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Compromising bradycardia: management in the emergency department
G H Sodeck1, H Domanovits, G Meron
1Department of Emergency Medicine, Vienna General Hospital, Medical School, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
Resuscitation
|January 11, 2007
Summary
Compromising bradycardia is a serious emergency. About 20% of patients needed temporary pacing, and 50% ultimately required a permanent pacemaker for stabilization.
Area of Science:
- Cardiology
- Emergency Medicine
Background:
- Bradycardia can indicate a serious medical emergency.
- The necessity for temporary and permanent pacing in bradycardia cases is not well-established.
Purpose of the Study:
- To investigate the incidence, symptoms, mechanisms, management, and outcomes of patients with compromising bradycardia.
- To determine the need for temporary and permanent pacing in emergency bradycardia cases.
Main Methods:
- Retrospective analysis of a 10-year registry from a university hospital's emergency department.
- Inclusion of 277 patients presenting with compromising bradycardia.
Main Results:
- The primary symptoms included syncope, dizziness, and collapse.
- High-grade AV block and sinus bradycardia were common initial ECG findings.
- Nearly 50% of patients received a permanent pacemaker, with a 5% 30-day mortality rate.
Conclusions:
- Approximately 20% of patients with compromising bradycardia required temporary emergency pacing.
- Half of the patients ultimately needed a permanent pacemaker for long-term management.
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