What is the function of a temporary cardiac pacemaker

Everyone knows that there are two types of pacemakers: temporary and permanent. However, compared with permanent pacemakers, people know less about temporary pacemakers. This is related to the fact that its clinical application is not as extensive as permanent pacemakers. Some friends don’t even know what kind of diseases require temporary pacemakers, let alone understand what role temporary pacemakers play.

There are two main indications for temporary pacemaker placement: emergency (usually acute myocardial infarction) or elective pacing. However, there is no consensus on the indications for temporary pacemaker implantation. Most opinions come from clinical experience rather than clinical trials. Many patients have bradycardia, and protective supportive care and treatment of the cause are the most appropriate management strategies.

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Temporary pacemaker placement should be considered in any patient with acute hemodynamic changes caused by bradycardia and/or transient asystole. For most patients, this is likely to occur during an acute MI; anterior MI with complete AV block usually indicates a poor prognosis and the need for pacing, whereas inferior MI with complete AV block is usually reversible, has a narrow QRS complex, and responds to atropine.

The American College of Cardiology (AHA) guidelines for the management of acute myocardial infarction provide a classification of indications based on the weight of the benefits of pacemaker implantation rather than the site of infarction. The indications for emergency temporary transvenous pacing are: acute myocardial infarction, cardiac arrest, symptomatic bradycardia (sinus bradycardia with hypotension, type II atrioventricular block with hypotension, unresponsive to atropine), bifascicular block (BBB or RBBB with LAHB/LPHB), type II atrioventricular block, new or age-indeterminate bifascicular block with type I atrioventricular block, bradycardia not associated with acute myocardial infarction, type II atrioventricular block or type III atrioventricular block with hemodynamic changes or syncope at rest, and ventricular tachycardia secondary to bradycardia.

During thrombolytic therapy, the occurrence of bradycardia often presents a dilemma: should thrombolytic therapy be started before or after the installation of temporary pacing? Thrombolytic therapy should be initiated first and should not be delayed until temporary pacing is installed. If bradycardia does not respond to medical therapy (eg, atropine, isoproterenol), a temporary pacemaker should be installed in preparation for thrombolytic therapy. If hemodynamically significant bradycardia persists after initiation of thrombolytic therapy, a temporary pacemaker should be installed.

I believe that through the analysis in this article you must know what the temporary pacemaker does. In fact, in addition to the above-mentioned situations, the temporary pacemaker can also be used for some situations such as slow heartbeat caused by trauma. The temporary pacemaker can be removed after the dangerous period of the disease has passed.