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Temporary A-V sequential pacing using transluminal pacing electrodes.

S E McNulty1, J McQueen

  • 1Department of Anesthesiology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania 19107.

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|May 1, 1988
PubMed
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This study demonstrates successful temporary atrial-ventricular sequential pacing using epicardial atrial wires and a transvenous ventricular pacing probe. This combined approach enhanced cardiac output and improved safety in a patient with post-operative heart block.

Area of Science:

  • Cardiology
  • Cardiac Electrophysiology

Background:

  • A 68-year-old female with a permanent pacemaker underwent aortocoronary bypass surgery.
  • Electrocautery during surgery necessitated conversion to ventricular pacing (VVI).

Observation:

  • A transvenous ventricular pacing probe was inserted via a pulmonary artery catheter.
  • Initial ventricular pacing increased cardiac output from 2.8 to 3.2 L/min.
  • Post-bypass, atrial epicardial wires were used for pacing.
  • The patient developed intermittent heart block, requiring temporary atrial-ventricular sequential pacing.

Findings:

  • Temporary atrial-ventricular sequential pacing was established using atrial epicardial wires and the existing ventricular probe.
  • Pacing at 7 mA with a 0.120 sec A-V interval increased cardiac output from 3.3 to 4.1 L/min.

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  • The combined pacing systems proved compatible and effective.
  • Implications:

    • This dual-system compatibility offers enhanced safety for cardiac surgery patients requiring atrial pacing.
    • It provides a reliable method for managing post-operative heart block.
    • This approach can improve hemodynamic stability in high-risk surgical patients.