Management of temporary epicardial pacing wires in the cardiac surgical patient

2021 ◽  
pp. 1-7
Author(s):  
Jeevan Francis ◽  
Sneha Prothasis ◽  
Rutwik Hegde ◽  
Antony Attia ◽  
Keith Buchan
Keyword(s):  
Cardiac Rhythm ◽  
Coronary Care Unit ◽  
Early Period ◽  
Surgical Patient ◽  
Cardiac Surgical Patient ◽  
Temporary Pacing ◽  
Coronary Care ◽  
Epicardial Pacing ◽  
Hospital Wards ◽  
Coronary Care Units

Temporary epicardial pacing wires are used after cardiothoracic surgery to maintain a stable cardiac rhythm. They must be distinguished from the more commonly encountered transvenous temporary pacing wires, which are often used in coronary care units for the same purpose. Patients with temporary epicardial pacing wires may be transferred to hospital wards where these wires are not usually encountered, such as COVID wards, the general intensive care unit, the coronary care unit or general surgical wards if a laparotomy was required in the early period following cardiac surgery. Serious complications may arise in managing patients with temporary epicardial pacing wires, which are well known in the cardiothoracic unit but not so well known elsewhere in the hospital. This article discusses the dangers associated with the management of temporary epicardial pacing wires in adult patients, some of which are common to temporary transvenous pacing wires and others are unique to temporary epicardial pacing wires.

Utilization of Coronary Care Units in Sweden

1977 ◽  
Vol 5 (3) ◽  
pp. 141-144 ◽  
Author(s):  
Bernard S. Bloom ◽  
Egon Jonsson ◽  
Marie-Louise Dolk
Keyword(s):  
Coronary Care Unit ◽  
Optimal Solution ◽  
The United States ◽  
Teaching Hospitals ◽  
Hospital Units ◽  
Rational Distribution ◽  
Continued Use ◽  
Coronary Care ◽  
Good Organization ◽  
Coronary Care Units

Coronary care unit usage has expanded rapidly in all high income countries with little attention to effectivity or cost. A study of six randomly chosen Swedish units showed that larger units in teaching hospitals had significantly lower age-adjusted mortality rates, higher proportions of myocardial infarction patients, and greater productivity and efficiency. Comparisons with a study from the United States showed better results in the Swedish hospital units according to all variables measured. Although proof of effectiveness of CCU's is lacking, their continued use is assured. A less than optimal solution is a rational distribution of units based upon epidemiologically determined need, while stressing good organization and efficiency.

scholarly journals Pilot study of the relationship between heart rate and ectopy and unrestricted vs restricted visiting hours in the coronary care unit

1993 ◽  
Vol 2 (2) ◽  
pp. 134-136 ◽  
Author(s):  
DA Schulte ◽  
LO Burrell ◽  
SH Gueldner ◽  
MH Bramlett ◽  
B Fuszard ◽  
...  
Keyword(s):  
Heart Rate ◽  
Coronary Care Unit ◽  
Premature Ventricular Contractions ◽  
Unit Design ◽  
Natural Support ◽  
Group A ◽  
Coronary Care ◽  
Group B ◽  
The Relationship ◽  
Coronary Care Units

OBJECTIVE: To determine the relationship between cardiac performance (as measured by heart rate and ectopy) and unrestricted vs restricted visiting hours in the coronary care unit. DESIGN: Patients were from two coronary care units. Group A had unrestricted visiting hours, and group B had restricted visiting hours. Heart rate and ectopy were measured three times both in patients with unrestricted visiting hours and in those with restricted visiting hours: (1) before visitors arrived, (2) 5 minutes after visitors arrived and (3) 1 to 5 minutes after the visitors left. A total of 25 visits were analyzed. FINDINGS: There were no significant differences in rates of premature ventricular contractions and premature atrial contractions between the two groups. Patients with unrestricted visiting hours had a significantly lower heart rate after visits than patients with restricted visits. CONCLUSION: Consideration should be given to development of unrestricted visiting policies that promote the continuing presence and natural support of the family and significant others for patients in coronary care units.

scholarly journals Monitoring Acute Myocardial Infarction Complicated with Cardiogenic Shock — from the Emergency Room to Coronary Care Units

2017 ◽  
Vol 3 (2) ◽  
pp. 61-71
Author(s):  
Andreea Barcan ◽  
Zsuzsanna Suciu ◽  
Emese Rapolti
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiogenic Shock ◽  
Coronary Care Unit ◽  
Therapeutic Interventions ◽  
Assessment And Monitoring ◽  
Novel Biomarkers ◽  
Coronary Care ◽  
Critical Patients ◽  
Coronary Care Units

AbstractCardiogenic shock remains the leading cause of death in patients hospitalized for acute myocardial infarction, despite many advances encountered in the last years in reperfusion, mechanical, and pharmacological therapies addressed to stabilization of the hemodynamic condition of these critical patients. Such patients require immediate initiation of the most effective therapy, as well as a continuous monitoring in the Coronary Care Unit. Novel biomarkers have been shown to improve diagnosis and risk stratification in patients with cardiogenic shock, and their proper use may be especially important for the identification of the critical condition, leading to prompt therapeutic interventions. The aim of this review was to evaluate the current literature data on complex biomarker assessment and monitoring of patients with acute myocardial infarction complicated with cardiogenic shock in the Coronary Care Unit.

Analysis of pacemaker malfunction and complications of temporary pacing in the coronary care unit

1982 ◽  
Vol 49 (2) ◽  
pp. 301-306 ◽  
Author(s):  
Joseph L. Austin ◽  
Lehman K. Preis ◽  
Richard S. Crampton ◽  
George A. Beller ◽  
Randolph P. Martin
Keyword(s):  
Coronary Care Unit ◽  
Temporary Pacing ◽  
Coronary Care

Care and safety of pacemaker electrodes in intensive care and telemetry nursing units

1997 ◽  
Vol 6 (4) ◽  
pp. 302-311 ◽  
Author(s):  
LS Baas ◽  
TA Beery ◽  
CS Hickey
Keyword(s):  
Cardiac Surgery ◽  
Coronary Care Unit ◽  
Static Electricity ◽  
Insulating Materials ◽  
Temporary Pacing ◽  
Surgical Icu ◽  
Pacemaker Electrodes ◽  
Coronary Care ◽  
Materials Used ◽  
The Ideal

BACKGROUND: Temporary pacing leads with electrodes are a potential risk, because microshock inadvertently transmitted across the catheter or wire can paradoxically cause lethal dysrhythmias. Much attention has been paid to this complication in clinical guidelines, but little is known about actual practices used to protect patients. OBJECTIVES: A national survey was done to describe current practices related to the care of patients with temporary epicardial or transvenous pacing catheters. The survey focused on environmental factors that affect generation of static electricity, equipment used with temporary pacing, and nursing practices used when handling temporary pacing electrodes. METHODS: The Pacemaker Electrical Care and Safety Survey was developed, validated, and pilot tested before it was mailed to all 895 hospitals that perform cardiac surgery. Surveys were sent to the coronary care unit, cardiac surgical ICU, and telemetry units of each hospital. RESULTS: Responses were received from 476 units representing 388 (43%) of the 895 institutions. Most respondents reported using gloves, although few hospitals had policies mandating this practice. The insulating materials used most often, in order, were a glove or finger cot, tape, and gauze. Few units (25%) use any measure to reduce static electricity generated by movement over carpeting. Little attention was paid to insulating exposed epicardial temporary pacing electrodes at the generator. CONCLUSIONS: Temporary pacing electrodes were usually handled in an electrically safe manner; however, little attention was paid to environmental sources of microshock or connections between the generator and the cable. Although the respondents reported using a variety of insulating materials, the ideal cover for the exposed tips of the electrodes has not yet been determined.

Temporary pacing in the cardiac surgical patient

1984 ◽  
Vol 4 (1) ◽  
pp. 108-114 ◽  
Author(s):  
BA Finkelmeier ◽  
SR O'Mara
Keyword(s):  
Surgical Patient ◽  
Cardiac Surgical Patient ◽  
Temporary Pacing
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