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BJA Advance Access published online on February 27, 2007
British Journal of Anaesthesia, doi:10.1093/bja/aem007
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 BJA: April 2007
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Percussion pacing—an almost forgotten procedure for haemodynamically unstable bradycardias? A report of three case studies and review of the literature

C. Eich1,*, A. Bleckmann1 and S. K. W. Schwarz2

1 Department of Anaesthesiology, Emergency and Intensive Care Medicine, Georg-August-University Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany
2 Department of Anesthesiology, Pharmacology and Therapeutics, The University of British Columbia, St. Paul's Hospital, 1081 Burrard Street, Vancouver, B.C., Canada V6Z 1Y6

* Corresponding author: Department of Anaesthesiology, Emergency and Intensive Care Medicine, Georg-August-University Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany. E-mail: ceich{at}zari.de

More than 80 years after its first description by Eduard Schott, percussion (fist) pacing remains a little known procedure even though it represents an instantly available and easy to perform treatment for temporary emergency cardiac pacing in haemodynamically unstable bradycardias, including bradycardic pulseless electrical activity and complete heart block with ventricular asystole. Based on the Consensus on Science and Treatment Recommendations of the International Liaison Committee on Resuscitation, the European Resuscitation Council recently incorporated percussion pacing in its advanced life support guidelines (Nolan and colleagues, Resuscitation 67 (Suppl 1): S39–S86, 2005). Here, we briefly describe three of our own cases and present a review of the literature on percussion pacing with respect to the available evidence on its efficacy, its practical application, and clinical indications.

Keywords: complications, cardiac arrest; complications, pacemakers; heart, arrhythmia, bradycardia; heart, pacemakers, artificial; heart, resuscitation


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