”, 1982 | - Prolonged aortic cross-clamp time - Larger volume of cardioplegic solution | - 0.001 - 0.025 | - - |