Comparison of the safety and efficiency of temporary cardiac pacing methods during left bundle branch pacemaker implantation: Femoral vein pacing vs. atrial spiral pacing with electrodes placed at the ventricle

Objective: To evaluate the safety and efficiency of replacing femoral vein pacing with atrial spiral pacing in the right ventricle for temporary cardiac pacing during left bundle branch pacemaker (LBBP) implantation. Method: A total of 179 patients who underwent temporary cardiac pacing (TCP) during LBBP were selected for retrospective analysis from April 2019 to April 2021 and divided into two groups: the atrial spiral electrode group (n=76) and the femoral vein electrode group (n=103). The following were observed: operation time; radiation dose; radiation time; operation expenses; hospitalization time; pacemaker parameters immediately after the operation and at 1 week, 1 month, 3 months, and 6 months after the operation; operation complications and femoral vein puncture point complications were observed in the two groups. Results: : Compared to the femoral vein electrode group, the atrial electrode group had significantly lower operation times [(116.86±24.63) vs. (128.94±25.27) min, P < 0.05], radiation doses [(805.07±132.94) mgy vs. (846.42±87.37) mgy, P < 0.05], and decreased risk of a displaced or dislodged temporary pacing electrode during the operation [(0.00%) vs. (4.85%), P < 0.05]. The atrial electrode group did not have significant operation costs or material costs associated with femoral vein temporary pacing electrode implantation. In addition, the atrial electrode group did not have an increased risk of pacemaker-related infections, and the parameters of the pacemaker were unaffected. However, some puncture point complications appeared in the femoral vein electrode group (8 cases of local subcutaneous hematoma, 3 cases of pseudoaneurysms, 3 cases of arteriovenous fistula). Conclusion: The replacement of the femoral vein pacing electrode with an atrial spiral pacing electrode in the right ventricle for temporary cardiac pacing during left bundle branch pacemaker (LBBP) implantation was safe and effective.