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
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: 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
- Prep and drape right shoulder area
- Ultrasound guided access to R Subclavian vein
- Insert peel-away sheath
- Insert lead and test
- Suture lead in place at skin
- Biopatch and place dressing
- Attach external PPM, secure with tegaderm