Temporary Epicardial Pacing Post Congenital Cardiac Surgery; Frequency and its Associated Outcomes

Objective: To determine the frequency and outcomes of Temporary Epicardial Pacing (TEP) after congenital cardiac surgery in pediatric patients. Study Design: Analytical Cross Sectional study. Place and Duration of Study: Armed Forces Institute of Cardiology/ National Institute of Heart Diseases, Rawalpindi Pakistan, from Jan to Jun 2024. Methodology: Total one hundred and ten patients having the age of <12 years who underwent cardiac surgery for congenital heart diseases were recruited. Frequency of patients requiring TEP was calculated and the pacing duration was noted for intervals of less than 12 hours, 12-24 hours, 25-48 hours, 49-72 hours and >3-15 days respectively. Patients were monitored post operatively to assess outcomes, including mortality and infection rate. Results: Overall, 110 patients (27.7%) required TEP, including 62(56.4%) males and 48(43.6%) females. Out of total, 31(28.2%) patients required pacing for <12 hours, 51(46.4%) for 12-24 hours, 20(18.2%) for 25-48 hours, 6(5.5%) for 49-72 hours and 2(1.8%) patients were shifted to permanent pacing later on. Statistically significant difference was observed between pacing in terms of duration (p=0.02) with mortality. Statistically significant association was found between mortality and post procedural infections (p<0.001). Conclusion: This study demonstrated that TEP was a common intervention following congenital cardiac surgery in pediatric patients with VSD and ASD, whereas majority required short-term pacing. Though most of the patients recovered without major complications, a small percentage may require permanent pacemakers due to prolonged pacing needs.