Cardiac Pacing Using A Guidewire In Emergency Situation

We were describing an interesting case of complete heart block (CHB) received in the emergency department (ED) with the cardiogenic shock in the life-threatening situation, who was successfully manage by cardiac pacing, initially using a J Tip guidewire (JTG) due to non-availability of temporary transvenous pacing catheter (TVPC) and later on using TVPC once available . TVPC placement is a potentially life-saving procedure that involves placing a catheter-based electrode within the right ventricle via central venous access, and then stimulating that electrode and the heart with an external pacing generator to optimize cardiac output. In the ED, the procedure can be performed either blindly or with ECG guidance and recently with USG guidance. After placement, CXR perform to verify position of TVPC as well as any procedural complication.