Upon admission to the PACU, a chest X-ray should be performed to assess for pneumothorax and confirm lead placement.
Assess the patient’s pulse, arterial waveform, and perfusion including capillary refill, mentation, MAP, and urine output. If the electrical stimulus does not produce ventricular ejection, no cardiac output will be present, and thus, no blood pressure. Increasing the MA until capture is advisable. The newly placed lead may have become dislodged or moved adjacent to damaged myocardial tissue, which no longer conducts. If this occurs, a pacer-dependent patient should be transcutaneously paced until the lead can be replaced.