Transcutaneous and transvenous XXXX for early bradyasystolic @entity1167 .

@entity1 @entity1167 @entity3897 @entity299
Emergency transcutaneous @entity299 was studied prospectively in 19 @entity1 presenting to the emergency department with a @entity1167 arrest of 20 minutes duration or less. Pacing was initiated when conventional advanced cardiac life support (including @entity3897 administration) and a fluid challenge failed to restore a pulse. Seventeen @entity1 also had placement of transvenous pacemaker electrodes for @entity299 . Transcutaneous @entity299 rapidly established a blood pressure in the two @entity1 who for clinical reasons did not receive a transvenous pacemaker. Five @entity1 were transcutaneously paced within five minutes of @entity1167 (Group 1) and the remaining 14 were paced between five and 20 minutes following @entity1167 (Group 2). Two of the Group 1 @entity1 were admitted and subsequently recovered full neurological and prearrest cardiac function. Fewer Group 2 @entity1 developed a blood pressure (P = .04), and there were no @entity1 with full neurologic recovery in this group (P = .06). Similar results were found for transvenous @entity299 ; there was a greater incidence of a palpable pulse and measurable blood pressure (P = .05 for both) in the Group 1 @entity1 than in the Group 2 @entity1 . No difference in clinical outcome was noted between the two pacing techniques. These results support the concept that @entity299 must be initiated early if the outcome of bradyasystolic @entity1167 is to be altered.
