Cardiology Research

Safety and Feasibility of Median Cubital Vein Approach in Temporary Pacemaker Insertion

Article Impact Level: HIGH
Data Quality: STRONG
Summary of Clinical Cardiology, 46(10), 1268–1275. https://doi.org/10.1002/clc.24097
Dr. Dehua He et al.

Points

  • The study evaluated a novel temporary cardiac pacemaker (PM) implantation method via a median cubital vein.
  • 279 patients were categorized into three groups based on implantation route: femoral vein, subclavian vein, and median cubital vein.
  • The median cubital vein group demonstrated significantly lower sheath placement time (SPT) than traditional routes.
  • The femoral vein group exhibited a higher electrode dislocation rate (EDR) than the subclavian and median cubital vein groups.
  • Results suggest that the median cubital vein is a safe, effective, and time-saving alternative for temporary PM implantation.

Summary

Compared to traditional routes through the femoral and subclavian veins, the study assessed the feasibility and safety of a new method for temporary cardiac pacemaker (PM) implantation via the median cubital vein. 279 patients requiring non-emergency PM implantation were enrolled from March 2020 to December 2021. Patients were divided into three groups based on the implantation route: femoral vein (F-control), subclavian vein (S-control), and median cubital vein (N-group). Various parameters, including sheath placement time (SPT), electrode placement time (EPT), electrode arrival rate (EAR), sensing and pacing rates (RSP), radiation quantity (RD), electrode dislocation rate (EDR), and average electrode retention time (AERT) were measured. Additionally, patient comfort levels were evaluated using the Hamilton Anxiety Scale (HAMA) and Self-Rating Depression Scale (SDS).

Results indicated no significant differences in age, EAR, RSP, EPT, RD, and AERT among the groups. However, the N-group exhibited significantly lower SPT than the F- and S-control groups. Furthermore, the F-control group showed a significantly higher EDR than the S-control and N-group. Assessment of HAMA and SDS scores revealed significant differences before and after PM implantation in the S-control and N-group.

In conclusion, temporary PM implantation via the median cubital vein proved safe, effective, and less time-consuming than traditional routes. These findings suggest the potential for the median cubital vein as a viable alternative for PM implantation, offering improved procedural efficiency and patient comfort.

Link to the article: https://onlinelibrary.wiley.com/doi/10.1002/clc.24097


References

He, D., Zhang, Z., Huang, H., Lin, K., Ge, Y., Lin, X., Xie, Q., Li, W., & Huang, Z. (2023). Temporary pacemaker implantation via median cubital vein: A simple safe and effective technique. Clinical Cardiology, 46(10), 1268–1275. https://doi.org/10.1002/clc.24097

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