Use of a balloon-tipped flotation electrode catheter for cardiac mounting.

A new balloon-tipped flotation catheter equipped with two pairs of electrodes has been developed for simultaneous monitoring of cardiac rhythm and hemodynamics as well as for temporary emergency atrial, ventricular and atrioventricular sequential pacing. Experience in 43 patients demonstrates the following: (1) The catheter can be passed and positioned with the tip in the pulmonary artery or its branches at the bedside with the use of fluoroscopy as easily as the standard (Swan-Ganz) catheters. (2) With the catheter in the proper position ans with the use of appropriate filters (proximal, 50 to 300 hertz; distal, 15 to 300 hertz), the intracavity electrograms recorded from the proximal and distal pair of electrodes provide characteristic high right atrial and right ventricular signals, virtually free of noise artifact, baseline drift and respiratory variation, that are particularly suitable for automated on-line monitoring of cardiac rhythm. (3) When indicated, atrial, ventricular or atrioventricular sequential pacing can be initiated without delay. (4) Large artifact-free right ventricular intracavitary signals can be used for reliable and consistent operation of any device requiring QRS triggering mechanisms. (5) Monitoring of pulmonary arterial or pulmonary capillary wedge pressure and withdrawal of blood samples from the central circulation is possible. This device can be particularly useful in patients with hemodynamic difficulties as well as arrhythmias.