Temporary transcutaneous pacing. New indications for an old technique.

ranscutaneous (external) temporary pacing ('ITP) was originally developed in the T 1950s. Although unquestionably effective, it caused extensive contraction of the chest wall muscles and diaphragm and was therefore largely abandoned with the advent of temporary transvenous pacing. Recent improvements in techniques have led to improved patient tolerance and a rekindled interest in TTP, especially in situations where transvenous pacing is unavailable. The sudden and unexpected Occurrence of bradyarrhythmias in the operating room is a potential cause of morbidity and mortality; however, those events are infrequent, even in highrisk patients, and therefore, prophylactic temporary pacing is unwarranted. The emergency insertion of a temporary transvenous pacemaker requires immediate availability of sophisticated