 It is only when bradycardia presents with signs and symptoms of shock that it requires emergency treatment with transcutaneous pacing.Some common causes of hemodynamically significant bradycardia include myocardial infarction, sinus node dysfunction and complete heart block.Transcutaneous pacing is no longer indicated for the treatment of asystole (cardiac arrest associated with a "flat line" on the ECG), with the possible exception of witnessed asystole (as in the case of bifascicular block that progresses to complete heart block without an escape rhythm).