Pulseless Electric Activity

Myerburg, Robert J.; Halperin, Henry R.; Egan, Debra; Boineau, Robin; Chugh, Sumeet S.; Gillis, Anne M.; Goldhaber, Joshua I.; Lathrop, David A.; Liu, Peter; Niemann, James T.; Ornato, Joseph P.; Sopko, George; Eyk, Jennifer E. Van; Walcott, Gregory P.; Weisfeldt, Myron L.; Wright, Jacqueline D.; Zipes, Douglas P.

doi:10.1161/circulationaha.113.004490

Cited by 143 publications

(63 citation statements)

References 90 publications

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“…Recent data demonstrate a pulseless electrical activity incidence of 19-23 %, with approximately 50 % of patients initially having asystole. 59 However, the majority of survivors are in the subgroup whose initial rhythm is VF or pulseless VT. 57 VF is a cause of cardiac arrest, and if untreated the arrhythmia is usually fatal. Spontaneous reversions to sinus rhythm have, however, been recorded.…”

Section: Pathophysiologymentioning

confidence: 99%

A Clinical Perspective on Sudden Cardiac Death

2016

Arrhythmia &Amp; Electrophysiology Review

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This article presents the epidemiology, aetiology and pathophysiology of sudden cardiac death. The modern management of survivors as well as of family members of victims is discussed, as are the relevant recommendations of guidelines prepared by learned societies. KeywordsOut-of-hospital cardiac arrest, sports-related sudden death, sudden cardiac death, sudden unexplained death syndrome Disclosure: The authors have no conflicts of interest to declare.

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Section: Pathophysiologymentioning

confidence: 99%

A Clinical Perspective on Sudden Cardiac Death

2016

Arrhythmia &Amp; Electrophysiology Review

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“…Potential limitations of ECG include: (i) delay in signal acquisition due to skin cleaning and lead placement; (ii) all infants are born covered in blood, mucus, vernix or amniotic fluid and a proper signal cannot be obtained if these bodily fluids are not cleaned off prior to lead placement; (iii) in particular, extremely low birth weight infants have very fragile skin which ECG leads might damage, and (iv) there is the potential of pulseless electric activity, which could be interpreted as HR on an ECG, thus potentially delaying resuscitation efforts [15,20,28]. …”

Section: Resultsmentioning

confidence: 99%

Heart Rate Assessment Immediately after Birth

et al. 2015

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Background: Heart rate assessment immediately after birth in newborn infants is critical to the correct guidance of resuscitation efforts. There are disagreements as to the best method to measure heart rate. Objective: The aim of this study was to assess different methods of heart rate assessment in newborn infants at birth to determine the fastest and most accurate method. Methods: PubMed, EMBASE and Google Scholar were systematically searched using the following terms: ‘infant', ‘heart rate', ‘monitoring', ‘delivery room', ‘resuscitation', ‘stethoscope', ‘auscultation', ‘palpation', ‘pulse oximetry', ‘electrocardiogram', ‘Doppler ultrasound', ‘photoplethysmography' and ‘wearable sensors'. Results: Eighteen studies were identified that described various methods of heart rate assessment in newborn infants immediately after birth. Studies examining auscultation, palpation, pulse oximetry, electrocardiography and Doppler ultrasound as ways to measure heart rate were included. Heart rate measurements by pulse oximetry are superior to auscultation and palpation, but there is contradictory evidence about its accuracy depending on whether the sensor is connected to the infant or the oximeter first. Several studies indicate that electrocardiogram provides a reliable heart rate faster than pulse oximetry. Doppler ultrasound shows potential for clinical use, however future evidence is needed to support this conclusion. Conclusion: Heart rate assessment is important and there are many measurement methods. The accuracy of routinely applied methods varies, with palpation and auscultation being the least accurate and electrocardiogram being the most accurate. More research is needed on Doppler ultrasound before its clinical use.

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“…Benefit would come from marrying a therapy for which one has significant understanding with a disease for which a positive response is likely. Initial studies could be performed in limited numbers of patients to acquire data that are hypothesis-generating and useful in preparing more rigorously designed, larger clinical trials for definitive hypothesis-testing (79). …”

Section: Translating Stem Cell Research To the Treatment Of Cardiac Dmentioning

confidence: 99%

Translating Stem Cell Research to Cardiac Disease Therapies

Rosen

Myerburg

Francis

et al. 2014

Journal of the American College of Cardiology

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Over the past 2 decades, there have been numerous stem cell studies focused on cardiac diseases, ranging from proof-of-concept to phase 2 trials. This series of articles focuses on the legacy of these studies and the outlook for future treatment of cardiac diseases with stem cell therapies. The first section by Rosen and Myerburg is an independent review that analyzes the basic science and translational strategies supporting the rapid advance of stem cell technology to the clinic, the philosophies behind them, trial designs, and means for going forward that may impact favorably on progress. The second and third sections were collected in response to the initial section of this review. The commentary by Francis and Cole discusses the Rosen and Myerburg review and details how trial outcomes can be affected by noise, poor trial design (particularly the absence of blinding), and normal human tendencies toward optimism and denial. The final, independent article by Marbán takes a different perspective concerning the potential for positive impact of stem cell research applied to heart disease and future prospects for its clinical application.

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Pulseless Electric Activity

Cited by 143 publications

References 90 publications

A Clinical Perspective on Sudden Cardiac Death

A Clinical Perspective on Sudden Cardiac Death

Heart Rate Assessment Immediately after Birth

Translating Stem Cell Research to Cardiac Disease Therapies

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