What is a temporary pacemaker?
A temporary pacemaker keeps the heart beating at a safe rate for a short period, usually hours to a few days, until the underlying problem is treated or a permanent pacemaker can be implanted. A thin wire is passed through a vein into the heart and connected to a small external box at the bedside, which sends electrical impulses whenever your own heartbeat is too slow. Nothing is left permanently in the body, and the wire is removed once it is no longer needed.
Why is it done?
It is used in urgent situations where the heart has become dangerously slow or may become so.
What happens on the day?
The procedure is often done as an emergency in the catheterisation laboratory. You are given a drip and continuous monitoring and the skin over a vein in the neck or groin is numbed with local anaesthetic. The wire is guided through the vein into the right lower chamber of the heart and its position is tested until it reliably paces the heart, after which it is stitched and taped securely to your skin and connected to the external box.
What to expect afterwards
You are cared for in a high care or coronary care unit, where the rhythm and the pacing box are checked frequently and the wire connections are protected. Movement is restricted so that the wire does not shift. Most patients feel considerably better once a normal rate is restored. The team continually reassesses whether your own rhythm is returning; if it does not, a permanent pacemaker is arranged, usually within a day or two. Removing the wire is quick and simple, and only mild pressure over the site is needed afterwards.
Possible complications
The wire can move out of position and stop pacing, which is why continuous monitoring is essential. Other problems include bleeding, bruising or clot formation at the vein, infection at the site or in the bloodstream if the wire stays in for several days, extra beats or fast rhythms triggered by the wire, and puncture of the heart wall with bleeding into the sac around the heart, which is uncommon but serious. If the neck vein is used, the lung can be nicked, causing air to leak around it.
This information does not replace a consultation. Please discuss your own risks and options with your cardiologist.