Management of patients with an invasive temporary pacemaker requires familiarity with cardiovascular anatomy and physiology, conduction system defects, and rhythm interpretation.

Invasive electrical pacing is used to initiate myocardial contractions when intrinsic stimulation is insufficient, the native impulses are not being conducted, or the heart rate is too slow to maintain an adequate cardiac output.1,2 Several pacing options are available. Selection of a particular method depends on both the patient’s current condition and his or her projected future needs. Among patients with cardiac disease, noninvasive (transcutaneous), semi-invasive (esophageal), temporary invasive, and implanted (permanent) pacemakers are often indicated.1,2 In this article, however, we focus on those invasive but temporary pacemaker systems that critical care nurses often find confusing.

Temporary invasive pacing of the myocardium is used for a variety of emergent and elective conditions1 (Table 1). Pacing electrodes are routinely inserted during certain cardiac surgical...

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