Consideration of Timing for Temporary Pacemaker Wires Removal after Heart Valve Surgery
- VernacularTitle:弁膜症術後の一時ペーシングリード早期抜去の妥当性
- Author:
Tomoaki MASUDA
1
;
Atsushi AOKI
1
;
Tadashi OMOTO
1
;
Kazuto MARUTA
1
;
Akitoshi TAKAZAWA
1
Author Information
- Keywords: postoperative care; arrhythmia; pacemaker; cardiac tamponade; postoperative infection
- From:Japanese Journal of Cardiovascular Surgery 2026;55(1):1-6
- CountryJapan
- Language:Japanese
- Abstract: Backgrounds: Previously, we routinely removed pacemaker wires (PW) one week after heart valve surgery, however, we have changed to remove PW on the second postoperative day in order to prevent retrograde infection. The purpose of this study was to clarify the clinical benefits of earlier PW removal. Subjects/Methods: Overall 133 patients were reviewed and a comparative study was conducted between the two groups; late group (n=48) and early group (n=85). Results: There were no significant differences in age, gender, body physique, diabetes, preoperative dialysis, operation time, cardiopulmonary bypass time, or cross-clamp time between the two groups. C-reactive protein was significantly lower in the early group at both 1 and 2 weeks postoperatively, Leukocyte was also significantly lower in the early group at 2 weeks, and the frequency of fever of 38 degrees Celsius or higher, frequency of additional antibiotic treatment, and the frequency of diagnosis of postoperative infection were also significantly lower in the early group. Platelet counts on the day of removal were significantly lower in the early group, however PT-INR was significantly lower in the early group, and the frequency of pericardial drainage tended to be lower in the early group. Among the cases in the early removal whose PW were removed on the second day, only one patient required pacing for transient complete atrioventricular block during hospitalization. Conclusions: After valve surgery, in patients who did not require pacing by the second postoperative day, removing the pacemaker wires on the second day might prevent postoperative infection, without increasing the need for pericardial drainage or a temporary pacing catheter. It was considered appropriate to remove the lead on the second postoperative day in cases where pacing was not required until the second postoperative day.
