Successful resuscitation using external cardiac pacing

The resuscitation of a patient with failure of a permanent artificial pacemaker is described. A mechanically inactive heart showed a variety of ineffective rhythms, and dissociation could not be overcome by drug therapy. The urgent need for artificial pacing presented problems that eventually were overcome. The time required to establish effective transvenous pacing would have prevented a favorable outcome if external cardiac pacing had not been available. External pacing maintained effective cardiac action for two hours and 55 minutes. The need for external cardiac pacing capability in EDs is considered.