Temporary Electrodes

Pairs of teflon insulated stainless st eel unipolar myocardial electrodes spaced 0.5-1.0 cm apart are used for temporary cardiac pacing. Needle conductors are attached to each end. The curved needle is use d for intramyocardial plac ement of the bare wire, the needle is then removed. The straight needle allows passag e externally typically to the epigastrium where the needles are blunted, capped with an insulating cover and bandaged for future use. By convention, atrial leads are exposed to the right of the sternum, ventricular le ads to the left of the sternum.

All temp orary pacing requires electrode pairs. Bip olar pacing uses pair ed myocardial electrodes; unipolar st imulation is achieved by one intramyocardial electrode (cathode) with a second myocardial electrode passed through the skin to function as the subcutaneous anode.

Electrode Care

• Daily dressing change with antiseptic cleaning of the electrode exit sites

• Insulating caps applied to electrode needle connectors when not in use

• Daily threshold/output and sensitivity checks while in use

• Daily dependency checks

• Continuous arrhythmia monitoring while in use

Unused pacing electrodes are removed on day five by steady direct traction before achieving full systemic anticoagulation. Patient monitoring for cardiac tamponade and mechanical ly triggered arrhythmias is r equired during removal. The sinus site must be covered with occlusive gauze to avoid air tracking with potential pne umomediast inum and pneumotho rax.

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