It can be used to treat symptomatic bradycardias that do not respond to transcutaneous pacing or to drug therapy.
For patients who present in an emergency setting with symptomatic bradycardias, usually drugs like atropine or sympathomimetic drugs (epinephrine or dopamine) can be used to increase the heart rate to an adequate level until the underlying cause of the bradycardia can be isolated and then, possibly, a permanent pacemaker can be placed.
For patients for whom transvenous pacing is chosen, the procedure is done at the bedside with a local anesthetic alone or in conjunction with conscious sedation.
The pacing electrode is advanced through the vein under fluoroscopic and electrocardiographic guidance.
An X-ray after the procedure is always obtained to confirm placement of the pacing electrode.