Temporary transvenous endocardial pacing: method of endocardial electrode reposition in the right ventricular cavity of the heart

Aim. To justify and develop method of endocardial electrode reposition in the right ventricular cavity of the heart in the spontaneous termination of temporary pacing in patients with recurrent myocardial infarction.

Methods. A method of endocardial electrode reposition was used in 23 patients with myocardial infarction complicated by acute bradyarrhythmias. Written informed consent was obtained from all patients, and in the absence of contact with the patient, decision to insert temporary artificial pacemaker was made by medical consultation.

Results. A method of endocardial electrode reposition that provides threading the electrode from the venous bed to the right ventricular cavity of the heart, cardiac stimulation by electrical impulses and creation the new contacts between electrode and right ventricular endocardium of the heart using the same electrode, both in the presence and in absence of the heart conduction and excitation function, was developed. At the same time, it excludes the electrode dislocation from the right ventricular cavity of the heart, provides the electrode fixation with endocardium, and at the same time allows to impose a stable artificial heart rhythm in the shortest time. During the spontaneous termination of the effective artificial pacemaker, endocardial electrodes reposition enabled to promptly regain the heart rhythm control in all 23 patients with acute bradyarrhythmia of infarction genesis.

Conclusion. Effective and safe method of endocardial electrode reposition in the right ventricular cavity of the heart in the spontaneous termination of temporary pacing in patients with recurrent myocardial infarction was developed and introduced into clinical practice.