Role of transcutaneous pacing in the setting of a failing permanent pacemaker

Abstract

A 15-year-old boy with acute symptomatic bradycardia caused by a failing permanent pacemaker was paced transcutaneously in the emergency department. Failure to recognize that electrical interference from noncaptured permanent pacemaker beats precluded the usual demand mode of application of the transcutaneous pacemaker led to asystole. We present this case to point out the potential for asystole and ventricular dysrhythmia in this situation and to increase awareness of the role of the potentially lifesaving device in children.