Temporary Pacing

Probably won't need another lead

by crustyg - 2019-08-27 08:16:43

Hi:

If you're only having a box replacement then there should be no need for you to have an additional pacing wire inserted, and a lot of reasons why it wouldn't be a good idea.

Your EP doc should be able to disconnect your pacing wire(s) from your existing box and connect them to (sterile) croc clips that are powered by an external pacing machine within a couple of seconds.  You might miss one or two beats but that really doesn't matter.  You can survive quite some time with no pacing - especially if you're calm, resting and lying flat - before your blood pressure falls so far that you don't supply the important stuff - brain and heart.  Everything else can handle a few minutes of low blood flow.  They could even drive your heart rate with an infusion if they're really under time pressure - it's what they do for emergencies who come in with new complete heart block and very low HR and BP.  But I can't imagine anyone needing this for a routine box change.

Then you're paced by an external machine while they check the other lead, the pocket etc., before the new box is ready and connected up, and then you're back onto pacing from a box that is about to become internal.

All of this is done through a re-opening of the incision where your box was implanted.  Probably with just local analgesia.

Box changes are usually very relaxed, calm, and quick procedures.  Some of the folk here have had lots...

pacing during replacement

by Tracey_E - 2019-08-27 09:41:06

I've heard of a few who had temporary pacing through the groin during a replacement but most of us have external or nothing. They have the new one programmed and ready to go so it's only a matter of seconds between disconnecting the old one and connecting the new one. When I get close to replacement, they usually turn off the pacer for a few seconds to see how low my underlying rate is. It's been anywhere from 20 to 60. External is giant sticky pads, so non-invasive and the worst part is getting the adhesive off later. I'm on my 5th. 

Temporary external PM

by IPGENG12 - 2019-08-30 20:10:58

I had to get a left ventricular lead revision done.  During that procedure they did place a temporary pacing wire through my right femoral vein,  but that was because the lead replacement can (and was) a lengthy affair where my pacemaker was disconnected.  As mentioned in one of the other posts,  a regular "box" change should not normally need placement of a temporary pace wire.