Abstract: AIM:To evaluate the safety and validity of temporary, bedside pacemaker implanted in critically ill patients with cardiac emergency and to compare the utility of different venous pathways and electrode catheter. METHODS: A total of 262 patients with different types of arrhythmia received temporary bedside pacemaker implantation via right internal jugular vein, bilateral subclavian vein or right femoral vein access during an emergency to evaluate the clinical operation, single puncture success rate, pacing success rate, and intra- and postoperative complications. RESULTS: In 262 patients, blind insertion catheter pacing at bedside was successfully done in 254 patients with a success rate of 96.95%. Four patients with DAS were successful and four cases were unsuccessful. Average surgical time was 2-12min. Twenty-seven cases were complicated by ventricular tachycardia, hemipneumothorax, ductal exfoliation, and pacemaker malfunctions in pacemaker implantation and application. There were 10.3% of cases without serious complications such as ventricular fibrillation or perforation. CONCLUSION: Temporary bedside pacemaker implantation used for severe arrhythmia is timely, safe and effective. Notable, the right internal jugular vein path and balloon floating pacing catheter has been shown to have obvious advantages in critically ill patients with comprehensive treatment.