Two-hit hypothesis
Transvenous pacing is a medical procedure used to control the heart's rhythm. It involves the insertion of a pacing wire into a vein, usually in the neck or groin, and threading it through to the heart. This wire is then connected to a pacemaker, which sends electrical impulses to the heart to maintain a regular heartbeat.
Indications
Transvenous pacing is typically used in emergency situations where the heart's natural pacemaker is not functioning properly. This can occur in conditions such as bradycardia (slow heart rate), heart block, and certain types of cardiac arrest. It may also be used temporarily after heart surgery or during certain diagnostic procedures.
Procedure
The procedure is usually performed under local anesthesia. The pacing wire is inserted into a vein and guided to the heart using fluoroscopy (a type of X-ray). Once in place, the wire is connected to a pacemaker, which can be adjusted to deliver the appropriate rate and strength of electrical impulses.
Risks and Complications
As with any invasive procedure, transvenous pacing carries some risks. These may include infection, bleeding, damage to the vein or heart, and complications related to the anesthesia. In rare cases, the pacing wire may move out of place and require repositioning.
Aftercare
After the procedure, patients are usually monitored in a hospital for a short period of time. The pacing wire and pacemaker may be removed once the heart's natural rhythm has been restored, or they may be left in place for longer-term treatment.
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