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Abstract
This study was conducted to prospectively evaluate immediate transthoracic pacing
in the emergency department for cardiac arrest patients presenting with asystole.
All adult patients presenting over an 11-month period to a university teaching hospital
with asystole following nontraumatic cardiopulmonary arrest received immediate transthoracic
cardiac pacing. In these 48 patients, electrical capture was achieved in 23% and mechanical
capture in 17%. With subsequent intraventricular administration of epinephrine and
sodium bicarbonate, the percentage of responders increased to 48% and 33%, respectively.
This is a statistically significant improvement in both electrical and mechanical
capture rates (P < 0.001) as compared with historical controls in whom transthoracic pacemakers were
employed several minutes into the resuscitation. In mechanical responders, blood pressure
never exceeded 50 mm Hg and could not be sustained for over 2 mintutes. Immediate
transthoracic pacing was temporarily effective at restoring myocardial electrical
and mechanical activity in a substantial number of asystolic patients. Although there
were no survivors, the improved electrical and mechanical capture rates with early
use of transthoracic pacing is encouraging. Future studies of transthoracic pacing
in the prehospital setting appear warranted.
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Article Info
Publication History
Accepted:
August 25,
1984
Received in revised form:
August 22,
1984
Received:
February 17,
1984
Footnotes
☆Presented at the Fifth Purdue Conference on CPR and Defibrillation, West Lafayette, Indiana, September 25–26, 1984.
Identification
Copyright
© 1985 Published by Elsevier Inc.
