The Use of the Balloon‐Tipped Floating Catheter in Temporary Transvenous Cardiac Pacing

The effectiveness and safety of balloon‐tipped, flow guided, electrodes for ventricular pacing as opposed to the fluoroscopy‐guided semi‐rigid bipolar electrodes have never been compared in a controlled study. A prospective study was therefore undertaken to compare both techniques in semi‐elective and emergency procedures. Flow guided electrodes were inserted in 67 patients (group A) and semi‐rigid electrodes in 44 patients (group B). The results of group A were judged to be superior to those of group B in four aspects: a) shorter insertion time (6′45″ vs. 13′30″, p < 0.0005); b) lower incidence of catheter displacement (13.4 vs. 32.0 percent, p < 0.05); c) longer interval of time between implantation and catheter displacement (4.4 vs. 1.9 days, p < 0.0005); d) lower incidence of serious ventricular arrhythmias during insertion (1.5 vs. 20.4 percent, p < 0.005). Threshold at insertion was not significantly different (0.6 ± 0.3 vs 0.7 ± 0.2 milliampere). The superiority of flow‐guided electrodes over fluoroscopy‐guided electrodes persisted in the comparison of semielective insertions in groups A and B. We conclude that the flow‐guided insertion technique is safer, more expeditious and more stable than the fluoroscopy‐guided technique in semi‐elective as well as in emergency insertions. (PACE, Vol. 4, September‐October, 1981)