Usage Techniques for Temporary Pace Wire

Information Bank

What are the things you need to know about the low density PE (LD-PE) coated (insulated) Tempowire surgical temporary heart pace wire and what are the usage techniques?

Tempowire surgical temporary heart pace wire has one-edge slipped insulation or diameter. It is fastened to myocardium with curved, round suture needle connected to ensure conductivity or fastened with a anchor by passing through the myocardium if it has anchor. The anchor is the stripped and winged piece of insulation close to the curved needle. The other end of the insulated wire is connected to the straight, sharp Keith needle that enables passage from inside to outside from the chest cavity wall to ensure conductivity. Keith needle is equipped with a special notch ensuring frangibility. The sharp part of the surgical needle is broken off from the notch, the part that remains attached to the wire forms the lead pin and connects to conventional pace or monitor equipment.

Tempowire Surgical Temporary Pace Wire Usage

Tempowire Cerrahi Geçici Pace Telinin Kullanım Teknikleri -

Please check the custom sterile package before opening. If the package is damaged, do not use the pace wire. Please check the instructions regarding opening the sterile package in Figure 2 and 3. The content of the sterile package is sterile (see also Figure 2, indication statement 1). Carefully remove the products in the sterile package. The insulation color on the surgical pacing wire body can be used for identification purpose. Please check Figure 4 for atrial usage (indication statement 1).

Tempowire Cerrahi Geçici Pace Telinin Kullanım Teknikleri - Surgical Temporary Pacing Wire
Tempowire Cerrahi Geçici Pace Telinin Kullanım Teknikleri - Surgical Temporary Pacing Wire
Tempowire Cerrahi Geçici Pace Telinin Kullanım Teknikleri - Surgical Temporary Pacing Wire
Tempowire Cerrahi Geçici Pace Telinin Kullanım Teknikleri - Surgical Temporary Pacing Wire
Tempowire Cerrahi Geçici Pace Telinin Kullanım Teknikleri - Surgical Temporary Pacing Wire

Insert the curved needle through the myocardium (see Figure 4) in a direction so that the entry point of the surgical temporary pacing wire into the heart can subsequently align with the exit in the chest. This method might facilitate retraction of the temporary pace wire. It is important to properly position the electrode inside or on the myocardium (see also Figure 5).

Note: The surgeon might opt for changing the wire fixing procedure based on the examination or experience. However, the selected fixing method must always enable the surgical pacing wire to be removed later.

Atrial Usage: Position the electrode inside the myocardium. This is ensure by slightly pulling the curved needle while pulling the wire inside the tissue.

Attention: The sutures must be placed not to harm the sinus nodule. To enable easy removal, the direction of the wire should be selected to align with the rest of the pacing wire body of the stripped wire end (electrode).

Cut the wire removed from the myocardium and curved needle until the rest of it stays in the myocardium (see also Figure 6). During the high displacement risk period, the cutting procedure might not be applied immediately because the wire is cut after a short period. Discard the myocardial curved needle.

Hold the chest needle distally from the separation mark (see Figure 7) and insert it through the chest wall in a direction that will allow the pacing wire in the heart to align with the chest exit. Keep some part of the conductive wire inside the check to prevent any displacement due to patient movement. Using a needle driver for this procedure is recommended.

Note: The previously described steps can be repeated for the second wire if bibolar configuration is required.

Break the chest needle from separation mark (see also Figure 8). Discard the chest needle.

Note: You must not try to reposition the pacing wire after removing the curved needle but before closing the chest if the wire is displaced. A new temporary pacing wire should be used.

Connect the wire connector pins to the external pulse generator, patient cable, or surgical cable, following the polarity below. Connect the pin to the negative pole (-). The neutral wires must be connected to the positive pole (+) of the external pulse generator.

Note: Ensure compatibility of external pulse generator and cable before use. Connect the patient cable or surgical cable to the suitable pole on the pulse generator. Consider the polarity and chamber assignment. If atrial sensing is desired, atrium mapping is highly recommended for maximum electrogram amplitude.

When the surgical wire is no longer needed, carefully pull to remove the wire.

Note: Due to the relatively thin atrial wall, extreme care must be exercised when removing the wire from the atrium. To minimize the atrial tissue damage, the wire must be removed slowly and carefully.

Tempowire

Surgical Temporary Pacing Wire

Tempowire surgical temporary pace wire might lead to slight acute inflammatory reaction and is not absorbed by the tissue.

Users should be familiar with surgical procedures and techniques for temporary electrical control of heart rate prior to use of the wire.

The steel might lead to electro lithic reaction if there are any other metals or alloys.

Bibliography

Tempowire – Cerrahi, Geçici Pace Teli, Emilemeyen, Mavi-LD-PE kaplı – Kullanma Talimatı – Prospektüs (t.y.). Boz Tıbbi Malzeme. Erişim adresi: https://www.boztibbi.com/wp-content/uploads/2023/01/tempowire-ifu.pdf.