Transcutaneous pacing

Transcutaneous pacing is accomplished by delivering pulses of electric current through the patient's chest, which stimulates the heart to contract.

Some common causes of hemodynamically significant bradycardia include myocardial infarction, sinus node dysfunction and complete heart block.

[citation needed] Transcutaneous pacing is no longer indicated for the treatment of asystole (cardiac arrest associated with a "flat line" on the ECG), with the possible exception of witnessed asystole (as in the case of bifascicular block that progresses to complete heart block without an escape rhythm).

The anterior/posterior position is preferred as it minimizes transthoracic electrical impedance by "sandwiching" the heart between the two pads[citation needed].

The pads are then attached to a monitor/defibrillator, a heart rate is selected, and current (measured in milliamps) is increased until electrical capture (characterized by a wide QRS complex with tall, broad T wave on the ECG) is obtained, with a corresponding pulse.