Techniques for Temporary Pacing

  • Ejigayehu Abate
  • Fred M. Kusumoto
  • Nora F. Goldschlager

Temporary pacing of the heart was first accomplished by Hyman in the early 1930s by a transthoracic approach using a clockwork-driven generator. In the early 1950s Zoll successfully resuscitated an asystolic patient using temporary transcutaneous pacing. Later in that decade, the feasibility of transvenous pacing and transesophageal pacing was demonstrated. Temporary pacing has become the standard method for providing immediate treatment of severe bradycardias and certain tachycardias for the past 20 years.


Internal Jugular Vein Atrial Flutter Subclavian Vein Cardiac Pace Pace Lead 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Zoll PM. Resuscitation of the heart in ventricular standstill by external electric stimulation. N Engl J Med 1952;247:768–952.PubMedGoogle Scholar
  2. 2.
    Zoll PM. Noninvasive cardiac stimulation revisited. PACE 1990;13:2014.PubMedGoogle Scholar
  3. 3.
    Zoll PM, Zoll RH, Falk RH, et al. External noninvasive temporary cardiac pacing: clinical trials. Circulation 1985;71:937.PubMedGoogle Scholar
  4. 4.
    Falk RH, et al. Safety and efficacy of noninvasive cardiac pacing: a preliminary report. N Engl J Med 1988;17:27.Google Scholar
  5. 5.
    Talit IJ, et al. The effect of external cardiac pacing on stroke volume. PACE 1990;13:598.PubMedGoogle Scholar
  6. 6.
    Niemann JT, et al. External noninvasive cardiac pacing: a comparative hemodynamic study of two techniques with conventional endocardial pacing. PACE 1984;7:230–984.PubMedGoogle Scholar
  7. 7.
    Falk RH, et al. External cardiac pacing: influence of electrode placement on pacing threshold. Crit Care Med 1986;14:93.CrossRefGoogle Scholar
  8. 8.
    Falk RH, et al. Cardiac activation during external cardiac pacing. PACE 1987;10:503.PubMedGoogle Scholar
  9. 9.
    Luck JC, et al. Clinical applications of external pacing: a renaissance? PACE 1991;14:1299.PubMedGoogle Scholar
  10. 10.
    Trigano JA, et al. Noninvasive transcutaneous cardiac pacing: modern instrumentation and new perspectives. PACE 1992;15:1937.PubMedGoogle Scholar
  11. 11.
    Furman S, et al. Intracardiac PACE maker for Stokes-Adams seizures. N Engl J Med 1959;261:943.PubMedGoogle Scholar
  12. 2.
    Marino PL. The ICU book. Central venous access. Philadelphia: Lea & Febiger, 1991:39.Google Scholar
  13. 13.
    Seneff MG. Central venous catheterization: a comprehensive review, Part 1. Int Care Med 1987;2:163.CrossRefGoogle Scholar
  14. 14.
    Seneff MG. Central venous catheterization: a comprehensive review, Part 2. Int Care Med 1987;2:218.CrossRefGoogle Scholar
  15. 15.
    Seldinger SI. Catheter replacement of the needle in percutaneous arteriography: a new technique. Acta Radiol Diagn 1953;89:368.CrossRefGoogle Scholar
  16. 16.
    McGee DC, Gould MK. Preventing complications of central venous catheterization. New Engl J Med 2003;348:1123–1133.CrossRefPubMedGoogle Scholar
  17. 17.
    Martin MJ, Husain FA, Piesman M, Mullenix PS, Steele SR, Andersen CA, Giacoppe GN. Is routine ultrasound guidance for central line placement beneficial? A prospective analysis. Curr Surg 2004;61:71–74.CrossRefPubMedGoogle Scholar
  18. 18.
    Nolewajka J, et al. Temporary transvenous pacing and femoral vein thrombosis. Circulation 1980;62:646.PubMedGoogle Scholar
  19. 19.
    Pandian NG, et al. Transfemoral temporary pacing and deep venous thrombosis. Am Heart J 1980;100:847.CrossRefPubMedGoogle Scholar
  20. 20.
    Austin JL, et al. Analysis of pacemaker malfunction and complications of temporary pacing in the coronary care unit. Am J Cardiol 1982;49:301.CrossRefPubMedGoogle Scholar
  21. 21.
    Dohlma ML, et al. Myocardial stimulation threshold in patients with cardiac pacemakers: effect of physiologic variables, pharmacologic agents, and lead electrodes. Cardiol Clin 1985;3:527.Google Scholar
  22. 22.
    Murphy JJ. Current practice and complications of temporary transvenous pacing. Br Med J 1996;312:1134.Google Scholar
  23. 23.
    Braun MU, Rauwolf T, Bock M, Kappert U, Boscheri A, Schnabel A, Strasser RH. Percutaneous lead implantation connected to an external device in stimulation dependent patients with systemic infection–A prospective and controlled study. Pacing Clin Electrophysiol 2006;29:875–879.CrossRefPubMedGoogle Scholar
  24. 24.
    Lever N, Ferguson JD, Bashir Y, Channon KM. Prolonged temporary pacing using subcutaneous tunneled axtive-fixation permanent pacing leads. Heart 2003;89:209–210.CrossRefPubMedGoogle Scholar
  25. 25.
    Zei PC, Eckart RE, Epstein LM. Modified temporary cardiac pacing using transvenous active fixation leads and external resterilized pulse generators. J Am Coll Cardiol 2006;47:1487–1489.CrossRefPubMedGoogle Scholar
  26. 26.
    Hynes JK, et al. Five-year experience with temporary pacemaker therapy in the coronary care unit. Mayo Clin Proc 1983;58:122.PubMedGoogle Scholar
  27. 27.
    Feliciano DV, et al. Major complications of percutaneous subclavian vein catheters. Am J Surg 1979;138:869.CrossRefPubMedGoogle Scholar
  28. 28.
    Sznajder JI, et al. Central vein catheterization: failure and complication rates by three percutaneous approaches. Arch Intern Med 1986;146:259.CrossRefPubMedGoogle Scholar
  29. 29.
    Kaiser CW, et al. Choice of route for central venous cannulation: subclavian or internal jugular vein: a prospective randomized study. J Surg Oncol 1981;17:345.CrossRefPubMedGoogle Scholar
  30. 30.
    Morelli RL, et al. Temporary transvenous pacing: resolving postinsertion problems. J Crit Illness 1987;2(4):73.Google Scholar
  31. 31.
    Gallagher JJ, et al. Esophageal pacing: a diagnostic and therapeutic tool. Circulation 1982;65:336.PubMedGoogle Scholar
  32. 32.
    Benson DW Jr, et al. Transesophageal cardiac pacing: history, application, technique. Clin Prog Pacing Electrophysiol 1984;2:360.Google Scholar
  33. 33.
    Benson DW Jr, et al. Transesophageal atrial pacing threshold: role of interelectrode spacing, pulse width and catheter insertion depth. Am J Cardiol 1984;53:63.CrossRefPubMedGoogle Scholar
  34. 34.
    Nishimura M, et al. Optimal mode of transesophageal atrial pacing. Am J Cardiol 1986;57:791.CrossRefPubMedGoogle Scholar
  35. 35.
    Crawford W, Plumb VJ, Epstein AE, et al. Prospective evaluation of transesophageal pacing for interruption of atrial flutter. Am J Med 1989;86:663–667.CrossRefPubMedGoogle Scholar
  36. 36.
    Falk RH, Werner M. Transesophageal atrial pacing using a pill electrode for termination of atrial flutter. Chest 1987;92:110–114.CrossRefPubMedGoogle Scholar
  37. 37.
    Doni F, Della Bella P, Kheir A. Atrial flutter termination by overdrive transesophageal pacing and the facilitating effect of oral propafenone. Am J Cardiol 1995;76:1243–1246.CrossRefPubMedGoogle Scholar
  38. 38.
    Butto F, Dunnigan A, Overholt E, et al. Transesophageal study of recurrent atrial tachycardia after atrial baffle procedures for complete transposition of the great arteries. Am J Cardiol 1986;57:1356–1362.CrossRefPubMedGoogle Scholar
  39. 39.
    Montoyo J, et al. Cardioversion of tachycardias by transesophageal atrial pacing. Am J Cardiol 1973;32:85.CrossRefPubMedGoogle Scholar
  40. 40.
    Benson DW Jr, et al. Transesophageal study of infant supraventricular tachycardia: electrophysiologic characteristics. Am J Cardiol 1983;52:1002.CrossRefPubMedGoogle Scholar
  41. 41.
    Santini M, et al. Transesophageal pacing. PACE 1990;13:1298.PubMedGoogle Scholar
  42. 42.
    Blomstrom-Lundqvist C, et al. Transesophageal versus intracardiac atrial stimulation in assessing electrophysiologic parameters of the sinus and AV nodes and of the atrial myocardium. PACE 1987;10:1081.PubMedGoogle Scholar
  43. 43.
    Critelli G, et al. Transesophageal pacing for prognostic evaluation of pre-excitation syndrome and assessment of protective therapy. Am J Cardiol 1983;51:513.CrossRefPubMedGoogle Scholar
  44. 44.
    Benson DW Jr, et al. Atrial pacing from the esophagus in the diagnosis and management of tachycardia and palpitations. J Pediatr 1983;102:40.CrossRefPubMedGoogle Scholar
  45. 45.
    Lee CY, Pellikka PA, McCully RB, et al. Nonexercise stress transthoracic echocardiography: transesophageal atrial pacing vs. dobutamine stress. J Am Coll Cardiol 1999;33:506–511.CrossRefPubMedGoogle Scholar
  46. 46.
    Edhag O, et al. Cardiac pacing through transthoracic electrode in acute myocardial infarction. Acta Med Scand 1972;192:145.PubMedGoogle Scholar
  47. 47.
    Tintinalli JE, et al. Transthoracic pacing during CPR. Am J Emerg Med 1981;10:113.Google Scholar
  48. 48.
    White JD, et al. Transthoracic pacing in cardiac asystole. Am J Emerg Med 1983;1:264.CrossRefPubMedGoogle Scholar
  49. 49.
    Brown CG, et al. Placement accuracy of percutaneous transthoracic pacemakers. Am J Emerg Med 1985;3:193.CrossRefPubMedGoogle Scholar
  50. 50.
    Del Nido P, et al. Temporary epicardial pacing after open heart surgery: complications and prevention. J Cardiac Surg 1989;4:99.CrossRefGoogle Scholar
  51. 51.
    Dzemali O, Bakhtiary F, Dogan S, Wittlinger T, Moritz A, Kleine P. Perioperative biventricular pacing leads to improvement of hemodynamics in patients with reduced left-ventricular function–interim results. Pacing Clin Electrophysiol. 2006 Dec;29(12):1341–1345.CrossRefPubMedGoogle Scholar
  52. 52.
    Waldo AL, et al. Use of temporarily placed epicardial atrial wire electrodes in the diagnosis and treatment of cardiac arrhythmias following open-heart surgery. J Thorac Cardiovasc Surg 1978;76:500.PubMedGoogle Scholar
  53. 53.
    Kurz DJ, Naegeli B, Kunz M, et al. Epicardial, biatrial synchronous pacing for prevention of atrial fibrillation after cardiac surgery. PACE 1999;22:721–726.PubMedGoogle Scholar
  54. 54.
    Waldo AL, MacLean WAH. Diagnosis and treatment of cardiac arrhythmias following open heart surgery: Emphasis on the use of atrial and ventricular epicardial wire electrodes. Mount Kisco, NY: Futura Publishing, 1980.Google Scholar
  55. 55.
    Kallis P, Batrick N, Bindi F, et al. Pacing thresholds of temporary epicardial electrodes: Variation with electrode type, time, and epicardial position. Ann Thorac Surg 1994;57:623–626.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Ejigayehu Abate
    • 1
  • Fred M. Kusumoto
    • 1
  • Nora F. Goldschlager
    • 2
  1. 1.Department of MedicineMayo ClinicJacksonvilleUSA
  2. 2.ECG Laboratory and Coronary Care UnitUniversity of California San Francisco School of MedicineSan FranciscoUSA

Personalised recommendations