Sunday, 1 July 2012

- Avoiding Problems with Temporary Cardiac Pacing.

Avoiding Problems with Temporary Cardiac Pacing.  

 Temporary pacing is used during emergency treatment of some bradyarrhythmias and tachyarrhythmias, and also used prophylactically for patients at risk for bradyarrhythmias during cardiovascular surgery.

Staff in one hospital reported many inadvertent disconnections with a new reusable extension cable that was supposed to connect the lead to the pacemaker. This problem had not occurred with the old cable. Staff resorted to using surgical tape to maintain the connection between the pacing wire and the extension cable, a practice that's not recommended in the instructions.

Leads can also fracture. In one case, the distal tip of a temporary epicardial lead broke off and remained in the patient when the lead was removed 13 days after surgery. The lead manufacturer had recommended only a 7-day implant duration.

There is also a risk of misconnection when using a balloon temporary pacing catheter that has an extra lumen for infusion, hemodynamic monitoring or blood sampling. In one case, a patient's caregiver accidentally connected I.V. tubing to the pacing catheter's balloon inflation port, causing the balloon to burst inside the patient.

There are several ways to help avoid problems like these. They include verifying that proper connections have been made throughout the entire pacing system, and knowing your hospital's policy and procedures for handling defective devices.

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