Abstract

Study Objective: We describe 5 patients who underwent transcutaneous cardiac pacing followed by ultrasound-guided transvenous cardiac pacing (TVCP) in which ultrasonography was used to assist and confirm the placement of electrode catheters within the right ventricle. Methods: We retrospectively considered consecutive patients with complete heart block who received emergency ultrasound-guided TVCP by the same team of trained and certified emergency clinicians at an Emergency Department (ED) of a tertiary care corporate urban hospital in India. Results: Ultrasound-guided TVCP was successful in 4 (80%) of the 5 patients studied. In one patient, there was failure-to-capture. Subsequent successful repositioning of pacing catheter in the patient was done by a cardiologist in the Catheterization Lab. 3 (60%) of the 5 patients had a good outcome, and were discharged from the hospital. 2 (40%) of the 3 patients required permanent pacemaker insertion (PPI). 2 of the 5 patients died. Conclusion: Most emergency clinicians in India often have limited exposure to TVCP in their careers; however, it is well within their scope of practice. TVCP can appear particularly valuable in hospitals where Catheterization Labs are unavailable. Our attempt is to advocate a bridge to the interdepartmental gap, for successful use of this critical procedure in the ED.

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