Transcutaneously Pacing

• Symptomatic Bradycardia:

  • When the heart rate is so slow that it leads to symptoms like chest pain, shortness of breath, dizziness, altered mental status, or syncope. Typically indicated when bradycardia is causing hemodynamic instability (e.g., hypotension, shock).

• Bradyarrhythmias Not Responsive to Medications:

  • When medications (e.g., atropine) are ineffective or contraindicated.

  • Conditions like sinus bradycardia, atrioventricular (AV) block (especially second-degree type II or third-degree AV block), or other significant bradyarrhythmias.

• Heart Block:

  • Especially in cases of high-degree AV block (second-degree Mobitz II and third-degree AV block) where there is a risk of progression to asystole.

​References

​​American Heart Association (n.d.) AHA RQI program: Program overview.
https://cpr.heart.org/-/media/CPR-Files/Courses-and-Kits/RQI/RQI-Program-Overview.pdf

American Heart Association (2020). ACLS Handout.
Novant Health (2022a) NH ALS Mega Code: Unstable Bradycardia Scenario

Novant Health ( 2022b) NH ALS Mega Code: Tachy Arrhythmia Scenario

Novant Health (2022c) NH ALS Mega Code: V Fib

Novant Health ( 2022d) NH ALS Mega Code: Zoll Teaching Scenario

Novant Health (2022e) ALS Mega Code: Pre and Post Test Questions

ZOLL. (n.d.). How to use the R Series® defibrillator [Video]. ZOLL.
https://www.zoll.com/contact/elearning/videos/r-series/how-to-use