Question about temporary and permanent PM

The run up to my PM procedure happened very quickly. Went to doc at 9:45 am and checked myself into hospital at 1:00pm. Had heart cath at 3:30 and PM insertion at 9:30 same night. Prior months I had Nuclear stress test, Echo, lots of EKG's but breathlessness and 2 presyncope " spells" sent me to doctor. I NEVER thought I needed a PM.

QUESTION: When my doc discussed procedure  he mentioned I would have Temporary PM before they placed the permanent one. I had a bandage on my neck so I assume this was done. So through which place were the leads done ?? I don't understand this and have tried to google it. Does anybody here know the answer ?

 


4 Comments

Temporary pacing

by AgentX86 - 2020-06-14 22:00:48

It's not clear why they used temporary pacing but here is an article that will, I think, answer most of your questions.

<https://patient.info/doctor/inserting-temporary-pacemakers>

"The preferred route of access for temporary transvenous pacing is a percutaneous approach of the subclavian vein, the cephalic vein or, rarely, the axillary vein, the internal jugular vein or the femoral vein[1].

Although right- or left-sided veins can be used, the right side is traditionally preferred as it is technically easier, and the left side is usually reserved for permanent systems."

It sounds like they used the internal jugular vein though it seems extreme to me.

Temporary pacing

by Sisterwash65 - 2020-06-14 22:16:48

Thanks for the link. I’m pretty sure bandage on my neck covered a needle stick. That’s what it looked like to me. When I see him in a couple of weeks I’m going to ask him. He told me this was to “ be on the safe side “ because of my LBBB and bradycardia.

 Felt like a strained muscle, not a true “ sore” throat.

Thanks again for the input .

 

 

leads

by Tracey_E - 2020-06-15 10:40:16

Have you seen your xray? Leads and pacer show up nice and bright, you can't miss it. The permanent leads would have been run through the same incision as the pacer box. I thought temp pacers were run through the groin but I've only ever had external one (big giant sticky pads) so I don't know for sure. But your permanent leads were not run through the neck if that's what you are asking. 

Temporary pacemaker

by Sisterwash65 - 2020-07-01 08:42:15

I posed a question about the TPM earlier because I knew I had one prior to the placement of my permanent PM. He told me beforehand he was going to do it because of my LBBB and 3rd degree heart block. It’s just a precaution when the patient has unstable arrhythmias. Mine was done through the IJ and the lead is placed in the heart, then they proceed with the permanent PM ( in its usual place ) and when it’s in place, the temporary one is removed. 

I asked him about this and when I saw my real time X-ray, the sheath from the TPM was still in place. When I went home the next day I still had a large bandaid on my neck. My husband asked me about it and I to.d him. I was afraid to take it off so I waited til the next day. The spot looked like a needle stick ! My doctor said, yep, that’s what they try to do. I have a wonderful doctor, still young and not jaded and tired yet ! He really loves his job. 

Just wanted to update how a temporary pacemaker was used in my case.

Blessings to all !

 

 

 

 

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