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


METHODS
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.


RESULTS
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.
Hasan
Shafqat
S
The South West Cardiothoracic Centre, Plymouth, United Kingdom. faizashafqat@hotmail.com
Lewis
C Terence
CT
D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged