Temp/Perm Guide

From Bay Area Structural Heart Wiki

The Temp/Perm pacemaker setup is used when a short term pacemaker is needed for heart block in the setting of Alcohol Septal Ablation or TAVI. It uses a standard passive fixation pacemaker lead placed through the subclavian vein. A permanent pacemaker unit is connected to the lead outside the body to provide stimulation.

Programmer setup

  • Take blue medtronic bag from TAVR cart
  • Plug in white wand base
  • Boot up iPad, password: Medtronic
  • Select SmartSync app on main screen
  • Follow prompts to connect wireless wand
  • Once connected, place wand over pacemaker
  • If testing capture of the lead make sure fresh set of alligator cables are on the table, they will connect to the lead and the white wand base
  • Program device according to MD preference

Note Warning: ***WHEN DEVICE RETURNED TO LAB PLEASE REPROGRAM TO "OVO"*** this will make sure it stops pacing while not in use by a patient, and preserve battery life!

Note Note: Rep is available for FaceTime during case if in need of assistance! Justin - 408-781-9997

PPM Pre-Programing Once Out of Box

  • Connect device to programmer
  • Select "PARAMETERS" under top right drop down icon
  • Click on box that says "PACING..."
  • Change "Pace Polarity AND Sense Polarity" from unipolar to bipolar
  • Next click on "ADDITIONAL FEATURES..." in lower right corner
  • Under "IMPLANT DETECTION" make sure you turn in OFF

Equipment

Open

  • US probe cover
  • Micropuncture set
  • 6fr. Peel away sheath
  • Pacemaker lead
  • Single chamber PPM
  • Alligator clip pacing cable
  • 2-0 Ethibond suture
  • 2 x 2-0 Prolene suture
  • Screwdriver
  • 3 x Medium Tegaderms
  • Biopatch

Procedure

  1. Prep and drape right shoulder area
  2. Ultrasound guided access to R Subclavian vein
  3. Insert peel-away sheath
  4. Insert lead and test
  5. Suture lead in place at skin
  6. Biopatch and place dressing
  7. Attach external PPM, secure with tegaderm