RN

Removal of Epicardial Pacing Wires: Part III

Post-operatively, there comes a time when the physician will need to remove epicardial wires. This is done by pulling the wires out through the skin. Remember that these wires were lightly sutured into the cardiac muscle. The nurse’s responsibility will be to monitor the patient for signs of cardiac tamponade.

Cardiac tamponade is the compression of the heart that occurs when blood or fluid builds up in the space between the myocardium (the muscle of the heart) and the pericardium (the outer covering sac of the heart).
Signs and symptoms of cardiac tamponade include:

• Tightness in the chest and or chest pain
• Difficulty breathing
• Distended neck veins
• Hypotension
• Tachycardia

Treatment of cardiac tamponade includes pericardiocentesis, fluid replacement, oxygen administration and medications to stabilize blood pressure.

Paradoxical pulse: Paradoxical pulse, is an exaggeration of the normal variation in the pulse during the inspiratory phase of respiration, in which the pulse becomes weaker as one inhales and stronger as one exhales.