Temporary Pacing

Abstract

Patients with significant intracardiac conduction defects who are symptomatic with dizziness or syncope due to bradycardia should have a temporary pacemaker (TPM) inserted if the defect is thought to be reversible, or if when deemed irreversible, permanent pacemaker implantation cannot be done immediately. After acute myocardial infarction (MI) (see Fig. 3.1) or cardiac surgery, evidence of new or extensive intracardiac conduction defect, prolonged sinus arrest or asystole require a TPM. Those with “at risk” conduction defects require a TPM prior to general anesthesia as do patients with certain drug overdosage associated with severe bradycardia, for example, digoxin toxicity, β-blocker, or verapamil overdosage.