Epicardial pacing wires

Last revised by Ian Bickle on 4 Mar 2023

Epicardial pacing wires or temporary pacing wires (TPW) allow rapid commencement of atrial and/or ventricular pacing in the event of a perioperative cardiac arrhythmia that has the potential to cause significant hemodynamic compromise.

They are usually inserted during open heart surgery, and especially in those with congenital heart disease 1.  Some surgeons will place epicardial pacing wires during CABG but this is not routine practice 2-3.

Removal is usually on the fourth postoperative day via gentle transcutaneous retraction. A coagulation screen should be checked prior to removal and the patient monitored post-procedure to allow early identification of rare, but serious complications such as a myocardial or pericardial injury and further arrhythmia.

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Cases and figures

  • Case 1 : post ASD repair
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  • Case 2: retained pacing wire post CABG
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  • Case 3
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  • Case 4: post VSD repair
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  • Case 5: retained pacing wire
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