Cardiac Tamponade Following the Removal of Epicardial Pacing Wires: Critical Care APRN Toolkit

Cardiac surgery is an unavoidable intervention when treating various life-threatening diseases. A common complication following cardiac surgery is dysrhythmia, which necessitates the placement of epicardial leads and temporary pacing. Epicardial leads remain in place temporarily—often 3 to 5 days postoperatively—until the risk of dysrhythmia has subsided.¹  Each hospital has guidelines for removing such leads, typically at the bedside in an intensive care unit (ICU) or a cardiac step-down unit. Cardiac tamponade is a life-threatening complication that can occur following the removal of epicardial leads. Unfortunately, it can be difficult to diagnose by using conventional cardiac monitoring approaches (eg, electrocardiography). Early recognition, prompt diagnosis, and expedient intervention are pivotal to ensuring a positive outcome for the patient. In this column we provide critical care advanced practice registered nurses (APRNs) with an updated review of the diagnosis and management of cardiac tamponade following the removal of epicardial pacing wires. We also...