The efficacy of transcutaneous cardiac pacing in ED

Bektaş, Fırat; Söyüncü, Seçgin

doi:10.1016/j.ajem.2016.07.022

Cited by 31 publications

(18 citation statements)

References 19 publications

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“…Another alternative is transcutaneous pacing, which can be used while waiting for implantation of a temporary transvenous-or permanent pacemaker [20]. The pads are preferably attached with anterior-posterior placement and are then connected to the defibrillator/monitor [21]. Transcutaneous pacing can be performed on a conscious patient, but sedation is preferred [21,22].…”

Section: Emergency Temporary Pacingmentioning

confidence: 99%

“…The pads are preferably attached with anterior-posterior placement and are then connected to the defibrillator/monitor [21]. Transcutaneous pacing can be performed on a conscious patient, but sedation is preferred [21,22]. During transcutaneous pacing, the patient must be monitored closely with ECG and with regard to hemodynamic stability [9].…”

Section: Emergency Temporary Pacingmentioning

confidence: 99%

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Clinical Indications for Therapeutic Cardiac Devices

Åberg¹,

Mattsson²,

Magnusson³

2019

Cardiac Pacing and Monitoring - New Methods, Modern Devices

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Both technology and clinical indications have changed since the first cardiac devices. Choosing the right therapy, or abstaining from it, is the key to good clinical management. Pacemakers effectively reduce symptoms of bradycardia, prevent syncope in patients with sick sinus syndrome, and reduce mortality in high-degree atrioventricular block. Cardiac resynchronization therapy improves symptoms and survival in heart failure patients with reduced ejection fraction and ventricular dyssynchrony. Implantable cardioverter defibrillators terminate life-threatening ventricular arrhythmias and are indicated for the prevention of sudden cardiac death, either as secondary prevention in survivors of ventricular fibrillation or ventricular tachycardia with hemodynamic compromise or as primary prevention due to heart failure with reduced ejection fraction or other miscellaneous diseases. More recently, leadless pacemakers and subcutaneous implantable cardioverter defibrillators have been developed as alternatives in specific conditions. 2 Pacemaker therapyThe medical properties of electricity have been known for some time. The physicians of ancient Rome treated acute gout with electric sea creatures. Alexander von Humboldt tested the theory of electrical conduction in biological tissue on himself. The first artificial pacemaker, powered by a hand-cranked motor, was invented by Albert Hyman in 1932. The first patient to receive an implantable pacemaker, Arne Larsson, had to wait until 1958, when he underwent the procedure at the Karolinska Clinical Indications for Therapeutic Cardiac Devices DOI: http://dx.doi.org/10.5772/intechopen.82463 University Hospital in Stockholm. He outlived both the surgeon Åke Senning and the engineer Rune Elmqvist who developed the system [1]. EtiologyThe most common etiology of bradycardia leading to pacemaker implantation is conduction tissue fibrosis, but there are several others etiologies responsible for slow heart rates according to data from registers, for example the Swedish pacemaker registry [4]. Some of these are reversible, such as infection/inflammation, metabolic conditions, and medications while others are congenital such as third-degree atrioventricular (AV) block associated with maternal systemic lupus erythematosus [5]. Pacing modeA code of four to five letters is used to describe the pacing mode. The first letter indicates where pacing occurs (where A stands for atrium, V for ventricle, and D for dual); the second describes which chamber is sensed. In the third position, the letters I (inhibit), T (trigger), or D (dual) are used to describe in which way the device responds to sensed events. An R in the fourth position means that rate response (increased pacing rate during physical exertion) is active. Finally, a fifth letter is occasionally used to describe where multicenter pacing is employed (A, V, or D) [6]. Rate responseThe purpose of rate response is to increase the heart rate in response to altered demand, and there are different solutions available to achieve this. Act...

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Section: Emergency Temporary Pacingmentioning

confidence: 99%

Section: Emergency Temporary Pacingmentioning

confidence: 99%

Clinical Indications for Therapeutic Cardiac Devices

Åberg¹,

Mattsson²,

Magnusson³

2019

Cardiac Pacing and Monitoring - New Methods, Modern Devices

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“…Dies ist bei ca. 20 % der Patienten mit symptomatischen Bradykardien notwendig [1,2] und führt bei erfolgreicher Stimulation zu einer signifikanten klinischen Verbesserung [2]. Aufgrund der einfachen Anwendung ist die transkutane Schrittmachertherapie für die initiale Stabilisierung hämodynamisch kompromittierender Bradykardien am besten geeignet [5].…”

Section: Indikationen Und Kontraindikationenunclassified

“…Im Gegensatz zur Defibrillation wird zur transkutanten Stimulation eine anterior-posteriore Elektrodenposition empfohlen (▶ Abb. 2) [2]. Bei der Anlage der Stimulationselektroden muss außerdem auf einen guten Hautkontakt geachtet werden.…”

Section: Indikationen Und Kontraindikationenunclassified

Externer Schrittmacher – Notfallpacing – Schritt für Schritt

Girrbach¹,

Neef²

2017

Notf.med. up2date

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“…Unstable bradycardia is an uncommon occurrence with an estimated incidence of six out of 10,000 patients seeking care in the emergency room (ER) [ 1 ]. Transcutaneous cardiac pacing (TCP) is an effective treatment recommended by the 2010 American Heart Association (AHA) guidelines for unstable bradycardia [ 2 , 3 ]. It can, however, be difficult to implement: pitfalls must be avoided, and assessment of ventricular capture is complicated [ 4 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Transcutaneous cardiac pacing competency among junior residents undergoing an ACLS course: impact of a modified high fidelity manikin

et al. 2018

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BackgroundTranscutaneous cardiac pacing (TCP) is recommended to treat unstable bradycardia. Simulation might improve familiarity with this low-frequency procedure. Current mannequins fail to reproduce key features of TCP, limiting their usefulness. The objective of this study was to measure the impact of a modified high-fidelity mannequin on the ability of junior residents to achieve six critical tasks for successful TCP.MethodsFirst-year residents from various postgraduate programs taking an advanced cardiovascular life support (ACLS) course were enrolled two consecutive years (2015 and 2016). Both cohorts received the same standardized course content. An ALS simulator® mannequin was used to demonstrate and practice TCP during the bradycardia workshop of the first cohort (control cohort, 2015) and a modified high-fidelity mannequin that reproduces key features of TCP was used for the second cohort (intervention cohort, 2016). Participants were tested after training with a simulation scenario requiring TCP. Performances were graded based on six critical tasks. The primary outcome was the successful use of TCP, defined as having completed all tasks.ResultsEighteen participants in the intervention cohort completed all tasks during the simulation scenario compared to none in the control cohort (36 vs 0%, p < 0.001). Participants in the intervention cohort were more likely to recognize when pacing was inefficient (86 vs 12%), obtain ventricular capture (48 vs 2%), and check for a pulse rate to confirm capture (48 vs 0%).ConclusionsTCP is a difficult skill to master for junior residents. Training using a modified high-fidelity mannequin significantly improved their ability to establish TCP during a simulation scenario.Electronic supplementary materialThe online version of this article (10.1186/s41077-018-0082-5) contains supplementary material, which is available to authorized users.

show abstract

The efficacy of transcutaneous cardiac pacing in ED

Cited by 31 publications

References 19 publications

Clinical Indications for Therapeutic Cardiac Devices

Clinical Indications for Therapeutic Cardiac Devices

Externer Schrittmacher – Notfallpacing – Schritt für Schritt

Transcutaneous cardiac pacing competency among junior residents undergoing an ACLS course: impact of a modified high fidelity manikin

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