Pulseless ventricular tachycardia
| Pulseless ventricular tachycardia |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Pulseless Ventricular Tachycardia
In pulseless ventricular tachycardia and electromechanical dissociation, organized electrical activity is present but fails to produce a detectable cardiac output.
In a patient who is in the middle of a cardiac arrest 12 lead electrocardiography is impractical; use a cardiac monitor to determine the rhythm, and any broad complex tachycardia should be assumed to be ventricular in origin.
Pulseless ventricular tachycardia is managed in the same way as ventricular fibrillation, early defibrillation being the mainstay of treatment.[1]
Pulseless Electrical Activity
In pulseless electrical activity the heart continues to work electrically but fails to provide a cardiac output sufficient to produce a palpable pulse.
Electrocardiographic features of pulseless electrical activity
The appearance of the electrocardiogram varies, but several common patterns exist. There may be a normal sinus rhythm or sinus tachycardia, with discernible P waves and QRS complexes. Sometimes there is a bradycardia, with or without P waves, and often with wide QRS complexes.[2]
Successful treatment of pulseless electrical activity depends on whether it is a primary cardiac event or is secondary to a potentially reversible disorder.
Potentially reversible causes of pulseless electrical activity
- Hypovolemia
- Cardiac tamponade
- Tension pneumothorax
- Massive pulmonary embolism
- Hyperkalemia, hypokalemia, and metabolic disorders
- Hypothermia
- Toxic disturbances as overdoses of beta blockers, tricyclic antidepressants, or calcium channel blockers.