Transcutaneous Pacing

Transcutaneous pacing (temporary pacemaker) is a temporary medical device that can increase the heart rate. The heart has a "natural" pacemaker that sends an electrical current throughout the heart. This electrical current stimulates the heart muscle and causes the heart to pump (contract). The natural pacemaker of the heart keeps the heart beating in a regular and normal rhythm. When there is a problem with the electrical system of the heart, the heart-rate may become slow and a person may experience:

  • Dizziness or fainting (loss of consciousness).

  • Trouble breathing (shortness of breath).

  • Low blood pressure.

  • Death due to cardiac arrest (the heart stops).

WHY A TRANSCUTANEOUS PACER IS NEEDED

Transcutaneous pacing sends quick spurts of electrical energy through (trans) the skin (cutaneous) of the chest. Transcutaneous pacing becomes necessary when the heart's own electrical current stops working or does not work very well. For instance, transcutaneous pacing could be used when:

  • Someone has a critically slow heartbeat and low blood pressure. Temporary pacing is necessary when medicine does not increase the heart rate.

  • A person's heart has stopped beating (cardiac arrest).

  • The person has a permanent pacemaker (a device that regulates the heartbeat) that is not working properly.

BEFORE THE PROCEDURE

Transcutaneous pacing is almost always done during a medical emergency. If there is time, the patient or a family member should let caregivers know about the following:

  • All medications the person is taking, including:

  • All prescription medication.

  • Herbs, eyedrops, over-the-counter medicines and creams.

  • Blood thinners (anticoagulants), aspirin or other drugs that could affect blood clotting.

  • Steroids (by mouth or as creams).

  • Any drugs or alcohol that the person recently consumed.

  • Any history of heart problems.

  • Any previous reactions to sedatives or pain medicines.

  • Any recent exposure to extreme cold. The procedure cannot be done if the person developed low body temperature (hypothermia).

  • Any allergies. This includes allergy to medical tape.

  • Any other health problems.

  • Possibility of pregnancy, if this applies.

TRANSCUTANEOUS PACING USE

A temporary pacemaker can be used get the heart back to its normal rhythm. Or, it can be used to keep the heartbeat steady until another procedure can be done to permanently correct the heart problem.

  • Preparation:

  • Any chest hair may be trimmed or shaved. Then, the chest and back will be cleaned and dried.

  • An IV is usually started in an arm. An IV allows your caregiver to infuse liquid medications that go directly into the bloodstream.

  • Round patches attached by wires to a pacemaker machine (electrodes) will be stuck to the chest and back. The pacemaker machine sets the pace for the heart.

  • Pacing the heart:

  • A temporary pacemaker can be uncomfortable. A drug to help the person relax (sedative) may be given through the IV.

  • Once the electrodes are in place, the pacemaker machine will be set to achieve a target heart rate.

  • Electric pulses will travel from the machine to the electrodes, then through the skin and to the heart.

  • A member of the healthcare team will monitor the person's heartbeat and blood pressure. The electrodes will be checked to make sure they do not irritate the skin.

  • Sometimes an electrode has to be moved to another spot during the procedure.

RISKS AND COMPLICATIONS

  • Pain or discomfort.

  • Irritated skin where the electrodes were placed.

  • Muscle contractions.

  • Changes in the hearts rhythm that require other medical interventions.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop severe chest pain or you have pain in your jaw, neck or between your shoulder blades.

  • You have problems breathing or cannot catch your breath.

  • You feel dizzy or pass out (loss of consciousness).

  • You have cannot think clearly or have confused thinking.

  • You feel your heart racing or "skipping" beats.

  • A fever of more than 102.0° F (38.9° C) develops.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.