Telec Wojciech, Al-Saad Salwan, Karbowski Lukasz, Kłosiewicz Tomasz, Baszko Artur
2nd Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland.
Cardiology Research Group, English Students' Research Association, Poznan University of Medical Sciences, Poznan, Poland.
Emerg Med Int. 2025 Sep 5;2025:9067144. doi: 10.1155/emmi/9067144. eCollection 2025.
Following an administered shock in cardiac arrest, the heart commonly experiences a short phase of inability to efficiently perfuse. Despite being a commonly used feature in the ICD population, postshock pacing (PSP) is yet to be adequately explored for its utility in this pulseless phase. Notably, an overwhelming proportion of available data for transcutaneous pacing in spontaneous cardiac arrest stem from the 1980s and 1990s and revolve largely around nonshockable, as opposed to shockable rhythms. The lack of large-scale clinical trials assessing the efficacy of transcutaneous PSP and the considerable advancements in technology and training facilities since the 1990s indicates a need for reevaluation of current understanding of PSP and its applicability in cardiac arrest. Shedding light into the possible implications of transcutaneous PSP in emergency setting cardiac arrest may not only reshape the current protocols of ALS but also carry the potential of improving survival rates. This concise review serves as a summary of the existing knowledge on the subject of PSP and reveals further possible directions for the development of this therapy.
在心脏骤停时给予电击后,心脏通常会经历一个短暂的无法有效灌注的阶段。尽管在植入式心律转复除颤器(ICD)人群中这是一个常用功能,但电击后起搏(PSP)在这个无脉阶段的效用尚未得到充分研究。值得注意的是,自心脏骤停患者经皮起搏获得的现有数据中,绝大多数来自20世纪80年代和90年代,并且主要围绕不可电击心律,而非可电击心律。自20世纪90年代以来,缺乏评估经皮PSP疗效的大规模临床试验,以及技术和培训设施的显著进步,这表明有必要重新评估目前对PSP的理解及其在心脏骤停中的适用性。阐明经皮PSP在紧急情况下心脏骤停可能产生的影响,不仅可能重塑当前的高级生命支持(ALS)方案,还具有提高生存率的潜力。这篇简要综述总结了关于PSP这一主题的现有知识,并揭示了该疗法进一步可能的发展方向。