Pulseless electrical activity historical perspective

Jump to navigation Jump to search


Resident
Survival
Guide

Pulseless electrical activity Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Pulseless Electrical Activity from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-Ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Pulseless electrical activity historical perspective On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Pulseless electrical activity historical perspective

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Pulseless electrical activity historical perspective

CDC on Pulseless electrical activity historical perspective

Pulseless electrical activity historical perspective in the news

Blogs on Pulseless electrical activity historical perspective

Directions to Hospitals Treating Pulseless electrical activity

Risk calculators and risk factors for Pulseless electrical activity historical perspective

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Karol Gema Hernandez, M.D. [2]

Overview

Pulseless electrical activity as the main approach for sudden cardiac arrest (SCA) was not completely studied until the middle of the 1980's. The explanation for this, is that ventricular fibrillation (VF) and ventricular tachycardia (VT), were the main causes for the morbidity and mortality of SCA. However there has been a change in approaching the causes of SCA, pointing to PEA as the initial rhythm leading to SCA.

Historical Perspective

The first approach against trying to decrease mortality due to SCA, was to target tachyarrhythmias, especially ventricular fibrillation (VF) and ventricular tachycardia (VT). This was mainly achieved by the improvements in CPR techniques, the availability of defibrillators to lay responders and the use of implantable cardioverter- defibrillators. Nevertheless, there is and increase in prevalence of PEA and asystolia, which makes them now more frequent than VT and VF. There is still not clear if this can be due to a proportional increase, rather than an absolute increase in cases of PEA. Studies suggest that there is a need to change this approach, because of the increased proportion of PEA cases, and mainly because of the better outcomes for survival in PEA patients, than those with VF/VT [1] [2]. Deeper studies will achieve ultimately a better therapeutic strategy, leading to better patient outcomes and a subsequent impact in overall mortality due to SCA.

There was a workshop created by Myerburg from a National Heart, Lung, and Blood Institute [2] as an attempt to record the current knowledge and direct the future research in the field. This workshop also described some of the pathophysiology of PEA, which may translate to improved clinical care.

  • Although the ECG findings of Brugada syndrome were first reported among survivors of cardiac arrest in 1989, it was only in 1992 that the Brugada brothers recognized it as a distinct clinical entity, causing sudden death by causing ventricular fibrillation

References

  1. Teodorescu C, Reinier K, Dervan C, Uy-Evanado A, Samara M, Mariani R; et al. (2010). "Factors associated with pulseless electric activity versus ventricular fibrillation: the Oregon sudden unexpected death study". Circulation. 122 (21): 2116–22. doi:10.1161/CIRCULATIONAHA.110.966333. PMID 21060069.
  2. 2.0 2.1 Myerburg RJ, Halperin H, Egan DA, Boineau R, Chugh SS, Gillis AM; et al. (2013). "Pulseless electric activity: definition, causes, mechanisms, management, and research priorities for the next decade: report from a national heart, lung, and blood institute workshop". Circulation. 128 (23): 2532–41. doi:10.1161/CIRCULATIONAHA.113.004490. PMID 24297818.

Template:WH Template:WS