Transcutaneous pacing is indicated for which condition?

• A. Unstable bradycardia
• B. Stable tachycardia
• C. Asystole
• D. Ventricular fibrillation

Answer: (A)

Transcutaneous pacing provides rapid external stimulation to the ventricles when the heart’s natural pacemaker isn’t delivering an adequate rate, making it a bridge to more definitive pacing or treatment. It is indicated for unstable bradycardia—where the heart rate is too slow and perfusion is compromised (e.g., hypotension, confusion, chest pain)—to maintain an adequate heart rate while addressing the underlying cause. It isn’t used for stable tachycardia, where the problem is too fast a rate and pacing wouldn’t help. It also isn’t the go-to in asystole or ventricular fibrillation, where there is little or chaotic electrical activity; the priority there is CPR and defibrillation (with medication as indicated).