External transcutaneous pacemakers

The concept of transcutaneous external cardiac pacing has been present for approximately 200 years. However, it was not until the early 1950s that transcutaneous pacing was practical. Implantable pacemakers were introduced in the late 1950s, superceding the more cumbersome and uncomfortable external models. Recent technologic improvements and the development of paramedic services have led to a resurgence of emergently placed external pacemakers, particularly for patients with symptomatic bradycardias and bradyasystolic cardiac arrests in both prehospital and emergency department settings. A review of the history, mechanics, and research of external pacemakers is presented.