Key result
Plethysmography, capnometry, and BP monitoring yield only ~59% sensitivity for detecting prehospital pacing capture.
Why the study?
Failure to achieve electrical capture during transcutaneous pacing is common and underrecognized.
Are pulse oximetry plethysmograph waveform synchrony, end-tidal capnometry increases, and systolic blood pressure increases associated with sustained electrical capture during prehospital transcutaneous pacing?
Observational
Are pulse oximetry plethysmograph waveform synchrony, end-tidal capnometry increases, and systolic blood pressure increases associated with sustained electrical capture during prehospital transcutaneous pacing?
Plethysmograph waveforms, capnometry, and blood pressure monitoring alone are not reliable indicators of electrical capture during prehospital transcutaneous pacing.
Plethysmograph synchronization should not guide confirmation of electrical capture during prehospital TCP; leaves open the need for reliable noninvasive markers in prospective studies.
BACKGROUND: Failure to achieve electrical capture during transcutaneous pacing (TCP) is common and underrecognized. We aimed to identify whether pulse oximetry plethysmograph waveform synchrony, end-tidal capnometry increases, and systolic blood pressure increases were associated with sustained electrical capture during prehospital TCP. METHODS: ) and blood pressure measurements were associated with sustained electrical capture. RESULTS: (2.6 mmHg (-2.9, +8.1)). Plethysmograph synchronization had a sensitivity of 58.8% (32.9, 81.6) and a specificity of 81.1% (73.2, 87.5). CONCLUSIONS: These findings suggest that plethysmograph waveforms, capnometry, and blood pressure monitoring alone are not reliable indicators of electrical capture during TCP performed by paramedics.
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Kimbrell et al. (2026) conducted an observational in Patients undergoing prehospital transcutaneous pacing. Plethysmograph waveforms, capnometry, and blood pressure monitoring was evaluated on Sustained electrical capture (Sensitivity 58.8%, 95% CI 32.9-81.6). Plethysmograph waveforms, capnometry, and blood pressure monitoring alone are not reliable indicators of electrical capture during prehospital transcutaneous pacing (sensitivity 58.8%, specificity 81.1%).
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