Cargando…

Transesophageal echocardiography (TEE)-guided transvenous pacing (TVP) in emergency department

BACKGROUND: Placement of a temporary pacemaker is a vital skill in the emergency setting in patients that present with life-threatening bradycardia. Transvenous pacing is the definitive method of stabilizing the arrhythmia compared to transcutaneous pacing, as it provides more comfort and better con...

Descripción completa

Detalles Bibliográficos
Autores principales: Adi, Osman, Fong, Chan Pei, Tze, Madeleine Kho Huei, Ahmad, Azma Haryaty, Panebianco, Nova, Ranga, Asri
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10441836/
https://www.ncbi.nlm.nih.gov/pubmed/37603103
http://dx.doi.org/10.1186/s13089-023-00332-7
_version_ 1785093460857978880
author Adi, Osman
Fong, Chan Pei
Tze, Madeleine Kho Huei
Ahmad, Azma Haryaty
Panebianco, Nova
Ranga, Asri
author_facet Adi, Osman
Fong, Chan Pei
Tze, Madeleine Kho Huei
Ahmad, Azma Haryaty
Panebianco, Nova
Ranga, Asri
author_sort Adi, Osman
collection PubMed
description BACKGROUND: Placement of a temporary pacemaker is a vital skill in the emergency setting in patients that present with life-threatening bradycardia. Transvenous pacing is the definitive method of stabilizing the arrhythmia compared to transcutaneous pacing, as it provides more comfort and better control of heart rate, until the insertion of a permanent pacemaker. CASE REPORT: In this case report, we describe the steps using TEE to guide the insertion of transvenous pacer at the emergency department. Traditionally, the process of floating a transvenous pacer wire is performed “blindly” using landmarks and a monitoring ECG finding for capture, or under transthoracic echocardiography (TTE) ultrasound guidance. The blind procedure is associated with higher rate of failure and complications. While guidance using TTE is associated with higher success rates and fewer complications, inadequate imaging of the right side of the heart may limit the utility of this imaging modality. The use of transesophageal echocardiography (TEE) by emergency medicine and critical care physicians has gained traction in recent years due to its clear images and lack of interference with procedures being performed on the chest. In this article, we describe a protocol using TEE to guide the insertion of transvenous pacer through a case illustration. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13089-023-00332-7.
format Online
Article
Text
id pubmed-10441836
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Springer International Publishing
record_format MEDLINE/PubMed
spelling pubmed-104418362023-08-22 Transesophageal echocardiography (TEE)-guided transvenous pacing (TVP) in emergency department Adi, Osman Fong, Chan Pei Tze, Madeleine Kho Huei Ahmad, Azma Haryaty Panebianco, Nova Ranga, Asri Ultrasound J Case Report BACKGROUND: Placement of a temporary pacemaker is a vital skill in the emergency setting in patients that present with life-threatening bradycardia. Transvenous pacing is the definitive method of stabilizing the arrhythmia compared to transcutaneous pacing, as it provides more comfort and better control of heart rate, until the insertion of a permanent pacemaker. CASE REPORT: In this case report, we describe the steps using TEE to guide the insertion of transvenous pacer at the emergency department. Traditionally, the process of floating a transvenous pacer wire is performed “blindly” using landmarks and a monitoring ECG finding for capture, or under transthoracic echocardiography (TTE) ultrasound guidance. The blind procedure is associated with higher rate of failure and complications. While guidance using TTE is associated with higher success rates and fewer complications, inadequate imaging of the right side of the heart may limit the utility of this imaging modality. The use of transesophageal echocardiography (TEE) by emergency medicine and critical care physicians has gained traction in recent years due to its clear images and lack of interference with procedures being performed on the chest. In this article, we describe a protocol using TEE to guide the insertion of transvenous pacer through a case illustration. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13089-023-00332-7. Springer International Publishing 2023-08-21 /pmc/articles/PMC10441836/ /pubmed/37603103 http://dx.doi.org/10.1186/s13089-023-00332-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Case Report
Adi, Osman
Fong, Chan Pei
Tze, Madeleine Kho Huei
Ahmad, Azma Haryaty
Panebianco, Nova
Ranga, Asri
Transesophageal echocardiography (TEE)-guided transvenous pacing (TVP) in emergency department
title Transesophageal echocardiography (TEE)-guided transvenous pacing (TVP) in emergency department
title_full Transesophageal echocardiography (TEE)-guided transvenous pacing (TVP) in emergency department
title_fullStr Transesophageal echocardiography (TEE)-guided transvenous pacing (TVP) in emergency department
title_full_unstemmed Transesophageal echocardiography (TEE)-guided transvenous pacing (TVP) in emergency department
title_short Transesophageal echocardiography (TEE)-guided transvenous pacing (TVP) in emergency department
title_sort transesophageal echocardiography (tee)-guided transvenous pacing (tvp) in emergency department
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10441836/
https://www.ncbi.nlm.nih.gov/pubmed/37603103
http://dx.doi.org/10.1186/s13089-023-00332-7
work_keys_str_mv AT adiosman transesophagealechocardiographyteeguidedtransvenouspacingtvpinemergencydepartment
AT fongchanpei transesophagealechocardiographyteeguidedtransvenouspacingtvpinemergencydepartment
AT tzemadeleinekhohuei transesophagealechocardiographyteeguidedtransvenouspacingtvpinemergencydepartment
AT ahmadazmaharyaty transesophagealechocardiographyteeguidedtransvenouspacingtvpinemergencydepartment
AT panebianconova transesophagealechocardiographyteeguidedtransvenouspacingtvpinemergencydepartment
AT rangaasri transesophagealechocardiographyteeguidedtransvenouspacingtvpinemergencydepartment