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.