During high-risk PCI, what is the purpose of a temporary pacing lead?

• A. To provide rapid pacing and prevent bradyarrhythmias or asystole during sensitive maneuvers
• B. To measure blood pressure
• C. To inject contrast
• D. To monitor oxygen saturation

Answer: (A)

During high-risk PCI, a temporary pacing lead is placed to provide rapid pacing and prevent bradyarrhythmias or asystole when the heart is at risk of slowing down during delicate steps. Some maneuvers, such as balloon inflation or guiding catheter activity near conduction tissue (often around the right coronary artery supplying the AV node), can transiently depress the heart’s rhythm or cause pauses. Having a pacing lead allows the operator to quickly pace the heart at a controlled rate, maintaining cardiac output and blood pressure so the procedure can proceed safely. This pacing acts as a safety net, ready to maintain rhythm if the intrinsic conduction becomes unreliable. It’s not for measuring blood pressure, injecting contrast, or monitoring oxygen saturation—those functions come from other monitoring tools.