Temporary pacemaker is necessary and used to treat transient bradycardia during various cardiovascular procedures such as percutaneous coronary intervention and structural heart intervention. The traditional design of temporary pacing lead includes two electrolytes attached to the distal tip of the catheter without stabilizing feature. Hence, the pacing wire can dislodge or move to different places and require restriction on patient mobilization with prolonged hospital stay.
There are different type of pacing wires available in the market and we can categorize into two groups.
- Pacing lead without active fixation (Abbott/St Jude, Teleflex, BD, Osypka)
- Pacing lead with active fixation (Biotrace Medical)
Pacel Bipolar Pacing Catheter (Abbott/St Jude)
- Pacing catheter: Ventricular pacing with 60 Degree Curve
- Pacing catheter: Ventricular pacing with Right Heart Curve
- Pacing catheter: Atrial J pacing
2. Flow Directed Pacing Catheter (with floating balloon)
- Pacing catheter: Straight
- Pacing catheter: Right Heart Curve
Arrow Temporary Pacing Catheters (Teleflex)
- Available in two styles of pacing catheters – torque-directed or balloon flotation
BD Temporary Pacing Catheters (BD)
BD Temporary Pacing Electrode Catheters are available in different designs to tackle any challenging clinic scenarios presented.
- The NBIH™ and GOETZ™ catheter lines are ideal for use in the cath lab or the critical care unit when fluoroscopy is available
- The Balloon Flow-Assisted catheter line is suited for emergency cases and in critical care units where fluoroscopy is not readily available
- The ZUCKER™, MYLER™ catheters are open-lumen diagnostic pacing catheters useful during right heart procedures and critical care unit monitoring
Bipolar Pacing Catheter (Edwards)
1. Bipolar pacing catheter
- Available in balloon floatation pacemaker to assist during device placement by flow-direction
2. Swan-Ganz Paceport and A-V Paceport pulmonary artery catheters
While the paceport catheter facilitates temporary ventricular pacing, the A-V Paceport catheter enables atrial, ventricular or A-V sequential temporary transvenous pacing.
Both catheters deliver basic hemodynamic monitoring including:
- Right heart catheterization for right heart pressure measurements (PAS, PAD, PAOP) for diagnostic purposes
- Single point-in-time calculations of cardiac output using bolus thermodilution for diagnosing cardiac function
- Fluid infusion and RV pressure monitoring when the pacing probe is not inserted
- Available in oximetry Paceport catheter versions
3. Chandler transluminal pacing for A, V, or A-V pacing
The Chandler transluminal v-pacing probe can be used with multiple Paceport catheter models for standby ventricular pacing when the patient’s condition warrants.
- The Flex-Tip transluminal a-pacing probe can be inserted into the A-probe lumen of the A-V Paceport catheter (model 991F8) for atrial pacing
- For atrio-ventricular pacing, the A-V Paceport catheter can be used with both the Chandler transluminal v-pacing probe and the Flex-Tip transluminal a-pacing probe
Temporary Leads (Osypka)
- Available in various shapes with or without flotation balloon
- Two types available – TB and Helios
Tempo Lead (Biotrace Medical)
- Only temporary pacing lead with active fixation system
- Enable postprocedural patient ambulation and commences physical therapy with pacing lead in situ
- Suitable to use for TAVR patients, alcohol septal ablation while waiting whether patient would require permanent pacemaker or not
- Data from a multicenter retrospective study performed at USA including 224 transcatheter procedures demonstrated no device related cardiac complications such as perforations, pericardial effusions, or sustained device-related arrhythmias. Of these patients, 84.1% mobilized out of bed with no lead dislodgment and ONLY two patients (0.8%) experienced loss of pace capture.1
- Nazif, Tamim M., et al. “The initial US experience with the Tempo active fixation temporary pacing lead in structural heart interventions.” Catheterization and Cardiovascular Interventions 95.5 (2020): 1051-1056.