The optimal size and placement of transdermal electrodes are critical for the efficacy of a transcutaneous pacemaker in dogs

Transcutaneous cardiac pacing (TCP) can be used in dogs with a high risk for bradyarrhythmias prior to anesthesia, either in an emergency room or intensive care unit setting. Furthermore, TCP can also be used on patients diagnosed with bradyarrhythmias that require temporary pacing at the induction of anesthesia for the implantation of a permanent pacemaker. Despite the importance of TCP in emergency medicine, no studies have evaluated the optimal size and placement of the transdermal electrodes crucial for the efficacy of TCP in dogs.This study evaluated four different sizes of electrodes (10.5, 20, 30 and 40 cm2), and four different anatomical sites (anterior–posterior, left–right, apex–base, modified left–right) in order to optimize the efficacy of TCP in dogs. Electrodes with a surface area of 20 cm2 and a modified left–right placement minimized the pacing current and involuntary skeletal muscular contraction (muscular twitching) and so achieved the most optimal effect of TCP in dogs.