Basics of temporary epicardial pacing in pediatric postoperative cardiac patients

The objective of this review is to provide the intensivist or trainee caring for a pediatric postoperative cardiac patient who has underlying congenital or acquired heart disease with a summary of the key aspects of temporary pacemaker device operation. These devices are commonly used in pediatric postoperative cardiac patients who have rate or conduction abnormalities. Pacemaker malfunction and troubleshooting can be intimidating, especially when coupled with hemodynamic compromise. The clinician must be aware of pacing indications, device functions, and programming. This must be coupled with a comprehensive awareness of the individual patient’s electrophysiology and how to use the pacing device to optimize clinical care. The management of the paced patient requires regular pacemaker device checks and a structured approach to trouble shooting commonly encountered problems or device malfunction to ensure ongoing and safe use.