OBJECTIVE

The goal of this clinical practice guideline (CPG) is to provide patient care guidance and optimization of patients with hemodynamically significant dysrhythmias, such as symptomatic bradycardia, bundle branch blocks, and 2nd and 3rd degree (complete) heart block, in the aeromedical environment. This guideline reviews the physiology, indications, and algorithms for initiating and troubleshooting transcutaneous and transvenous cardiac pacing systems. A pre-flight checklist has been developed for patients that are to be transported. The algorithms to troubleshoot pacemaker malfunction also include the special conditions encountered by en route care personnel. Appendix A includes a basic transvenous pacemaker programming instruction set as reference; however, it is not intended to replace the device manual.