Transcutanous Pacing

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A temporary means of pacing the heart in an emergency situation. Transcutanous pacing is pacing of the heart that is done through the skin on the chest. The Zoll Defibrillator and other machines used for cardioversion and defibrillation can be used for transcutanous pacing.

Common indications for transcutanous pacing are a slow heart rate that causes the patient to be symtomatic (bradycardias like 1st, 2nd, or 3rd degree heart block). A less common use is to treat asystole, i.e. the lack of any rhythm, in an emergency. Attempting to transcutanous pace for asystole, in addition to other therapies like intraveinous epineprine, is recommended by the American Heart Assocation.

During transcutanous pacing, gel pads with conductive electrolytes are placed on the right anterior superior chest and the left inferior medial chest. The gel pads are then attached to the defibrillator and an amperage and a rate are selected. A rate is selected based on the needs of the patient (80-100 is typical) and then the miliamps are increased until capture is obtained. Transcutanous pacing is not a permanent solution because it is hard on the skin and may be uncomfortable for the patient; it is meant to stabalize the patient until a more permanent means of pacing is acheived.

Other forms of cardiac pacing are transveinous pacing, epicardial pacing, and implanted.