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Should Percussion Pacing Have a Role in Perioperative Advanced Cardiac Life Support?: A Case Report

Giordano, Chris, MD; Miller, Jordan, MD; Keidan, Ilan, MD

doi: 10.1213/XAA.0000000000000670
Case Reports

Percussion pacing involves using one’s fist to repeatedly strike a patient’s left sternal border in a rhythmic manner. The resulting increase in ventricular pressure can trigger myocardial depolarization and subsequent contraction. We describe the successful treatment of acute preoperative symptomatic sinus bradycardia with percussion pacing in a 63-year-old patient scheduled for placement of a gastric feeding tube after trauma involving spinal cord injury. Although no longer included in current advanced cardiovascular life support guidelines, percussion pacing may be a suitable alternative to chest compressions in multitrauma cases where the force of compressions could cause further complications.

From the Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida.

Accepted for publication September 25, 2017.

Funding: None.

The authors declare no conflicts of interest.

Address correspondence to Chris Giordano, MD, Department of Anesthesiology, University of Florida College of Medicine, 1600 SW Archer Rd, PO Box 100254, Gainesville, FL 32610. Address e-mail to

© 2018 International Anesthesia Research Society
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