Successful use of emergency transthoracic pacing in bradyasystolic cardiac arrest

We present the document successful resuscitation of six patients using emergency transthoracic pacing. Two patients were resuscitated from asystole, one had a slow supraventricular bradycardia following head trauma and spinal shock, and three patients had cardiovascular collapse secondary to complete A-V dissociation. One patient developed a non-fatal pericardial tamponade, but there were no cases of pneumothorax. All patients failed to respond to standard medical therapy. We believe that the initially successful resuscitation of these patients was related directly to the pacing procedure. Three patients had underlying pathology that did not allow longterm survival. Three patients were discharged from the hospital without neurologic sequelae. Although emergency transthoracic pacing has a relatively low success rate in bradyasystolic cardiac arrest and may be associated with serious complications, the procedure may be life-saving in selected cases.