Electrocerebral Signature of Cardiac Death

Matory, Adu; Alkhachroum, Ayham; Chiu, W. Henry; Eliseyev, Andrey; Doyle, Kevin; Rohaut, Benjamin; Egbebike, Jennifer; Velázquez, Ángela; Paniker, Lucy; Prager, Kenneth; Agarwal, Sachin; Roh, David; Park, Soo‐Jin; Claassen, Jan

doi:10.1007/s12028-021-01233-0

Cited by 16 publications

(21 citation statements)

References 61 publications

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“…Our study has several strengths. In contrast to previously published retrospective research, 38,39 we show that it is feasible to prospectively consent and enroll imminently dying patients in research involving addition of EEG monitoring solely for research. 23 Feasibility threats were mainly operational.…”

Section: Strength and Limitationscontrasting

confidence: 74%

“…Feasibility threats were mainly operational. Our cohort included patients with and without primary neurologic injuries, which is a closer representation of potential DCDD candidates than cohorts with isolated primary neurological injuries 35 or patients with sudden cardiac death 5,39 . Finally, we used multiple EEG analysis techniques that can be applied in future multicenter observational studies.…”

Section: Discussionmentioning

confidence: 99%

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Cerebral cortical activity after withdrawal of life-sustaining measures in critically ill patients

Gofton

Norton

Laforge

et al. 2022

American Journal of Transplantation

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Establishing when cerebral cortical activity stops relative to circulatory arrest during the dying process will enhance trust in donation after circulatory determination of death. We used continuous electroencephalography and arterial blood pressure monitoring prior to withdrawal of life sustaining measures and for 30 min following circulatory arrest to explore the temporal relationship between cessation of cerebral cortical activity and circulatory arrest. Qualitative and quantitative EEG analyses were completed. Among 140 screened patients, 52 were eligible, 15 were enrolled, 11 completed the full study, and 8 (3 female, median age 68 years) were included in the analysis. Across participants, EEG activity stopped at a median of 78 (Q1 = −387, Q3 = 111) seconds before circulatory arrest. Following withdrawal of life sustaining measures there was a progressive reduction in electroencephalographic amplitude (p = .002), spectral power (p = .008), and coherence (p = .003). Prospective recording of cerebral cortical activity in imminently dying patients is feasible. Our results from this small cohort suggest that cerebral cortical activity does not persist after circulatory arrest. Confirmation of these findings in a larger multicenter study are needed to help promote stakeholder trust in donation after circulatory determination of death.

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Section: Strength and Limitationscontrasting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Cerebral cortical activity after withdrawal of life-sustaining measures in critically ill patients

Gofton

Norton

Laforge

et al. 2022

American Journal of Transplantation

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“…Main observations are that brain inactivity preceded autonomic measurements and the presence of delta waves after death by neurological criteria and cessation of autonomic markers are rare 39 . In another study was reported that the cessation of cortical activity occurred in parallel to either the last QRS complex or the cessation of cerebral blood flow 40 . The existing evidence from human case reports shows that EEG could not predict the cardiac arrest period 39 .…”

Section: Discussionmentioning

confidence: 96%

“…EEG spectrogram was computed using short-time Fourier transform with a sliding time window of 2 s with a 50% overlap. Time-varying EEG oscillations were integrated within the ranges delta (1-4 Hz), theta (4-8 Hz), alpha (8-12 Hz), beta (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), and gamma (30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45).…”

Section: Participantmentioning

confidence: 99%

Changes in the heartbeat-evoked potential under ventricular fibrillation: a near-death case report

Candia-Rivera¹,

Machado²

2023

Preprint

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Background & Purpose: Whether brain-heart communication continues under ventricular fibrillation (VF) remains to be acknowledged. There is limited evidence of the physiological changes in cortical activity under VF. Moreover, brain-heart communication has not been studied before in this condition. We aim to illustrate parallel changes in heart-rate variability, cortical activity, and brain-heart interactions in a case report undergoing VF. Methods: The case report's EEG and EKG was acquired for approximately 20h. We selected different one-minute-long segments, based on the changes in the EKG waveform. We present the changes in heartbeat-evoked responses (HERs), heart rate variability (HRV), and EEG power for each selected segment.Results: The overall physiological activity appears deteriorated in the ongoing VF. Brain-heart interactions measured with HERs disappear, with a few aberrant amplitudes appearing occasionally. The parallel changes in EEG-HRV are not pronounced, suggesting an absence of bidirectional neural control.Conclusions: The measurements of brain-heart interactions suggest that the evolving VF causes deteriorated communication between the central and autonomic nervous systems. These results may support that reduced brain-heart interactions reflect the loss of consciousness and overall health state.

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“…More recently, Matory et al ( 2021 ) studied continuous EEG recording from 19 ICU patients who died from heart attacks despite receiving treatment. Two of the 19 had some brief EEG activity (for up to 2 min) following the last QRS complex recorded in the ECG, and 11 showed EEG activity briefly (for <5 min) after blood flow to the brain had ceased, as estimated by blood pressure and heart rate falling below set thresholds.…”

Section: Discussionmentioning

confidence: 99%

Commentary: Enhanced Interplay of Neuronal Coherence and Coupling in the Dying Human Brain

Greyson

Lommel

Fenwick

2022

Front. Aging Neurosci.

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Electrocerebral Signature of Cardiac Death

Cited by 16 publications

References 61 publications

Cerebral cortical activity after withdrawal of life-sustaining measures in critically ill patients

Cerebral cortical activity after withdrawal of life-sustaining measures in critically ill patients

Changes in the heartbeat-evoked potential under ventricular fibrillation: a near-death case report

Commentary: Enhanced Interplay of Neuronal Coherence and Coupling in the Dying Human Brain

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