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.
- 1. Hodam RP, Starr A. Temporary postoperative epicardial pacing electrodes. Their value and management after open-heart surgery. Ann. Thorac. Surg. 1969;8 (6): 506-10. - Pubmed citation
- 2. Archbold RA, Schilling RJ. Atrial pacing for the prevention of atrial fibrillation after coronary artery bypass graft surgery: a review of the literature. Heart. 2004;90 (2): 129-33. doi:10.1136/hrt.2003.015412 - Free text at pubmed - Pubmed citation
- 3. Bethea BT, Salazar JD, Grega MA et-al. Determining the utility of temporary pacing wires after coronary artery bypass surgery. Ann. Thorac. Surg. 2005;79 (1): 104-7. doi:10.1016/j.athoracsur.2004.06.087 - Pubmed citation
- 4. Samuels LE, Samuels FL, Kaufman MS et-al. Temporary epicardial atrial pacing electrodes: duration of effectiveness based on position. Am. J. Med. Sci. 1998;315 (4): 248-50. Am. J. Med. Sci. (link) - Pubmed citation