Hemodynamic monitoring and pacing with one catheter: a pilot study

Attempts to incorporate the monitoring of central pressures and pacing into one catheter have heretofore been unsuccessful. Recently, a new catheter for monitoring central hemodynamic pressures, which has a right ventricular port (Chandler pacing port), has been devised, which has been reported to allow for simultaneous acquisition of hemodynamic data and reliable pacemaker function as well. To assess the reliability of this catheter, we studied ten consecutive Swan-Ganz catheterizations utilizing this new catheter system. In all instances, hemodynamic monitoring was established without difficulty. In three instances, because of right heart enlargement, fluoroscopy was necessary to position the pacing probe at the right ventricular apex. In all ten instances, a threshold of less than 2.5 mV was obtained. Isolated PVCs and nonsustained ventricular tachycardia were common during insertion. After initial placement, the threshold for sensing and pacing was assessed every 6 hr. Malfunction occurred in three patients. In all, repositioning was accomplished without marked difficulty; in one it required fluoroscopy. In three instances, the Swan-Ganz pacing catheter system malfunctioned. These data are similar to data utilizing other modalities of temporary pacing and suggest that this catheter may be capable of providing hemodynamic monitoring and pacing from a single percutaneous procedure.