Temporary pacing

When the heart's intrinsic pacemaking ability fails, temporary internal or external pacing can be instituted. Internal electrodes can be endocardial (inserted via a central vein) or epicardial (placed on the external surfaceof the heart at thoracotomy). The endocardial wire may be placed under fluoroscopic control or 'blind' using a balloon flotation catheter. External pacing can be rapidly performed by placement of two electrodes on the front and rear chest wall when asystole or third degree heart block has produced acute haemodynamic compromise. It is often used as a bridge to temporary internal pacing. It can also be used as a prophylactic measure, e.g. for Mobitz Type II second-degree heart block.

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