Management of Epicardial Pacer Wires

Epicardial pacemaker wires are commonly placed by the surgeon after cardiac surgery. They are lightly sutured into the pericardium before closure of the thorax. The pacemaker wires are then pulled through the skin and secured externally, to the chest wall. Patients may have a single or a double set of electrodes. Dual sets have usually 2 wires attached to the atria and 2 wires attached to the ventricle. In most case, the atrial pair exits on the right side of the chest and the ventricular on the left side. However, as this may vary between facilities, it is imperative that these wires be labeled appropriately for future emergency use.

Pacer wires are wrapped and secured to prevent accidental dislodgement and possible microshock.  Each wire should be carefully wrapped and placed in the finger of a glove and then secured to the chest. To prevent microshock wear gloves when handling the wires.