Pacing hazards in helicopter aeromedical transport

A 62-year-old man with third-degree atrioventricular block and hemodynamically unstable ventricular tachycardia had a cardiac arrest during helicopter transport to a specialized cardiac care unit. Before transport, his ventricular tachycardia had been successfully terminated by a rapid overdrive pacing technique. The failure of "burst suppression" and the absence of pacer spike artifact on the electrocardiographic monitor raise questions about the potential hazards of using various pacing techniques during helicopter transports. Most significantly, this case points to the possibility of interference by exogenous electromagnetic signals in the medical compartment of the helicopter.