transcutaneous pacing

This could be due to an increased skin thickness, obesity, pads not adhering properly, but the more common cause is that you just don't have the mA up high enough. You go up until you achieve mechanical capture (pulse) then down slightly.

The proper setting for ma is actually about 10% higher than the number that allows you 100% capture. Only in cardiac arrest do you start at the maximum and work down. But even then you leave the ma at more than what provides 100% capture.
For a review of transcutaneous pacing check out Tom Ahrens on this web site http://www6.medical.philips.com/CMSM...es/default.htm

I think I need to apologize. When I went to bed last nite the lightbulb went on. I am at home and can't remember for sure but I bet the max is 100 and that is what prompted your question. If you are receiving a electrical signal of capture but no signs of mechanical capture, then, outside of correcting the underlying problem I believe you are done.
sorry for the misunderstanding, and please let me know if I still don't have it right.