Successful treatment with transesophageal pacemaker for medically refractory bradycardia during endovascular thoracoabdominal aortic aneurysm surgery: 2 case reports

We present two cases of external pacing using esophageal atrial pacing for the treatment of medically refractory bradycardia during endovascular treatment of thoracoabdominal aortic aneurysms (TAAA) under general anesthesia. TAAA are life-threatening medical emergencies. Prompt management is required to prevent rupture or further dissection. Management focuses on impulse and blood pressure control followed by endovascular repair. Beta-blockers and antihypertensives are considered first line agents. General anesthetics can potentiate the effect of these medications intraoperatively. In our patients, favorable outcome was achieved using transesophageal pacing. Currently, there is limited literature supporting the use of transesophageal pacing in the perioperative setting.