Removal of temporary transvenous pacing wires

[cardiaccrn]

Hi everyone

i am new to this, but have decided this may be the best way to get a variety of opinions.

I am new to my hospital and have many policies/guidelines to put in place. Does anyone have specific guidelines for removal of temp. transvenous pacing wires? Do nurses or medical staff perform this procedure? Do you take into consideration post removal tamponade and therefore perform an echo at some stage to determine placement of lead?

Any info would be welcomed

thanks

cardiaccrn

[tvccrn, ASN, RN]

If it's a tranvenous temp pacer, there should be no possibilty of tamponade as the lead aren't attached to the heart in any way. They would touch the heart, but not be imbedded. Therefore, no need for an ECHO.

I work in the cath lab, so I can't speak for the rest of the hospital. Sorry, I know it's not much help.

[Zookeeper3]

RN's once trained and perform 3 wire Dc'd under supervision can pull transvenous wires. We also pull the eipicardial ones. After pulling the epicardial wires we do a chest x-ray 4 hours post to ensure no tamponade. Our transvenous wires have a thin corkscrew appearance on the end to catch the myocardial tissue. We use heavy anticoagulation so our co-ags need to be corrected prior to the dc to help prevent tamponade.