A temporary pacemaker is a device used to support heart rhythm in emergencies or until a permanent pacemaker is implanted.
What is a Temporary Pacemaker?#
A temporary pacemaker is a system that provides external electrical stimulation to ensure the heart beats at an adequate rate. Unlike a permanent pacemaker, the generator is located outside the body.
Types of Temporary Pacing:
- Transvenous pacing: Electrode placement in heart via blood vessel
- Transcutaneous pacing: Pacing through electrodes on skin
- Epicardial pacing: Used after cardiac surgery
Temporary Pacemaker Indications#
Emergency Indications#
Symptomatic Bradycardia:
- Syncope or presyncope
- Hypotension
- Heart failure signs
- Altered consciousness
Specific Conditions:
- Complete AV block
- Mobitz type II AV block
- Sinus arrest
- Symptomatic sick sinus syndrome
- Acute myocardial infarction + conduction disturbance
Prophylactic Indications#
- Bridge therapy until permanent pacemaker implantation
- Before high-risk cardiac procedures
- Drug intoxication (beta blocker, calcium channel blocker)
- Until electrolyte abnormalities are corrected
Transvenous Temporary Pacing#
Procedure Steps#
- Vascular access: Internal jugular, subclavian, or femoral vein
- Electrode placement: Under fluoroscopy or ECG guidance
- Right ventricular apex placement: For optimal pacing
- Threshold testing: Determination of pacing and sensing thresholds
- Generator connection: Connection to external pacemaker device
- Fixation: Prevention of electrode displacement
Pacing Parameters#
| Parameter | Typical Value |
|---|---|
| Rate | 60-80/min |
| Output | 2-5 mA |
| Sensitivity | 2-5 mV |
| Mode | VVI or DDD |
Transcutaneous Pacing#
Use Cases#
- First intervention in emergencies
- Bridge until transvenous pacing is prepared
- Short-term pacing need
Application#
- Adhesive electrodes placed on chest
- Connected to defibrillator/pacemaker device
- Rate and output adjusted
- Capture verified
Disadvantages#
- Can be painful (may require sedation)
- Not suitable for long-term use
- Capture reliability may be low
Temporary Pacing Complications#
Access Site#
- Bleeding/hematoma
- Pneumothorax (with subclavian access)
- Arterial puncture
- Infection
Electrode Related#
- Electrode dislocation
- Heart perforation
- Tamponade (rare)
- Arrhythmia induction
Temporary Pacing Care#
Daily Checks:
- Pacing and sensing thresholds
- Electrode position (X-ray)
- Access site infection signs
- Battery status
Patient Care:
- Bed rest (with femoral access)
- Prevention of electrode movement
- Infection prevention measures
Transition to Permanent Pacemaker#
Temporary pacing is usually replaced with a permanent pacemaker in these situations:
- Irreversible bradycardia
- Pacing need longer than 48-72 hours
- Inability to correct underlying cause
Frequently Asked Questions#
How long does a temporary pacemaker stay in?
Can I move with a temporary pacemaker?
Is temporary pacing painful?
How is the temporary pacemaker removed?
Is a permanent pacemaker needed after temporary pacing?
Appointment and Contact#
For emergency rhythm support or evaluation:
📍 Avrasya Hospital - Beştelsiz Mah. 101. Sokak No:107, Zeytinburnu, Istanbul
📞 Phone: +90 212 665 50 50 (Ext: 4012)
This content has been prepared by Assoc. Prof. Dr. Habib Çil for general informational purposes. Please consult a cardiology specialist for definitive diagnosis and treatment.
Related Arrhythmia Treatments#
Other arrhythmia treatments related to temporary pacemaker:
- Permanent Pacemaker - Permanent pacing
- Biventricular Pacemaker - CRT pacemaker
- ICD - Implantable cardioverter defibrillator
- Cardioversion - Electrical cardioversion
- EKG - Electrocardiography