[Then hemodynamic efficacy of transcutaneous cardiac stimulation]

Bradyarrhythmia or asystole is the most common rhythm disturbance with ventricular fibrillation and tachycardia, for 30-40% of patients admitted in intensive coronary care units. Already use in the therapy of bradyarrhythmia or asystole, as a method of emergency, immediately in place, the external pacing is very useful in an out of hospital therapy with personnel skilled in its use until the initiation of support therapy in coronary care units. Actually, with less significant side effects (no severe pain, no strong muscular contractions, no skin burns) and a best innocuity and tolerance based on the employment of larger adhesive pre-gelled patches, temporary transcutaneous cardiac stimulation is not only confined to unconscious patients but also in case of severe bradycardia, complete AV block in conscious patients. Our hemodynamic study shows a good level of systemic pressure and of cardiac index to permit the transport of patients in coronary care units in good conditions. Furthermore, the experimental study demonstrates the importance of the polarity of the electrodes and of the duration of the stimulus (more than 10 ms) to minimize the threshold (mA/cm2) so as to increase the tolerance in clinical application. Transcutaneous cardiac pacing is a simple and rapid pacing procedure with effective hemodynamic results for victims of out-of-hospital cardiac arrest and can be easily used in conscious patients without any complication.