Ventricular Fibrillation Treatment and Causes Ventricular fibrillation (VF or V-fib) is the most common initial heart rhythm in patients with out-of-hospital cardiac arrest (OHCA), and the most salvageable one.5 In VF, the etiology of arrest is often attributed to either acute ischemia or non-ischemic arrhythmia.8 Although VF appears as a chaotic and disorganized rhythm, characteristics of the ventricular fibrillation waveform such […]
Pulseless Electrical Activity (PEA) Causes and Treatment Approximately 300,000 out-of-hospital cardiac arrests (OHCA) occur annually in the United States, with survival around 8%.10 The initial rhythm may be ventricular fibrillation (VF), pulseless ventricular tachycardia (VT), asystole, or pulseless electrical activity (PEA).16 Two-thirds of OHCA has an initial non-shockable rhythm of PEA or asystole with an increasing incidence compared with initial shockable rhythms (ventricular fibrillation […]
Becoming Familiar with Synchronized Cardioversion Between 370,000 and 750,000 American patients suffer in-hospital cardiac arrest with attempted cardiopulmonary resuscitation each year.9 In this population, the only rhythm-specific therapy proven to increase survival to hospital discharge is timely defibrillation.2 Timely defibrillation is the only rhythm-specific therapy proven to increase survival to hospital discharge following cardiac arrest secondary to ventricular tachyarrhythmia.9 For certain types of […]
Conscious Sedation for Cardioversion Direct current cardioversion (DCCV) is a safe and effective treatment for recent-onset atrial fibrillation (AF) or flutter, and when performed in the emergency department (ED), it can provide an excellent treatment option for patients, as well as reducing unnecessary hospital admissions and healthcare costs3. DCCV refers to the application of a synchronized electrical shock across […]
Understanding Atrioventricular Blocks Cardiac Conduction System The myocardium contains sets of specialized cells that form the conduction system of the heart, and are responsible for automaticity and rhythm maintenance. The specific areas are the sinoatrial (SA) node, internodal tracts, atrioventricular (AV) node, atrioventricular bundle, and Purkinje system. SA Node The SA node is a small collection of specialized […]
Vagal Maneuvers with Supraventricular Tachycardia Supraventricular tachycardia (SVT) is a common heart abnormality that presents as a fast heart rate. SVT is a generic term applied to any tachycardia originating above the ventricles and which involves atrial tissue or atrioventricular (AV) nodal tissue.4 This heart rhythm disturbance can occur in healthy individuals and may include such symptoms as chest pain, palpitations, […]
Shockable Rhythms: Ventricular Tachycardia, Ventricular Fibrillation, Supraventricular Tachycardia Much of Advanced Cardiac Life Support (ACLS) is about determining the right medication to use at the appropriate time and deciding when to defibrillate. Along with high-quality CPR, emergency medicines and defibrillation are the only two interventions that are likely to restart the arrested heart. Defibrillation a powerful tool in the hands of the ACLS […]
AEDs – Special Circumstances AEDs were originally developed to speed defibrillation in cases of out of-hospital cardiac arrest due to ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) by enabling more rescuers, including laypeople, to defibrillate.3 The process behind successfully using an AED in an emergency is well-known to healthcare providers and laypersons who have taken even the most basic […]
Sudden Cardiac Arrest and the Hs and Ts Sudden cardiac arrest and sudden cardiac death can happen in every healthcare setting. Sudden cardiac arrest is a major healthcare problem in the United States that accounts for up to 350,000 deaths per year.27 Irrespective of the cause of cardiac arrest, early recognition and calling for help, including appropriate management of the deteriorating patient, early defibrillation, […]
