Bedside emergency transvenous cardiac pacing: experience in two community hospitals

Emergency bedside transvenous subclavian cardiac pacing in 51 patients over a three-year period in two community hospitals is described. Fifty-three procedures were performed at the bedside with semifloating bipolar pacemaker catheters under continuous electrocardiographic monitoring to assist in the placement of the catheter tip. Of the 53 procedures, initial success in pacing was observed in 41 patients (77%). The largest number of failures to either initiate or maintain pacing was observed in the group with cardiac arrest associated with extensive myocardial infarction and complete heart block. Complications of this procedure were minimal. Only one 10% pneumothorax was noted. This modified technique is easily mastered and may prove lifesaving in an emergency.