Ekg pulseless electrical activity9/28/2023 Beta-blockers and calcium channel blockers may alter contractility, leading to increased susceptibility and resistance to treatment. Pulseless electrical activity is the first documented rhythm in 30 to 38% of adults with in-hospital cardiac arrest. In addition, hospitalized patients are more likely to have a pulmonary embolism, among other complications. Ī study found that 68% of the recorded in-hospital deaths and 10% of all in-hospital deaths were attributed to pulseless electrical activity. It accounts for approximately 20% of sudden cardiac deaths outside of the hospital setting. ![]() The incidence of pulseless electrical activity varies among different the United States patient populations. Ĭauses of secondary pulseless electrical activity include the famous "5 Hs and 5 Ts." These are as follows: Primary pulseless electrical activity, often caused by or related to cardiac arrest, is due to the depletion of myocardial energy reserves. The etiology of pulseless electrical activity is classified into primary i.e., cardiac, and secondary i.e., noncardiac causes. Pulseless electrical activity can include a number of organized cardiac rhythms that may be supraventricular in origin, sinus versus non sinus, or ventricular in origin such as accelerated idioventricular or escape. An impalpable pulse should not always be taken as a pulseless electrical activity because it may be due to severe peripheral vascular abnormality. True pulseless electrical activity is a state in which cardiac contractions are lacking in the presence of coordinated electrical impulses. There can be ventricular contractions and detectable pressures in the aorta, which are also known as pseudo-PEA. Pulseless electrical activity does not necessarily mean the lack of mechanical activity. The word “sufficient” is being used to describe a degree of ventricular mechanical activity that is adequate to generate a palpable pulse. In the case of cardiac arrest, the organized ventricular electrical activity does not usually follow sufficient ventricular response. It means that the electrical activity is pertinent, but not sufficient, condition for contraction. Pulseless electrical activity (PEA), also known as electromechanical dissociation, is a clinical condition characterized by unresponsiveness and impalpable pulse in the presence of sufficient electrical discharge. A lack of ventricular impulse often points to the absence of ventricular contraction, but the contrary is not always true. ![]()
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