Trans Venous Pacers

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docB

Chronically painful
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  1. Attending Physician
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I have terrible luck with TVP. It seems like I can never get decent capture. Part of the problem is that if I'm doing a TVP it's a code situation and I'm floating with CPR. I pretty much only wind up dong it if the pt is failing TCP and therfore coding. It's one of those procedures I only do about 5 or 6 times a year so it's tough to get good at it. Anyone else have similar problems.
 
docB said:
I have terrible luck with TVP. It seems like I can never get decent capture. Part of the problem is that if I'm doing a TVP it's a code situation and I'm floating with CPR. I pretty much only wind up dong it if the pt is failing TCP and therfore coding. It's one of those procedures I only do about 5 or 6 times a year so it's tough to get good at it. Anyone else have similar problems.

Make sure to let the balloon down. When the balloon is inflated, it covers the tip of the electrode, which prevents it from touching the myocardium. It will only capture if the balloon is deflated. I learned this the hard way after spending a huge amount of time trying to figure out why I wasn't getting pacing, then a seasoned RN told me to deflate the balloon and it worked perfectly....
Hope this helps.
Mark
 
Another tip: I spoke with a cardiologist who recommended putting a small bend at the end (a little curve to it). This is so you can direct it a little easier into the wall. He says it works well for him. My N of 1 says this works. Might have been luck though.
 
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