5-YEAR EXPERIENCE WITH TEMPORARY PACEMAKER THERAPY IN THE CORONARY-CARE UNIT

Abstract

The clinical course of 1022 consecutive patients who received a temporary transvenous pacemaker in the coronary care unit during a 5-yr period between Jan. 1976 and Jan. 1981 was reviewed. The route of pacemaker insertion was identified in 942 patients (92.2%) and included antecubital vein cutdown in 606 patients (59.3%), subclavian venipuncture in 177 patients (17.3%), right internal jugular venipuncture in 111 patients (10.9%) and femoral venipuncture in 48 patients (4.7%). Pacemaker-related complications occurred in 140 instances (13.7% morbidity), without associated mortality. The most common complication was the development of a new pericardial rub (54 patients, 5.3%). The right internal jugular approach was associated with the lowest complication rate. On the basis of these findings, temporary pacemakers are inserted via the right internal jugular or subclavian route.