<s>
Transvenous	O
cardiac	B-Device
pacing	I-Device
(	O
TVP	O
)	O
,	O
also	O
called	O
endocardial	O
pacing	O
,	O
is	O
a	O
potentially	O
life-saving	O
intervention	O
used	O
primarily	O
to	O
correct	O
profound	O
bradycardia	B-Algorithm
.	O
</s>
<s>
It	O
can	O
be	O
used	O
to	O
treat	O
symptomatic	O
bradycardias	B-Algorithm
that	O
do	O
not	O
respond	O
to	O
transcutaneous	B-Algorithm
pacing	I-Algorithm
or	O
to	O
drug	O
therapy	O
.	O
</s>
<s>
Transvenous	B-Algorithm
pacing	I-Algorithm
is	O
achieved	O
by	O
threading	O
a	O
pacing	O
electrode	O
through	O
a	O
vein	O
into	O
the	O
right	O
atrium	O
,	O
right	O
ventricle	O
,	O
or	O
both	O
.	O
</s>
<s>
This	O
means	O
of	O
pacing	O
the	O
heart	O
is	O
not	O
as	O
popular	O
as	O
other	O
means	O
of	O
pacing	O
(	O
see	O
transcutaneous	B-Algorithm
pacing	I-Algorithm
,	O
implanted	B-Device
pacemaker	I-Device
,	O
epicardial	O
pacing	O
)	O
because	O
it	O
is	O
a	O
temporary	O
solution	O
to	O
pace	O
the	O
heart	O
and	O
yet	O
involves	O
a	O
similar	O
level	O
of	O
risk	O
of	O
bleeding	O
as	O
a	O
more	O
permanent	O
solution	O
like	O
placing	O
an	O
implanted	B-Device
pacemaker	I-Device
.	O
</s>
<s>
For	O
patients	O
who	O
present	O
in	O
an	O
emergency	O
setting	O
with	O
symptomatic	O
bradycardias	B-Algorithm
,	O
usually	O
drugs	O
like	O
atropine	O
or	O
sympathomimetic	O
drugs	O
(	O
epinephrine	O
or	O
dopamine	O
)	O
can	O
be	O
used	O
to	O
increase	O
the	O
heart	O
rate	O
to	O
an	O
adequate	O
level	O
until	O
the	O
underlying	O
cause	O
of	O
the	O
bradycardia	B-Algorithm
can	O
be	O
isolated	O
and	O
then	O
,	O
possibly	O
,	O
a	O
permanent	B-Device
pacemaker	I-Device
can	O
be	O
placed	O
.	O
</s>
<s>
For	O
patients	O
for	O
whom	O
transvenous	B-Algorithm
pacing	I-Algorithm
is	O
chosen	O
,	O
the	O
procedure	O
is	O
done	O
at	O
the	O
bedside	O
with	O
a	O
local	O
anesthetic	O
alone	O
or	O
in	O
conjunction	O
with	O
conscious	O
sedation	O
.	O
</s>
<s>
The	O
greater	O
use	O
of	O
atropine	O
and	O
epinephrine	O
or	O
external	B-Device
pacing	I-Device
may	O
make	O
transvenous	B-Algorithm
pacing	I-Algorithm
unnecessary	O
by	O
stabilizing	O
patients	O
early	O
in	O
the	O
process	O
of	O
caring	O
for	O
the	O
patient	O
.	O
</s>
<s>
Some	O
debate	O
exists	O
over	O
the	O
efficacity	O
and	O
reliability	O
of	O
transvenous	B-Algorithm
pacing	I-Algorithm
,	O
especially	O
if	O
the	O
need	O
for	O
permanent	O
pacing	O
is	O
anticipated	O
.	O
</s>
