A new temporary atrial pacing catheter inserted percutaneously into the subclavian vein without fluoroscopy: a preliminary report.

A permanently formed "J" shaped 6F bipolar electrode catheter specially designed to facilitate temporary atrial pacing was constructed and tested in 15 patients. A pair of rigid, "orienting wings" was fixed to the catheter 28 cm from a large spherical tip electrode to establish directional orientation of the "J" while in the right atrium. Rapid percutaneous introduction is possible with a peel-away sheath via the subclavian vein. Positioning in the right atrium can be accomplished without fluoroscopy. The catheter could be inserted and positioned against the right atrial wall generally in less than three minutes and required little or no additional manipulation for capture. No instance of loss of capture was documented during subsequent continuous monitoring as the catheter remained in place from one to thirteen days. Ease of insertion of this electrode catheter, as well as stability, provided an effective method for temporary atrial pacing without fluoroscopy. This novel catheter design warrants testing in a large patient population by others and could have a potential application to other types of catheter needs.