Name of the Procedure:

Catheter, Pacing, Transesophageal (C1756)

Common Name: Transesophageal pacing catheter insertion Technical Term: Transesophageal temporary pacing catheter insertion

Summary

A transesophageal pacing catheter insertion is a procedure where a special type of catheter is inserted into the esophagus to help regulate the heart's rhythm. This is done through the esophagus because it is close to the heart, allowing for effective pacing without the need for invasive surgery.

Purpose

This procedure is used to address abnormal heart rhythms, such as arrhythmias or atrial flutter. The goal is to stabilize the heart's rhythm temporarily, especially during emergencies or until a more permanent solution can be implemented.

Indications

• Symptomatic bradycardia (slow heart rate)
• Tachycardia (rapid heart rate)
• Atrial flutter or fibrillation
• Heart rate abnormalities detected during other cardiac procedures
• Need for temporary pacing during certain surgeries

Preparation

• Patients are generally advised to fast for 6-8 hours before the procedure.
• Blood tests and electrocardiograms (EKG) are often performed beforehand to assess the heart’s condition.
• Medications may need to be adjusted; for example, blood thinners might be paused.
• Patients should arrange for transportation post-procedure as they may not be able to drive immediately afterward.

Procedure Description

1. The patient is positioned comfortably, usually in a supine position.
2. Local anesthesia or mild sedation is administered to ease discomfort.
3. A flexible catheter is inserted through the mouth and advanced down the esophagus.
4. The catheter is positioned near the heart, and its electrodes are used to deliver electrical impulses that regulate the heart’s rhythm.
5. The process is monitored via EKG to ensure accurate placement and effective pacing.

Duration

The procedure typically takes about 30-60 minutes.

Setting

This procedure is usually performed in a hospital setting, often in a cardiac catheterization lab or specialized cardiac care unit.

Personnel

• Cardiologist or specialist in cardiac electrophysiology
• Registered nurses (RNs)
• Anesthesiologist or nurse anesthetist (if sedation is required)

Risks and Complications

• Sore throat or discomfort in the esophagus
• Minor bleeding or irritation
• Rare risks include esophageal perforation, infection, or adverse reactions to sedation
• Temporary arrhythmias during catheter placement

Benefits

• Rapid stabilization of abnormal heart rhythms
• Minimally invasive compared to surgical alternatives
• Immediate results can often be seen

Recovery

• Most patients can resume normal activities within a few hours.
• Specific instructions will include avoiding heavy lifting for 24-48 hours and attending follow-up appointments.
• Patients are advised to monitor for any unusual symptoms such as fever, severe pain, or irregular heartbeats.

Alternatives

• External pacing using skin electrodes
• Implantable cardiac devices (e.g., pacemakers)
• Medications to manage heart rhythm
• Surgical interventions in more severe cases

Patient Experience

During the procedure, patients might feel mild discomfort or pressure but significant pain is uncommon due to sedation or anesthesia. Post-procedure, a sore throat or mild esophageal discomfort can be managed with over-the-counter pain relievers and soothing beverages. Clear communication with healthcare providers ensures optimal comfort and understanding throughout the experience.