![]() First-degree AV block with bifascicular block.Second-degree or third-degree AV block.Support for procedures that may promote bradycardia.Ventricular tachyarrhythmias secondary to bradycardia.Second-degree or third-degree AV block with haemodynamic compromise or syncope at rest.Bradycardia not associated with acute myocardial infarction:.New or indeterminate-age bifascicular block with first-degree AV block.Symptomatic bradycardia (sinus bradycardia with hypotension and type I second-degree atrioventricular (AV) block with hypotension not responsive to atropine).Indications for temporary transvenous cardiac pacingĪll the indications for permanent pacing are also suitable for temporary pacing. The underlying rhythm should also be assessed and recorded at these checks.Temporary pacemakers must be checked by competent staff at least once daily for pacing thresholds, evidence of infections around venous access sites, integrity of connections, and battery status of the external generator.Consensus guidelines recommend that temporary pacemaker insertion should be avoided if there is a high probability that permanent pacing will eventually be required. In one review, 2-18% of patients developed sepsis after temporary pacemaker insertion.The most frequent complications are failure to secure venous access, failure to place the lead correctly, infection, thromboembolism, puncture of arteries, lung or myocardium, and life-threatening arrhythmias. Complication rates have certainly improved over time due to technological improvement and increasing operator experience. ![]() An American review suggested a maximum complication rate of 12.6% with considerable variation between studies.Fluoroscopy is the preferred imaging technique but this is often not available, so ultrasound is an acceptable alternative. The use of antibiotics should be considered for all wire insertions.Although right- or left-sided veins can be used, the right side is traditionally preferred as it is technically easier, and the left side is usually reserved for permanent systems.The preferred route of access for temporary transvenous pacing is a percutaneous approach of the subclavian vein, the cephalic vein or, rarely, the axillary vein, the internal jugular vein or the femoral vein.Temporary transvenous pacing involves two components - obtaining central venous access and intracardiac placement of the pacing wire.Complications are common and include infection, local trauma, pneumothorax, arrhythmias and cardiac perforation. Temporary cardiac pacing provides electrical stimulation to a heart that is compromised by disturbances in the conduction system, resulting in haemodynamic instability.Ī temporary pacemaker to treat a bradydysrhythmia is used when the condition is temporary and when a permanent pacemaker is either not necessary or is not immediately available.
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