Temporary transvenous pacemaker placement: What criteria constitute an adequate pacing site?

Goldberger, Jeffrey J.; Kruse, Jane; Ehlert, Frederick A.; Kadish, Alan H.

doi:10.1016/0002-8703(93)91083-q

Cited by 8 publications

(3 citation statements)

References 13 publications

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“…For example, only 7% of emergency TTCP operators had ever received any formal training in the UK. 21 In our study, even though TTCP was well prepared and IC-ECG guidance was used to ensure that the pacing lead properly touched the right ventricle wall, [16][17][18] a high incidence of myocardial injury was still demonstrated.…”

Section: Discussionmentioning

confidence: 77%

“…Pacing catheterization was guided by intracavity electrocardiography (IC-ECG). 16 , 17 The target of the proximal electrode was shown by a slight ST-segment elevation <2 mV on IC-ECG, constituting a proper positioning against the ventricular wall and an adequate pacing site, 18 which can be very difficult to maintain it if the patient changes positions ( Figure 1 ). The location of the catheter tip was further confirmed with downward QRS waves in leads II, III, and aVF on standard pacing ECG.…”

Section: Methodsmentioning

confidence: 99%

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Myocardial Injury After Temporary Transvenous Cardiac Pacing

Liu¹,

Wu²

2021

TCRM

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Introduction: Temporary transvenous cardiac pacing (TTCP) can lead to potential penetration and occasional perforation of the right ventricular wall. No study to date has analyzed the effect of TTCP on myocardial injury by cardiac troponin (cTn) measurement. The present study was designed to investigate perioperative myocardial injury in elective TTCP in noncardiac surgical settings. Patients and Methods: This retrospective study investigated the data collected from August 2018 through March 2020 from 22 eligible patients who underwent elective TTCP for noncardiac procedures. The patients had a median age of 66 (50-83) years; six (27.3%) of them were women, and all of them had a baseline cTn <1 upper reference limit (URL). Cardiac biomarker assays were performed before and after TTCP, and their results were compared. Results: After TTCP, cTn > 1 URL was detected in 20 (91%, N=22) patients. Among these 22 patients, paired t-test comparing assay results before and after TTCP lead insertion showed a mean cTn elevation of 3.599 URL (95% CI: 1.566 to 5.632, P<0.01), and a mean creatine kinase-MB isoform elevation of 0.1550 URL (95% CI: −0.01239 to 0.3224, P>0.05). Conclusion:The study demonstrates a high incidence of myocardial injury associated with TTCP, which should be a matter of concern for the involved physicians.

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Section: Discussionmentioning

confidence: 77%

Section: Methodsmentioning

confidence: 99%

Myocardial Injury After Temporary Transvenous Cardiac Pacing

Liu¹,

Wu²

2021

TCRM

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“…Although some current of injury may be necessary to ensure adequate endocardial contact and normal pacemaker function, advancing the catheter to obtain greater than 0.5 mV PR elevation for an atrial wire or greater than 2.0 mV of ST elevation for a ventricular lead does not appear to improve pacing thresholds [46]. In urgent situations, neither fluoroscopic nor intracardiac e1ectrographic guidance may be available.…”

Section: Pacing Catheter Insertion: Techniques and Assessmentmentioning

confidence: 99%

Temporary Cardiac Pacing in the Intensive Care Unit

Goldschlager

1996

J Intensive Care Med

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Indications for temporary cardiac pacing have increased substantially in the last several years. Although most temporary cardiac pacing is still carried out to treat symptomatic bradycardia due to atrioventricular conduction system disease or atrial bradycardia (i.e., sinus node dysfunction), temporary pacing is currently used to induce and to terminate some supraventricular tachyarrhythmias, prevent pause-dependent ventricular tachycardia (usually torsades de pointes), and vagally mediated atrial fibrillation, to allow the maintenance of hemodynamic competence in postoperative cardiac patients and to evaluate selected patients with hypertrophic and dilated cardiomyopathies who might benefit hemodynamically from cardiac pacing. The roles of transcutaneous and esophageal pacing have also expanded; transcutaneous pacing is now commonly used in patients at high risk for the development of atrioventricular block, such as those with acute myocardial infarction and bifascicular block. We review available types of temporary pacing leads and pulse generators, the methods by which temporary pacing is accomplished, complications of pacing system insertion, and current indications for this therapy. Guidelines for troubleshooting normal and abnormal pacemaker function in the intensive care unit setting are provided.

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Temporary Cardiac Pacing

Wood¹,

Ellenbogen²

2005

Cardiac Pacing and ICDs

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Temporary transvenous pacemaker placement: What criteria constitute an adequate pacing site?

Cited by 8 publications

References 13 publications

Myocardial Injury After Temporary Transvenous Cardiac Pacing

Myocardial Injury After Temporary Transvenous Cardiac Pacing

Temporary Cardiac Pacing in the Intensive Care Unit

Temporary Cardiac Pacing

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