Temporary epicardial pacing after cardiac surgery: a practical review

Epicardial wires allow temporary pacing after cardiac surgery. Pacing is often the best, and sometimes the only method of treating temporary rhythm disturbances in this context. Temporary epicardial pacing has evolved from simple one-chamber systems to dual chamber, biatrial, and even biventricular systems. The first part of this two-part review provides an overview of the management of temporary epicardial pacing systems. Factors influencing the placement of the various types of epicardial wires and the routine care of a pacemaker-dependent patient are outlined, followed by a description of the diagnostic use of pacing wires, how to remove wires, and when to consider transition to permanent pacing. Special circumstances such as compatibility with magnetic resonance imaging and intra-aortic balloon pumps are also discussed. The second part of this review will describe the various pacing modes, and solutions to common pacing problems using various adjustable parameters.