Temporary Epicardial Pacing After Cardiac Surgery

• Published in: Journal of cardiothoracic and vascular anesthesia Vol. 36; no. 12; pp. 4427 - 4439
• Main Authors: Cronin, Brett, Dalia, Adam, Goh, Regine, Essandoh, Michael, Orestes O'Brien, E.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2022
• Subjects: anesthesia; Arrhythmias, Cardiac; Cardiac Pacing, Artificial - methods; cardiac surgery; Cardiac Surgical Procedures - adverse effects; Hemodynamics; Humans; Pacemaker, Artificial; preoperative management; temporary epicardial pacing; temporary epicardial pacing; cardiac surgery; preoperative management; anesthesia
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1053/j.jvca.2022.08.017

Temporary epicardial pacing frequently is employed after cardiac surgery, and can have a significant impact on a patient's hemodynamics, arrhythmias, and valvulopathies. Given that anesthesiologists often are involved intimately in the initial programming and subsequent management of epicardial pacing in the operating room and intensive care unit, it is important for practitioners to have a detailed understanding of the modes, modifiable intervals, and potential complications that can occur after cardiac surgery. Because this topic has not been reviewed recently in anesthesia literature, the authors attempted to review relevant epicardial pacemaker specifics, discuss modes and parameters that apply to the perioperative period, present an algorithm for mode selection, describe the potential effects of epicardial pacing on valvulopathies and hemodynamics, and, finally, discuss some postoperative considerations.