Temporary Pacing with Active-Fixation Leads: Clinical and Economic Impact Versus Conventional Temporary Transvenous Pacing

Abstract

Background/Objectives: The use of temporary pacemakers is increasing every year. Conventional temporary pacemakers are connected to the myocardium via a passive-fixation lead (temporary pacing with passive fixation leads; TPPF), which compromises their effectiveness and safety. Off-label active-fixation systems (temporary pacing with active fixation leads; TPAF) are a safer alternative. The main objective of this study was to assess the clinical and economic impact of TPAF versus TPPF. Methods: We conducted a literature search based on the clinical outcomes of both pacing techniques. We then carried out a descriptive comparative analysis and extrapolated the results to the Spanish, European, and global populations. Results: Of the 1015 articles located, the analysis included five articles from ECTSF and eight from ECTEFA, prospective and focused on the recording of complications. It is estimated that the implementation of ECTEFA as the first option for ECT would lead to a 94.7% reduction in complications. In economic terms, it would mean a 55.72% reduction in the cost of the procedure. Conclusions: TPAF leads to considerable clinical improvement compared with TPPF. Furthermore, while the price of TPAF doubles the procedural cost, the reduced cost of hospital stays and treating complications means the active-fixation systems could substantially reduce the overall cost of temporary pacing for healthcare systems.