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Right arrow Electrophysiology - arrhythmias

Ann Thorac Surg 2005;79:1384-1387
© 2005 The Society of Thoracic Surgeons

New technology

A New Method of Temporary Epicardial Atrioventricular Pacing Utilizing Bipolar Pacing Leads

Shafqat Hasan, FRCS(CTh)*, C. Terence Lewis, FRCS

The South West Cardiothoracic Centre, Plymouth, United Kingdom

Accepted for publication April 14, 2004.

* Address reprint requests to Dr Hasan, Aston Cottage, Heyford Rd, Steeple Aston, Oxon, OX25 4SH UK (E-mail: faizashafqat{at}hotmail.com).

PURPOSE: We evaluated a convenient method of temporary atrioventricular pacing utilizing bipolar epicardial pacing leads that offer better sensing and pacing performance.

DESCRIPTION: Fifty-one patients undergoing coronary artery bypass grafting had atrial and ventricular bipolar leads implanted. The ventricular leads were inserted onto the front of the right ventricle, and the atrial leads were inserted into the lateral muscular part of the right atrium near the interatrial groove. Sensing values, pacing thresholds, and impedance were measured on all leads on postoperative days 0, 2, and 4, and complications of insertion and removal were noted.

EVALUATION: The method was convenient and there were no complications during insertion or removal. The mean pacing threshold increased from 1.1 V to 1.5 V in both the atrial and ventricular leads from day 0 to day 4 (not significant). The mean sensed p wave amplitude decreased from 2.2 mv to 2.0 mv (not significant), and the mean sensed R wave amplitude decreased from 6.2 mv to 4.1 mv (p = 0.001) from day 0 to day 4. In spite of this significant drop in the sensed R wave amplitude, this value remained in an acceptable range. There was also a significant decrease in impedance, but overall all values were in an acceptable range assuring safe and effective pacemaker function. Only one atrial lead (2%) and three ventricular leads (6.1%) failed to pace on day 4.

CONCLUSIONS: We conclude that this temporary epicardial pacing method is safe, convenient, and less time consuming. Satisfactory pacing and sensing performance was achieved with low thresholds and minimal complications.






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