Transcutaneous Cardiac Pacing for Symptomatic Bradycardia

Street Science


 
 

Keith Wesley | | Wednesday, June 27, 2007


Review of: Sherbinoa J, Richard Verbeeka PR, MacDonalda RD, et al: "Prehospital transcutaneous cardiac pacing for symptomatic bradycardia or bradyasystolic cardiac arrest: A systematic review." Resuscitation. 70:193 200, 2006.

The Science

The authors reviewed the literature to examine the value of transcutaneous cardiac pacing for symptomatic bradycaridia and bradyasystolic arrest. They searched Medline and, based on their criteria, they identified 34 articles that addressed the issue. However, they selected only seven for review because of various deficiencies in the others.

They determined that the quality of the studies for all seven of these trials was poor. They further concluded that there is no evidence to support the use of pacing for either of these conditions.

The Street

The first thing to remember when reading a research conclusion is this: The absence of evidence is not the evidence of absence. What I mean is just because you can t find any literature to support a given intervention does not mean that the intervention has no value. This is what s meant by Class Indeterminate.

In relation to this study, the seven studies the authors chose were published between 1983 and 1992. The AHA guidelines have gone through substantial changes since then. What inferences can we make by the fact that pacing had no impact on cardiac arrest survival using 25-year-old protocols? Additionally, the seven articles chosen did not have sufficient numbers of cases in either group to make statistical analysis possible.

Advances in the uses of pharmacologic agents, such as atropine and vassopressors, will certainly change the role of pacing. However, instead of saying that the literature doesn't support the use of pacing, I wish the researches would just say, "We don't know what the answer is."




Connect: Have a thought or feedback about this? Add your comment now
Related Topics: Cardiac and Circulation, Research

What's Your Take? Comment Now ...

Featured Careers & Jobs in EMS

 

 

 

 

 

 

 

 

 

Get JEMS in Your Inbox

 

Fire EMS Blogs


Blogger Browser

Today's Featured Posts

 

EMS Airway Clinic

The Evolution of Civilian High Threat Medical Guidelines

How mass killing events have proven a need for new guidelines.
More >

Multimedia Thumb

British Medics Bid Farewell to Afghanistan Base

Medical team and troops leave Camp Bastion.
Watch It >


Multimedia Thumb

Plane Crash at Wichita Airport

Small plane crashes into airport safety building.
Watch It >


Multimedia Thumb

Authorities Investigate Firefighters at Arizona EMS Call

Confrontation caught on video involving Glendale firefighters.
Watch It >


Multimedia Thumb

Radio Problems for New York Medics

Medic’s radio failed during a call with an armed patient.
Watch It >


Multimedia Thumb

Ottawa Shooting Incident

Solider is shot by gunman at national memorial in Ottawa.
More >


Multimedia Thumb

Life Link III Trauma Tactics Conference in Minnesota

Conference was designed to enhance the skills of providers of all levels, covering rescue and prehospital situations, to transport and in-hospital treatment.
More >


Multimedia Thumb

Field Bridge Xpress ePCR on iPad, Android, Kindle Fire

Sneak peek of customizable run forms & more.
Watch It >


Multimedia Thumb

VividTrac offered by Vivid Medical - EMS Today 2013

VividTrac, affordable high performance video intubation device.
Watch It >


Multimedia Thumb

The AmbuBus®, Bus Stretcher Conversion Kit - EMS Today 2013

AmbuBus®, Bus Stretcher all-hazards preparedness & response tool
Watch It >


More Product Videos >