Exclusives
FacebookTwitterLinkedInGoogle+RSS Feed
Fire EMSEMS TodayEMS Insider

Transcutaneous Cardiac Pacing for Symptomatic Bradycardia

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."

RELATED ARTICLES

Thorough Assessment is Crucial in Patients with Respiratory Distress

Accurate observation and treatment go a long way when considering all causes of respiratory distress.

Oklahoma City & Tulsa EMS Become First System to Adopt ResQCPR as a Standard of Care

Today the Medical Control Board for the EMS System for Metropolitan Oklahoma City and Tulsa, Okla., unanimously voted to approve the ResQCPR system by ZOLL a...

Tilt Angle Significantly Affects CPR

Test on pigs show patient tilt angle can have a positive effect on cerebral perfusion.

ZOLL ResQCPR™ System Receives Premarket Approval from the FDA

Chelmsford, Mass.— ZOLL® Medical Corporation, a manufacturer of medical devices and related software solutions, today announced that the company&rs...

Vic Convertino Presents on New Technology for Early Diagnosis and Treatment of Shock at EMS Today 2015

Vic Convertino, PhD, presented on how the use of intrathoracic pressure regulation (IPR) therapy applied with an impedance threshold device can restore the b...

Taking the Plunge

Over the course of Keith Lurie’s, MD, more than 25-year career, he’s devoted himself to the kinds of research innovations that have saved thousan...

Features by Topic

JEMS Connect

CURRENT DISCUSSIONS

 
 

EMS BLOGS

Blogger Browser

Today's Featured Posts

Featured Careers