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Abstract
Cardiac pacing has been used successfully in patients with asystole or bradycardia
compromising hemodynamics when it was applied soon after the onset of the event. An
external cardiac pacemaker was used as part of initial resuscitative efforts for patients
in primary, out-of-hospital, cardiac arrest who arrived in the emergency department
in asystole, agonal rhythm, pulseless idioventricular rhythm, or bradycardia with
hemodynamic compromise. A pulse was successfully generated in only one of twelve patients.
That patient developed complete atrioventricular dissociation while in the emergency
department. The nonresponding patients were in asystole or pulseless idioventricular
rhythm when the pacemaker was applied. Pacing was initiated 1–13 minutes (mean 7 minutes)
after arrival in the emergency department, but 27–90 minutes (mean 59 minutes) after
arrest. The interval between arrest and application of the pacemaker was prolonged
because of long periods for ambulance response, field resuscitation, and transport.
It is concluded that the external cardiac pacemaker is a useful instrument for the
treatment of bradyarrhythmias. While it may also be useful in the first few minutes
after development of asystole, pulseless idioventricular rhythm, or agonal rhythm,
it is of no benefit if applied long after the event.
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Article Info
Publication History
Accepted:
October 15,
1984
Received in revised form:
October 14,
1984
Received:
March 12,
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.
