Indications

• Symptomatic second-degree type II or third-degree AV block.
• Symptomatic bradycardia unresponsive to atropine.
• Bradycardia with ventricular escape rhythms.
• May be useful in witnessed rhythm degradation to asystole.
• Overdrive pacing of tachycardia refractory to drug therapy or electrical cardioversion (to be performed by MD only).
• When standby or demand pacing is indicated.

Contraindications

• Severe hypothermia (not recommended for asystole).

Pacing Modes

• Demand (synchronous) mode senses Pt’s heart rate and paces only when heart rate falls below predetermined rate.
• Fixed (asynchronous) mode paces at a predetermined rate regardless of Pt’s heart rate.

Procedure

• Pads: Apply pacing electrodes to Pt per package instructions.
• Power: Turn on pacemaker, and ensure cables are connected.
• Rate: Set demand rate to 60 bpm and adjust up or down, based on Pt’s response, once pacing is initiated.
• Current: Output ranges from 0 to 200 mA.
• Technique: Increase mA from minimum setting until consistent capture is achieved, and then increase by 2 mA.