{ "schemaVersion": 2, "eyebrow": "Cardiac electrophysiology", "title": "Temporary Pacing for Bradycardia", "summary": "Use temporary pacing for hemodynamically unstable bradycardia, high-grade conduction disease, or impending bradyasystolic collapse when pharmacologic reversal is ineffective, inappropriate, or too slow. Select transcutaneous pacing for immediate bridging and transvenous pacing when reliable support must continue.", "seoDescription": "Temporary pacing indications for unstable bradycardia: when to use transcutaneous or transvenous pacing, procedural cautions, and escalation decisions.", "clinicalQuestion": "When should temporary transcutaneous or transvenous pacing be used for adult bradycardia?", "specialty": "Cardiology and emergency medicine", "audience": "U.S. physicians and medical trainees", "tags": [ "temporary pacing", "transcutaneous pacing", "transvenous pacing", "unstable bradycardia", "complete heart block", "symptomatic bradycardia" ], "keyTakeaways": [ "Initiate temporary pacing for symptomatic bradycardia with hemodynamic instability; transcutaneous pacing is the fastest available pacing method and is commonly used as a bridge to transvenous or permanent pacing. [12][17][23]", "Do not rely on transcutaneous pacing when pacing support will be prolonged; move to transvenous pacing when ongoing reliable pacing is required. [23]", "Avoid or use temporary pacing cautiously in stable bradyarrhythmias with tolerable symptoms, hypothermia, prolonged bradyasystolic arrest, prosthetic tricuspid valves, and patients with major bleeding risk. [19][23]", "Confirm mechanical—not only electrical—capture after initiating external or transvenous pacing by pulse assessment and hemodynamic response. [21]", "For propranolol overdose with hypotension or depressed myocardial function, IV glucagon 50-150 mcg/kg followed by 1-5 mg/hour infusion is a labeled supportive option; severe bradycardia may require temporary pacing. [1]" ], "sections": [ { "id": "decision-to-pace", "eyebrow": "Immediate triage", "heading": "Pace unstable bradycardia before prolonged organ hypoperfusion", "intro": "The pacing decision depends on instability, rhythm mechanism, reversibility, and anticipated duration of support.", "paragraphs": [ "Use emergency temporary pacing when bradycardia produces hemodynamic instability or symptomatic deterioration and requires immediate rate support. Emergency indications include unstable bradyarrhythmias from degenerative conduction disease and acute coronary syndrome complicated by bradycardia. [12][20]", "Treat pacing as a bridge when a reversible cause is being corrected or when definitive rhythm support is being arranged. External pacing is particularly useful in transient settings such as digoxin toxicity and atrioventricular block with inferior-wall myocardial infarction, but it should not be the sole strategy when prolonged temporary pacing is anticipated. [23]", "Do not pace solely because the heart rate is low in a hemodynamically stable patient with rare or tolerable symptoms. Temporary pacing is also generally avoided in hypothermia and may be futile in prolonged bradyasystolic arrest, especially after delayed resuscitation exceeding 20 minutes. [19][23]" ], "bullets": [ "Escalate immediately to pacing for unstable symptomatic bradycardia when delay risks cardiovascular collapse, organ hypoperfusion, or death. [17]", "Use a temporary pacing strategy for severe sinus node dysfunction, high-grade atrioventricular block, or bradycardic arrest when clinically appropriate. [23]", "In acute myocardial infarction, consider prophylactic temporary pacing when high-degree AV block, severe sinus node dysfunction, or asystole is anticipated. [13]" ], "subsections": [], "table": { "caption": "Temporary pacing modality selection for clinically significant bradycardia. [17][19][23]", "columns": [ "Clinical situation", "Preferred immediate approach", "What changes management" ], "rows": [ [ "Unstable bradycardia requiring the fastest rate support", "Start transcutaneous pacing while preparing a durable strategy. [17][23]", "Assess for electrical and mechanical capture; absent pulse response or persistent shock requires immediate escalation. [21]" ], [ "Need for continued, reliable temporary pacing", "Place a temporary transvenous pacemaker rather than relying on prolonged transcutaneous pacing. [19][23]", "Use central venous access, pacing catheter, external generator, sterile technique, and continuous physiologic monitoring. [19]" ], [ "Reversible or transient bradyarrhythmia", "Use transcutaneous pacing as a bridge while correcting the cause or arranging definitive treatment. [23]", "Examples include digoxin toxicity and AV block during inferior-wall MI. [23]" ], [ "Stable bradycardia with minimal symptoms", "Do not routinely pace; monitor and reassess if instability develops. [19]", "Pacing becomes appropriate if symptoms or hemodynamic instability emerge. [12][20]" ] ] } }, { "id": "transcutaneous-pacing", "eyebrow": "Bridge therapy", "heading": "Use transcutaneous pacing when time to capture matters", "intro": "Transcutaneous pacing provides immediate temporary rate support but has important reliability and tolerability limits.", "paragraphs": [ "Transcutaneous pacing is the fastest pacing method for many bradyarrhythmias and selected conduction disturbances. It is appropriate when transvenous pacing is not immediately available, when a transient cause is likely, or while a transvenous lead or permanent pacemaker is being arranged. [17][23]", "Do not interpret pacing spikes alone as success. Confirm electrical capture on the ECG and mechanical capture by pulse palpation and hemodynamic response; a procedural checklist specifically requires pulse confirmation by a nonsterile assistant after electrical capture is seen. [21]", "Anticipate discomfort, possible failure of electrical or mechanical capture, monitoring interference, skin injury, and arrhythmia induction. Keep medications and a transvenous pacing system immediately available when external pacing may fail or when ongoing pacing is likely. [17]" ], "bullets": [ "Use transcutaneous pacing as a bridge—not a prolonged maintenance modality—when the patient requires persistent temporary pacing. [23]", "Use caution or avoid transcutaneous pacing in hypothermia and in asystolic cardiac arrest after resuscitation has been delayed more than 20 minutes. [23]", "If external pacing is ineffective or poorly tolerated and clinically meaningful pacing remains necessary, proceed to transvenous pacing. [17][23]" ], "subsections": [], "table": { "caption": "Practical limitations of transcutaneous pacing. [17][21][23]", "columns": [ "Issue", "Bedside check", "Next action" ], "rows": [ [ "Electrical pacing without mechanical perfusion", "Palpate a pulse and assess blood pressure after paced complexes appear. [21]", "Treat absent mechanical capture as pacing failure and escalate to an alternative strategy. [17]" ], [ "Need for ongoing temporary support", "Reassess whether the expected pacing duration exceeds a short bridge period. [23]", "Transition to transvenous pacing if reliable prolonged pacing is required. [23]" ], [ "Pain, skin injury, or monitoring interference", "Monitor skin and the quality of ECG and hemodynamic assessment. [17]", "Prepare transvenous pacing and required medications at the bedside. [17]" ] ] } }, { "id": "transvenous-pacing", "eyebrow": "Durable temporary support", "heading": "Choose transvenous pacing when external pacing is inadequate or prolonged support is expected", "intro": "Temporary transvenous pacing is an emergency procedure for unstable bradyarrhythmia requiring dependable intracardiac capture.", "paragraphs": [ "Temporary transvenous pacing is indicated for hemodynamically unstable symptomatic bradycardia when temporary pacing must be reliable or sustained. It is performed by advancing a catheter-based electrode to the right side of the heart through central venous access and connecting it to an external pulse generator. [12][19][20]", "Prepare the procedure with a 6 Fr percutaneous venous introducer sheath, transvenous pacing catheter, external generator, 12-lead-capable ECG, continuous cardiac monitoring, pulse oximetry, and noninvasive or invasive blood-pressure monitoring. Ultrasound guidance for central venous access is strongly recommended, and sterile technique is required. [19]", "After placement, identify the capture threshold by reducing output until capture is lost, then set output above the capture threshold; secure the lead and generator, obtain chest radiography to confirm lead position, and repeatedly assess for loss of capture. [21][19]" ], "bullets": [ "Avoid transvenous pacing when a prosthetic tricuspid valve could be damaged or entrap the catheter unless the clinical benefit outweighs that risk. [19]", "Weigh bleeding risk carefully in patients with acute MI receiving thrombolytics, anticoagulants, or antiplatelet therapy. [19][23]", "Use transvenous pacing for second- or third-degree heart block when immediate pacing support is required; FDA labeling for sotalol overdose specifically identifies transvenous pacing for heart block. [2][3]", "For pacemaker-dependent patients undergoing transvenous lead extraction, femoral venous access is necessary for temporary pacing. [18]" ], "subsections": [ { "heading": "Failure or complication surveillance", "paragraphs": [ "A patient who loses capture, develops recurrent hypotension, or has discordance between paced ECG complexes and pulse pressure requires immediate reassessment of lead position, output, and the need for replacement or an alternative pacing route. Frequent evaluation for loss of capture is required during temporary transvenous pacing. [19][21]", "Use temporary support only until the reversible cause resolves or a permanent pacing decision is made. In one emergency-care report, a patient receiving temporary transvenous pacing for unstable bradyarrhythmia subsequently underwent permanent pacemaker implantation and was discharged after 1 week; this illustrates the bridge role rather than a universal implantation threshold. [20]" ], "bullets": [] } ], "table": { "caption": "Transvenous pacing precautions and monitoring actions. [18][19][21]", "columns": [ "Risk or procedural issue", "Action", "Rationale" ], "rows": [ [ "Central venous access complications", "Use ultrasound guidance and full sterile technique. [19]", "Temporary transvenous pacing requires central venous catheter placement and sterile procedural conditions. [19]" ], [ "Lead displacement or loss of capture", "Secure the sheath, sterile covering, and generator; repeatedly verify capture and pulse response. [19][21]", "Electrical capture can be lost after initial placement and must be detected promptly. [19]" ], [ "Bleeding risk", "Reconsider access strategy and urgency in patients exposed to thrombolytics, anticoagulants, or antiplatelet agents. [19][23]", "These exposures increase concern for invasive temporary pacing. [19]" ], [ "Prosthetic tricuspid valve", "Avoid transvenous catheter passage when feasible. [19]", "The pacing catheter may damage or become entrapped in the prosthetic valve. [19]" ] ] } }, { "id": "etiology-directed-escalation", "eyebrow": "Cause-directed decisions", "heading": "Treat reversible causes while pacing only as long as necessary", "intro": "The underlying rhythm cause determines whether pacing is a bridge, a rescue intervention, or a path to permanent device evaluation.", "paragraphs": [ "In acute myocardial infarction, temporary pacing is used for clinically significant bradyarrhythmia and may be considered prophylactically when higher-degree AV block, severe sinus node dysfunction, or asystole is anticipated. Inferior MI, older age, worse Killip class, female sex, smoking, hypertension, and diabetes have been reported as predictors of AV block. [13]", "For suspected digoxin intoxication with advanced bradyarrhythmia, prioritize digoxin-specific Fab when indicated; a reported case of advanced toxicity had no ventricular-rate response to 3.0 mg IV atropine before temporary pervenous pacing was used. [5] Temporary pacing remains a bridge when clinically needed, not a substitute for toxin-directed therapy. [23]", "For propranolol overdose with hypotension or depressed myocardial function, administer IV glucagon 50-150 mcg/kg followed by a 1-5 mg/hour infusion for chronotropic support; atropine or isoproterenol may treat bradycardia, and serious bradycardia may require temporary cardiac pacing. [1]", "For sotalol-associated bradycardia, cardiac asystole, or high-grade AV block, labeled rescue measures include atropine or another anticholinergic drug, a beta-adrenergic agonist, and transvenous pacing; second- and third-degree heart block may require transvenous pacing. [2][3] Bradycardia itself increases torsade de pointes risk in patients receiving sotalol. [2]" ], "bullets": [ "With beta-blocker toxicity, combine hemodynamic support and antidotal therapy with pacing when severe bradycardia persists. [1]", "With sotalol toxicity or marked bradycardia, assess the QT-related proarrhythmic context because bradycardia increases torsade risk. [2]", "With MI-related conduction disease, reassess pacing dependence as ischemia is treated; do not assume an acute temporary pacing requirement establishes a permanent pacing indication. [13][23]" ], "subsections": [], "table": { "caption": "Etiology-specific actions when bradycardia requires temporary pacing. [1][2][3][5][13][23]", "columns": [ "Etiologic context", "Immediate cause-directed action", "Pacing role" ], "rows": [ [ "Acute MI with high-grade AV block, severe sinus node dysfunction, or asystole risk", "Treat the acute ischemic syndrome and monitor for progression of conduction disease. [13]", "Temporary pacing may be used prophylactically or therapeutically when severe conduction deterioration is anticipated or present. [13]" ], [ "Digoxin intoxication", "Use digoxin-specific Fab for advanced intoxication when indicated. [5]", "External or transvenous pacing can bridge severe bradyarrhythmia while toxin-directed treatment takes effect. [5][23]" ], [ "Propranolol overdose", "For hypotension or depressed myocardial function, give glucagon 50-150 mcg/kg IV, then 1-5 mg/hour infusion. [1]", "Use temporary pacing for serious bradycardia not adequately controlled with supportive pharmacologic measures. [1]" ], [ "Sotalol-associated bradycardia or heart block", "Use atropine, another anticholinergic, or a beta-adrenergic agonist as appropriate; address associated proarrhythmic risk. [2][3]", "Use transvenous pacing for severe bradycardia, asystole, or second- and third-degree heart block when needed. [2][3]" ] ] } }, { "id": "transition-and-disposition", "eyebrow": "After stabilization", "heading": "Reassess pacing dependence and plan definitive rhythm support", "intro": "Temporary pacing should trigger a structured reassessment of reversibility, ongoing pacing need, and procedural risk.", "paragraphs": [ "Continue continuous ECG, pulse, blood-pressure, and oxygen-saturation monitoring while temporary pacing is active. For transvenous systems, reassess electrical and mechanical capture frequently because lead displacement or output failure can convert apparent pacing into ineffective support. [19][21]", "Transition from temporary to permanent pacing only after evaluating whether the bradyarrhythmia is persistent and whether the patient can safely receive a transvenous permanent device. Active infection, especially bacteremia, is a reason not to implant a transvenous permanent pacemaker; unfavorable vascular or cardiac anatomy may warrant epicardial lead placement through thoracoscopy or thoracotomy. [22]", "If pacing is no longer needed after correction of a reversible cause, remove temporary support promptly rather than maintaining an invasive pacing system solely for observation. If persistent pacing is expected, avoid prolonged right-ventricular temporary pacing when alternatives are clinically feasible because long-term RV pacing has been associated with ventricular dyssynchrony, lower cardiac output, and heart failure. [7]" ], "bullets": [ "Before permanent device implantation, exclude active bacteremia or another active infection. [22]", "After permanent implantation, monitor vital signs, pacing function, and rhythm, and inspect the wound for redness, swelling, warmth, or drainage. [22]", "Consider epicardial pacing options when conventional transvenous anatomy is unfavorable. [22]" ], "subsections": [], "table": { "caption": "Disposition decisions after temporary pacing initiation. [7][19][21][22]", "columns": [ "Reassessment finding", "Disposition action", "Key constraint" ], "rows": [ [ "Stable mechanical capture while reversible cause is treated", "Continue monitored temporary pacing and reassess intrinsic rhythm. [19][21]", "Temporary pacing should remain a bridge rather than default long-term therapy. [23]" ], [ "Resolved bradyarrhythmia after reversible treatment", "Discontinue temporary pacing when ongoing support is no longer required. [23]", "Continue clinical and ECG monitoring for recurrence. [19]" ], [ "Persistent clinically significant pacing requirement", "Evaluate for permanent pacemaker implantation. [20][22]", "Defer transvenous permanent implantation during active infection, especially bacteremia. [22]" ], [ "Unfavorable transvenous anatomy", "Consider epicardial lead placement by thoracoscopy or thoracotomy. [22]", "This is an alternative when conventional transvenous implantation is unsuitable. [22]" ] ] } } ], "faq": [], "references": [ { "number": 1, "title": "[PDF] Inderal - accessdata.fda.gov", "detail": "www.accessdata.fda.gov", "url": "https://www.accessdata.fda.gov/drugsatfda_docs/label/2004/16418s073lbl.pdf", "authors": "www.accessdata.fda.gov", "host": "www.accessdata.fda.gov" }, { "number": 2, "title": "[PDF] 3929060 This label may not be the latest approved by FDA. 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Verify recommendations against current guidance and patient-specific factors.", "citations": [ { "number": 1, "title": "[PDF] Inderal - accessdata.fda.gov", "detail": "www.accessdata.fda.gov", "url": "https://www.accessdata.fda.gov/drugsatfda_docs/label/2004/16418s073lbl.pdf", "authors": "www.accessdata.fda.gov", "host": "www.accessdata.fda.gov", "snippet": "Supportive Therapy: Hypotension and bradycardia have been reported following propranolol overdose and should be treated appropriately. Glucagon can exert potent inotropic and chronotropic effects and may be particularly useful for the treatment of hypotension or depressed myocardial function after a", "score": 0.289563 }, { "number": 2, "title": "[PDF] 3929060 This label may not be the latest approved by FDA. For ...", "detail": "www.accessdata.fda.gov", "url": "https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019865s021lbl.pdf", "authors": "www.accessdata.fda.gov", "host": "www.accessdata.fda.gov", "snippet": "by the hypotension. In addition, if required, the following therapeutic measures are suggested: Bradycardia or Cardiac Asystole: Atropine, another anticholinergic drug, a beta-adrenergic agonist or transvenous cardiac pacing. Reference ID: 3929060 This label may not be the latest approved by FDA. Fo", "score": 0.19232725 }, { "number": 3, "title": "[PDF] 205108Orig1s000 | FDA", "detail": "www.accessdata.fda.gov", "url": "https://www.accessdata.fda.gov/drugsatfda_docs/nda/2014/205108Orig1s000Lbl.pdf", "authors": "www.accessdata.fda.gov", "host": "www.accessdata.fda.gov", "snippet": "by the hypotension. In addition, if required, the following therapeutic measures are suggested: Bradycardia or Cardiac Asystole: Atropine, another anticholinergic drug, a beta-adrenergic agonist or transvenous cardiac pacing. Heart Block: (second and third degree) transvenous cardiac pacemaker. Hypo", "score": 0.13870688 }, { "number": 4, "title": "[PDF] 208289Orig1s000 - accessdata.fda.gov", "detail": "www.accessdata.fda.gov", "url": "https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208289Orig1s000OtherR.pdf", "authors": "www.accessdata.fda.gov", "host": "www.accessdata.fda.gov", "snippet": "with a myocardial infarction due to coronary vasospasm and tachycardia. Case # 776853939 is a literature case of a 41-year-old male who developed coronary artery spasm, myocardial ischemia and perioperative myocardial infarction after receiving ephedrine and atropine for sinus bradycardia. The patie", "score": 0.22397944 }, { "number": 5, "title": "Reversal of Advanced Digoxin Intoxication with Fab Fragments of ...", "detail": "www.nejm.org", "url": "https://www.nejm.org/doi/full/10.1056/NEJM197604082941501", "authors": "www.nejm.org", "host": "www.nejm.org", "snippet": "The ventricular rate did not respond to a total of 3.0 mg of atropine given intravenously, and a temporary pervenous pacing catheter", "score": 0.30544916 }, { "number": 6, "title": "Cardiac pacing - The Lancet", "detail": "www.thelancet.com", "url": "https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(96)07059-6.pdf", "authors": "www.thelancet.com", "host": "www.thelancet.com", "snippet": "Provocative manoeuvres of lead stability are done, such as deep breathing and generator manipulation, and, especially in unipolar systems,", "score": 0.105698995 }, { "number": 7, "title": "New drug discovery of cardiac anti-arrhythmic drugs - Nature", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41598-023-41942-4", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "diagnostic criteria rely on interpreting cardiac imaging and ECG data. An important line of investigation understands the molecular mechanisms that drive the development of the disease, as early disease progression escapes detection and the heterogeneity of genes involved makes prognosticating a dia", "score": 0.10274522 }, { "number": 8, "title": "Retrospective exploratory dual-center analysis of temporary transvenous cardiac pacing in cardiogenic shock | Scientific Reports", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41598-025-10364-9", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "Title: Retrospective exploratory dual-center analysis of temporary transvenous cardiac pacing in cardiogenic shock | Scientific Reports\nDespite previous studies analyzing TTP treatment, data on its use in patients with cardiogenic shock (CS) remain limited. We retrospectively included registry data ", "score": 0.694241 }, { "number": 9, "title": "Temporary transvenous pacing via the percutaneous femoral vein approach: A prospective study of 100 cases - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/0002870373901786", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "### 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society\n\n### Perman", "score": 0.7522497 }, { "number": 10, "title": "Utility and Cost Effectiveness of Temporary Pacing Using Active Fixation Leads and an Externally Placed Reusable Permanent Pacemaker - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S0002914906017176", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "### Int J Cardiol\n\n### Temporary cardiac pacing\n\n### Current practice and complications of temporary transvenous cardiac pacing\n\n### BMJ\n\n## Cited by (42)\n\n### 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: A Report of the Ameri", "score": 0.7295395 }, { "number": 11, "title": "Transvenous Pacemaker Placement: A Review for ...", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S0736467923005802", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "### J Am Coll Cardiol\n\n### 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society\n\n### J A", "score": 0.7163977 }, { "number": 12, "title": "Transvenous Pacemaker Placement: A Review for Emergency ...", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S0736467923005802", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Temporary cardiac pacing can be a life-saving procedure. Indications for pacemaker placement include hemodynamic instability with symptomatic bradycardia", "score": 0.71425 }, { "number": 13, "title": "Study of Bradyarrhythmias in Acute Myocardial... : Egyptian Journal of Critical Care Medicine", "detail": "journals.lww.com", "url": "https://journals.lww.com/ejccm/fulltext/2022/06000/study_of_bradyarrhythmias_in_acute_myocardial.4.aspx", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "Idioventricular Rhythm: With the failure of the dominant and subsidiary pacemaker, an escape rhythm at a rate of 30 since we could obtain improvement in the hemodynamics after pacing.\n\nTemporary pacing is indicated prophylactically in patients at risk of developing higher degree AV block, severe sin", "score": 0.5425973 }, { "number": 14, "title": "Lyme Carditis in Children: Presentation, Predictive Factors, and ...", "detail": "pediatrics.aappublications.org", "url": "http://pediatrics.aappublications.org/content/123/5/e835?variant=long&sso=1&sso_redirect_count=1&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3A+No+local+token", "authors": "pediatrics.aappublications.org", "host": "pediatrics.aappublications.org", "snippet": "Atropine, isoproterenol, temporary pacing, CHB resolved within 14 d; normal ECG at follow-up. Patial et al9, 1, 14, Palpitations, SOB, CHB, NA", "score": 0.3181784 }, { "number": 15, "title": "[PDF] AtriCure, Inc. - ClinicalTrials.gov", "detail": "cdn.clinicaltrials.gov", "url": "https://cdn.clinicaltrials.gov/large-docs/77/NCT05089877/Prot_SAP_000.pdf", "authors": "cdn.clinicaltrials.gov", "host": "cdn.clinicaltrials.gov", "snippet": "bypass. HIT (Heparin Induced Thrombocytopenia): Low blood platelet count as a result of the medication heparin. Must have lab evidence of HIT +. Leukopenia: Leukopenia is defined as leukocyte count of < 3.5 x109/liter for more than 3 days. Neutropenia: Neutropenia is defined as ANC <1000 per mm3 for", "score": 0.13178682 }, { "number": 16, "title": "[PDF] CLINICAL TRIAL PROTOCOL NOAH - AFNET 6 Non-vitamin K ...", "detail": "cdn.clinicaltrials.gov", "url": "https://cdn.clinicaltrials.gov/large-docs/77/NCT02618577/Prot_000.pdf", "authors": "cdn.clinicaltrials.gov", "host": "cdn.clinicaltrials.gov", "snippet": "according to the individual patient and to the most recent practice guidelines (25, 26, 27), ensuring as far as possible optimum hemodynamic and avoiding unnecessary ventricular pacing. Cardiac rhythm management (CRM) device manufacturers use different detection algorithms and settings for the most ", "score": 0.10296147 }, { "number": 17, "title": "Transcutaneous Pacing - StatPearls - NCBI Bookshelf - NIH", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/books/NBK519567", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "Relative contraindications are limited but include situations in which pacing is unlikely to achieve capture or when immediate transvenous pacing is available and feasible. Challenges include patient discomfort, failure of electrical or mechanical capture, and interference with monitoring. Potential", "score": 0.62248284 }, { "number": 18, "title": "Transvenous Lead Extraction Procedure—Indications, Methods, and Complications", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9687878", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "An anesthesia cart, vasopressors, other emergency medications and additional emergency equipment such as temporary pacing equipment, transthoracic and/or transesophageal echocardiography, vacuum containers for chest tube drainage, a pericardiocentesis tray, are required to be present at immediate av", "score": 0.53531766 }, { "number": 19, "title": "Overdrive Pacing - StatPearls - NCBI Bookshelf", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/books/NBK549874", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "Temporary transvenous pacing also requires an interprofessional team-based approach. An interprofessional approach to central venous catheter placement and maintenance has been shown to decrease the complication rate.(#article-37739.r12) Similar to TTCP, all members of the healthcare team should fre", "score": 0.5174983 }, { "number": 20, "title": "Transesophageal echocardiography (TEE)-guided transvenous pacing (TVP) in emergency department - PMC", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10441836", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "### Supplementary Information\n\nThe online version contains supplementary material available at 10.1186/s13089-023-00332-7.\n\n## Introduction\n\nTemporary cardiac pacing is a life-saving procedure for hemodynamically unstable patients with bradycardia in the emergency department (ED) . Indications for e", "score": 0.4974371 }, { "number": 21, "title": "Development of a Rigorously Designed Procedural Checklist for Assessment of Emergency Medicine Resident Performance of Temporary Transvenous Cardiac Pacing - PMC", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8171784", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "The iterative review process used while designing the checklist led to several modifications to the preliminary draft. In contrast to a previously published TVP checklist that included items pertaining to documentation and patient handoffs,12 our panel elected to exclusively assess psychomotor skill", "score": 0.47139415 }, { "number": 22, "title": "Pacemaker Insertion - StatPearls - NCBI Bookshelf - NIH", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/books/NBK526001", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "## Contraindications\n\nThough no absolute contraindications to the pacemaker implantation have been established, a transvenous permanent pacemaker is not recommended in the presence of an active infection, especially bacteremia. The other contraindications may include patient refusal and terminal ill", "score": 0.44391435 }, { "number": 23, "title": "Using transcutaneous cardiac pacing to best advantage - PMC - NIH", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6376978", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "In this article, we will review the indications and techniques for transcutaneous pacing and how to avoid complications.\n\n## .\n\nIt is particularly helpful in reversible or transient conditions (such as digoxin toxicity and atrioventricular [AV] block in the setting of inferior wall myocardial infarc", "score": 0.43367022 }, { "number": 24, "title": "Pacemaker Indications - StatPearls - NCBI Bookshelf - NIH", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/books/NBK507823", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "Objectives:\n\n Identify the indications for pacemaker placement.\n Describe the contraindications to pacemaker placement.\n Review the complications of pacemaker placement.\n Explain interprofessional team strategies for improving care coordination and communication to advance management of sinus node d", "score": 0.32306018 } ], "publishedAt": "2026-09-15T17:51:15.127536+00:00", "updatedAt": "2026-09-15T17:51:15.127536+00:00", "readingMinutes": 6, "slug": "temporary-pacing-for-bradycardia" }