In a patient who arrests with asystole or extreme bradycardia with a rate of less than 30 bpm, external pacing or percussion pacing should be attempted prior to chest compressions.IIaC
If either external or percussion pacing is ineffective and the cardiologist feels that there is a persisting bradycardia as the cause of the arrest a temporary pacing wire should be inserted while chest compressions are performed.IIaC