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Related Experiment Videos

Transcutaneous pacing for cardiac emergencies.

E Rosenthal1, N Thomas, E Quinn

  • 1Department of Cardiology, Royal Sussex County Hospital, Brighton, UK.

Pacing and Clinical Electrophysiology : PACE
|December 1, 1988
PubMed
Summary

Transcutaneous cardiac pacing with the Pace-Aid showed limited success in emergency patients with profound bradycardia or asystole. While occasional capture occurred, it rarely resulted in survival, especially in asystole cases.

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Area of Science:

  • Emergency Medicine
  • Cardiology
  • Critical Care

Background:

  • Profound bradycardia and asystole are life-threatening cardiac emergencies.
  • Advanced life support, including epinephrine, is the initial treatment.
  • Transcutaneous cardiac pacing offers a non-invasive alternative when initial measures fail.

Observation:

  • Pacing stimuli were delivered using anteroposterior gel-pad electrodes.
  • Electrical capture was definite in 5 patients, possible in 16, and absent in one-third.
  • A palpable pulse was achieved in 7 patients.

Findings:

  • Among 21 asystole patients, 11 showed only possible electrical capture; none survived.
  • Four bradycardia patients received transvenous pacing, with two discharged.

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  • Challenges included electrical overload obscuring ECG capture and muscle artifact hindering pulse palpation.

    • Implications:

    • Transcutaneous pacing may offer occasional benefit for profound bradycardia unresponsive to initial treatment.
    • Its utility in complete asystole appears limited, with no survivors in this group.
    • Further research is needed to optimize transcutaneous pacing techniques and patient selection.