Pulseless electrical activity

Pulseless electrical activity

Any rhythm without a pulse can be called a pulseless electrical activity. It is also sometimes called electromechanical dissociation. Usually it is a fast ventricular tachycardia, especially the polymorphic variety which causes pulseless electrical activity. Supraventricular tachycardia is less likely to cause a pulseless electrical activity. Untreated, the pulseless electrical activity soon progresses to ventricular fibrillation or asystole. The treatment of pulseless electrical activity is same as that of cardiac arrest, immediate cardiopulmonary resuscitation is needed.

Once the advanced cardiac life support team arrives, if there is a shockable rhythm like ventricular tachycardia or fibrillation, a DC shock will restore normal sinus rhythm. Both arrhythmias are likely to recur and needs pharmacological therapy for prevention. Correction of metabolic abnormalities like acidosis, hypokalemia and hypomagnesemia also helps in the prevention of recurrence. A treatable cause like a recent coronary occlusion or cardiac tamponade should also be diligently sought for and treated. Massive pulmonary embolism is another possibility. Non cardiac causes like pneumothorax, hypovolemia and hypothermia have also to be considered.