Abstract 54: Preliminary Results With The Use Of Stat · Padz Pacing Electrode For Treatment Of Symptomatic Bradycardia In Emergency Department.

Abstract

Background: Since the mid-1980’s transthoracic pacing has been a common temporary treatment for arrhythmias. Present external pacing technology requires the application of both multifunction defibrillation electrodes and separate leads for electrocardiogram (ECG) monitoring. Separate ECG leads are required as the current from the pacing pulse creates artifact in the signal that prevents one from distinguishing between pace-captured and non-captured rhythms when using the defibrillation electrode alone. Hypotheses: We hyothezised that Stat· padz MWP electrode, a transthoracic electrode that integrates the ECG electrodes into the defibrillation and pacing pad woud be abble to reconize captured and non-captured rhythms in a typical clinical setting of the syntomatic bradycardia. Methods: We conducted a prospective study at Emergency Department of a University Hospital. During October 2006 to April 2007, 28 patients with symptomatic bradycardia were include in the study. Comparison between monitoring by conventional electrode and Stat· padz MWP electrode was performed. After that was selected Lead II, and adjusted pacing rate and milliamps for the stimulation. Records and comparison of electrical capture was performed with the three lead conventional electrodes and Stat· padz MWP electrodes. Results: The mean electrocardiographic diagnoses was third degree atrio-ventricular block in 50% of patients, and the principal symptoms were presyncope in 82 %, symptoms of reduced cardiac output in 79% and syncope in 43%. Previous diagnoses were Hypertension in 57%, Chagas’s heart disease in 21%, Valvar heart disease in 14% and Dilated Cardiomyopathy in 18 %. Monitoring of cardiac rhythm, electrical and mechanical capture were obtained in 100 % of patients. The mean energy for capture was 69±18 milliamps. When compared the records of electrocardiographic capture with Stat· padz MWP electrode, it was equal than conventional electrodes in 46 % and better in 54 %. Conclusion: The Stat· padz MWP electrode has the feasibility of recognise capture and non-capture rhythms and to perform pacing function effectively. It presents the possibility of providing rapid treatment in patients with syntomatic bradycardia avoiding monitoring by conventional electrodes.