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Noninvasive temporary pacing: experience in a community hospital.

During a 1-year period 37 patients who underwent treatment with a noninvasive temporary pacemaker were followed to evaluate effectiveness and outcome of therapy. The device was most frequently used in the emergency department and coronary care unit and was applied by a nurse in 51% of cases. Pacing thresholds ranged from 20 to 110 mA (mean 43 mA) with 91% obtaining capture. Pacing was continuous in 11 patients for 5 to 180 minutes (mean 32 minutes) and intermittent in 16 patients for up to 72 hours. Pacing did not take place in 10 patients because of failure to capture or because a satisfactory intrinsic rate was maintained. After external pacing, six patients received permanent pacemakers, 14 required temporary transvenous pacemakers, 10 required no further pacing, and seven (19%) died. Few problems were encountered, although eight of the 20 responsive patients had severe discomfort related to pacing, with two of these requiring discontinuation of pacing. The number of temporary transvenous pacemaker insertions in the coronary care unit decreased 32% over a 6-month period after introduction of the noninvasive temporary pacemaker. We conclude that the noninvasive temporary pacemaker is safe and effective although discomfort may limit its use in some patients.