Clinical and mechanical factors associated with the removal of temporary epicardial pacemaker wires after cardiac surgery
Bibliographic record
Abstract
BACKGROUND: Temporary pacemaker wires are placed in the majority of patients after cardiac surgery. There is no information on mechanical factors related to wire removal. METHODS: Clinical information related to temporary wire use and removal was prospectively collected from a large cardiac surgical unit over one year. Measurements of maximal tension that nurses and doctors would apply to remove temporary wires was determined using a hand-held portable scale. In a prospective trial, patients (n = 41) had their wires extracted in series to the portable scale to determine the maximal tension required for safe removal. RESULTS: Ventricular wires were placed in 86.5 % of patients during the observed year. Pacing facilitated weaning from CPB in over 15 % of patients and pacer dependence was seen in 2.1 %. No patients suffered major complications after wire removal. There was no difference in the tension that physicians or nurses would apply to comfortably extract temporary wires. In the prospective trial, there was no difference in the tension required for removal of atrial or ventricular wires (atrial 18.3 ± 17.9 oz versus 14.5 ± 14.2 oz, p = 0.430). There were no patient factors that correlated with the degree of resistance and there was no significant difference between the tension required to remove wires with (21.0 ± 22.5 oz) or without (14.1 ± 5.1 oz) an atrial button. CONCLUSIONS: Temporary epicardial wire removal is innocuous and was not associated with any complications. In some patients tension required for safe removal exceeded 20 ounces. Strategies to standardize wire removal may prevent complications and may minimize unnecessary wire retention.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".