User:Mr. Ibrahem/Transvenous pacing

Transvenous pacing is a procedure used to correct a slow heart rate that is resulting in significant symptoms. It may be used in cases that do not respond to atropine. Often this rhythm is a complete heart block. Other options include epinephrine or dopamine and transcutaneous pacing.

The procedure is done with the person on their back with the head of the bed down. A sheath introducer is than placed in the right internal jugular. Connect the sleeve to the hub of the introducer. Pass the device about 20 cm through the introducer and inflate the balloon. Set the energy source to 80 BPM and the output at 20 mA, with sensitivity on full. Advance the device until capture is obtained and deflate the balloon. Extend and secure the sleeve so it covers the device.

Verify both electrical capture and a pulse of 80 BPM. Usually the device needs to be placed at a depth of 35 to 40 cm. Decrease mA output until capture is lost than double the output to capture again. A chest X-ray is than done to verify placement and rule out some complications. Complications may include heart dysrhythmias and those of placing a central venous catheter, such as pneumothorax.