INTRODUCTION
Temporary cardiac pacing is required in patients with brady-arrhythmias.
Medical conditions such as myocardial infarction, infections,
electrolytes disturbance, cardiac trauma, and primary cardiac conduction
system disease can cause abnormalities in initiating and propagating the
normal electrical impulse throughout the heart(1). In specific cardiac
procedures, such as open-heart surgery and transcatheter valve
replacement, temporary cardiac pacing is frequently utilized. (2)
Currently, temporary transvenous pacemaker catheters only pace the
ventricle and lack atrioventricular (AV) synchrony in patients with
intact sinus rhythm. When the heart is paced in an AV synchronized
manner, it is estimated to increase stroke volume by 50% in normal
hearts and increase the cardiac index by 25-30%2compared to ventricular-only pacing. AV synchronization performs better
at maintaining proper cardiac output than ventricular pacing alone and
is essential in achieving optimal cardiovascular hemodynamics(3).
There is a need for an easily insertable and positionable trans-venous
AV sequential temporary pacing catheter. All patients who require
temporary pacing would ideally benefit from AV pace and tract capacity,
except for those in atrial fibrillation. Currently, temporary AV
sequential pacing requires the placement of two separate leads in the
right atrium and ventricle. Moreover, lead dislodgement, particularly in
the atrium, is frequently encountered unless an active fixation atrial
lead is used.
We describe a new temporary AV sequential system that can be advanced
into the right heart from the jugular vein with ease and swiftly allow
for AV sequential pacing. Also described is acute in man trial showing
its feasibility and efficacy.