Quote from graciev
Does anyone have experience with placing an atrial pacing wire into the ventricular port of a pacer in order to increase the available output? Is there anything special we need to know about the rest of the settings after doing this? i.e. the pacer is now sensing the atrial activity I believe, but it "thinks" it's ventricular, is there a possibilty of inappropriate firing???
I would say, at first glance, that the main issue would be if the leads were 'cross threaded' meaning that BOTH the atrial and ventricular leads were reversed and THEN, only if the pacer is in mode to correlate the two signals. So, as far as precautions, I would make sure that the atrial side of the pacemaker is turned down to no output (because, you should only be using the ventricular side of the pacer for this).
If you purposely inserted atrial wires into the ventricular pacing chambers, then, theoretically, you are using a only a 'ventricular' mode to stimulate the atria, if that makes sense. Why I say that is you are doing this for one of 2 reasons, most likely: 1. decreased overall sensativity, in which case, you would not want relatively more power to the atria, but less to the ventricals, in any case, or 2. you have some output problem with the atrial wires themselves, which means that you are shunting 'power' based on the knowledge that some defect prevents correlated pacing to start with.
I would say that this is an attempt, it seems, to circumvent the capacity of the temporary pacer in general and ANY time you circumvent manufacturer specs, you create a risk to have to legally justify such a decision. That means, documentation is of paramount importance.
Also, TEMPORARY means just that: if you are not getting the desired performance from temporary wires, the 'fix' is a more permanent solution. This sounds like someone that needs a permanent pacer, and soon.
Now, this is just thinking off the top of my head, and I'm certainly open to other intepretations.