Implementing Epicardial Pacing Safety Check Protocols in a Cardiothoracic ITU

Temporary epicardial pacing is routinely placed in patients after cardiac surgery to manage arrhythmias including ventricular arrhythmias and conduction disturbances.1 A known complication of epicardial pacing is an increase in capture threshold over time.2 Given the risk of arrhythmias, it is important to ensure that epicardial pacing is functional and able to safely pace the ventricles should a patient become pacing dependent. We identified a deficit in epicardial pacing checking in our cardiothoracic ICUs.