Temporary pacemaker leads are placed on the epicardial surface of the heart during cardiac surgery to assist in maintenance of cardiac rate and rhythm postoperatively. In addition to providing a reliable cardiac stimulus in the event of bradyarrhythmias or asystole, pacing wires can be used to optimize cardiac output and assist in the diagnosis and suppression of arrhythmias. Although placement of epicardial pacing leads was once considered essential, pacing is required in only 25% of valve patients and 10% in those undergoing coronary bypass procedures.1,2  This therapy is not without risk; in addition to surgical considerations of lead placement, pacing can potentially reduce cardiac output or precipitate life-threatening arrhythmias, warranting a thorough knowledge of this therapy to promote optimal patient outcomes.

The essential components of any pacing system include a generator to initiate an electrical stimulus, which is then transmitted...

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