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Emergency noninvasive external cardiac pacing.

J E Clinton, P M Zoll, R Zoll

    The Journal of Emergency Medicine
    |January 1, 1985
    PubMed
    Summary
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    External cardiac pacing effectively treated hemodynamically significant bradycardia in emergency patients. However, it showed limited effectiveness for asystole or idioventricular rhythm, particularly after prolonged cardiac arrest.

    Area of Science:

    • Emergency Medicine
    • Cardiology
    • Critical Care

    Background:

    • Bradyarrhythmias are common in critical emergency department patients.
    • External cardiac pacing is a potential intervention for hemodynamic instability.

    Purpose of the Study:

    • To evaluate the effectiveness of external cardiac pacing in critically ill emergency department patients.
    • To identify patient populations most likely to benefit from external pacing.

    Main Methods:

    • Retrospective analysis of 37 emergency department patients receiving external cardiac pacing.
    • Review of indications for pacing, patient response, hemodynamic changes, and survival outcomes.

    Main Results:

    • Eight patients (21.6%) were successfully paced, with a mean systolic blood pressure increase of 95 mmHg.

    Related Experiment Videos

  • Successful pacing occurred in patients with asystole, complete heart block, sinus/atrial fibrillation with bradycardia, and idioventricular rhythm.
  • Six patients (16.2%) survived to hospital discharge, including one asystole patient and others with bradycardia.

    • Conclusions:

    • External cardiac pacing is effective for hemodynamically significant bradycardia.
    • Pacing is less effective for asystole or idioventricular rhythm in prolonged cardiac arrest.
    • Pacing can be lifesaving in patients with a responsive myocardium.