Author: Dr Josh Mclarty
Peer Reviewer: Dr Ken Hoffman
It is important to understand Temporary Pacing Threshold Checks when caring for post-operative patients in cardiac ICU. This 9 minute video tutorial discusses:
- Why we do pacing checks
- Setup and checking for safety
- Sensitivity threshold checks
- Output threshold checks
- Finishing the check
You might also want to review the previous video on Temporary epicardial pacing and sensitivity.
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Finally, this video was made possible by an education project grant awarded by The Australian and New Zealand Intensive Care Foundation, a charity dedicated to improving the care of critically ill patients by raising funds for clinical research projects as well as the education of health professionals responsible for intensive care.
Hi there.
Can epicardical thershold tests be performed on hypothermic patients.?
The problem with performing threshold tests in a hypothermic patient is that intrinsic heart rate may not be sufficient to maintain cardiac output during the threshold checks (i.e. unsafe), and the thresholds may be different once the patient is warm (will have to recheck anyway).
“Ideally the patient should have a normal temperature (>36 °C) and normal serum potassium before the first routine pacing check. If a more urgent pacing check is indicated, best practice is to repeat the check once the patient’s temperature and potassium have returned to normal.” from: Gillham MJ, Barr TM. Temporary epicardial pacing after cardiac surgery. BJA Educ. 2023 Sep;23(9):337-349. doi: 10.1016/j.bjae.2023.05.003. Epub 2023 Jul 6. PMID: 37600212; PMCID: PMC10433321.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10433321/