Temporary Transvenous Catheter-Electrode Pacing of the Heart

Experience with 110 separate periods of transvenous cardiac pacing by means of a catheter-electrode in 91 patients has been reviewed. Indications for the use of the catheter-electrode included (1) complete heart block with and without Adams-Stokes syndrome, (2) other arrhythmias with and without cardiogenic syncope, (3) malfunction of previously implanted permanent pacemaker units, and (4) need for pacing during general surgical procedures in patients with a variety of rhythm disturbances. A case illustrating the combined use of drug therapy and catheter-electrode pacing in controlling paroxysmal ventricular tachycardia is presented.Only six deaths occurred in spite of the serious heart disease in all 91 patients in this series. Two were related to complications of temporary transvenous intracardiac pacing. The major complications associated with the procedure included perforation of the heart, bacteremia, acute myocardial infarction, cephalic vein phlebitis, and ventricular tachyarrhythmia. Minor problems were primarily related to equipment failure or positional difficulties with the catheter-electrode and were usually of no serious consequence.