Follow procedure as in transvenous pacemaker insertion. Procedure same except for connecting of electrode to pacemaker generator. Connect atrial electrode to atrial output terminals, connecting positive and negative electrode terminals to respective positive and negative output terminals. Secure connections are essential for proper conduction of pacemaker energy. Connect ventricular electrode to ventricular output terminals, connecting positive and negative electrode terminals to respective positive and negative output terminals.
Secure connections are essential for proper sensing and conduction of pacemaker energy.
Set A-V interval control at desired level. Usually set to the normal PR interval. In patients with intermittent second degree block, the A-V interval is set above the patient's normal PR interval, allowing for normal conduction as well. Set remainder of settings as described in transvenous pacing procedure. Set fast enough to optimize cardiac output and blood pressure without causing myocardial ischemia.