Margaret Hauck1, Jonathan Studnek2, Alan C Heffner3, David A Pearson4. 1. Carolinas Medical Center, Charlotte, NC. 2. Mecklenburg EMS Agency, Charlotte, NC. 3. Department of Emergency Medicine, Pulmonary and Critical Care Consultants, Carolinas Medical Center, Charlotte, NC. 4. Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC. Electronic address: margaret.hauck@carolinashealthcare.org.
Abstract
OBJECTIVES: Cardiac arrest is a leading cause of death in the United States, with pulseless electrical activity (PEA) as a common initial arrest rhythm. We sought to determine if rate of electrical activity and QRS width correlate with survival in patients who present with PEA out-of-hospital cardiac arrest. METHODS AND RESULTS: This is a retrospective review of patients with PEA out-of-hospital cardiac arrest with first documented cardiac rhythm of PEA from January 2010 to September 2013. Demographic, arrest and initial rhythm characteristics, and patient outcome were abstracted via systematic chart review. The initial 20 seconds of each rhythm strip were used to ascertain electrical rate and QRS width. Primary outcome was survival to hospital discharge. Four hundred fourteen patients were eligible for the study. One hundred fifty-two patients did not have sufficient data for analysis. Two hundred sixty-two patients were included in the final analysis with mean age, 66 years. There were 23 (8.8%) survivors and 17 (6.5%) neurologically intact survivors. Mean heart rate was 58 (confidence interval, 54-63) beats per minute, and mean QRS interval was 100 (confidence interval, 95-106) milliseconds. Twenty-nine point seven percent of patients had wide QRS complexes, and 70.3% were narrow. There was no difference in survival in patients based on heart rate (13.1% vs 7.4%, P = .16) or QRS interval (8.7% vs 7.7%, P = .79). CONCLUSIONS: In this single emergency medical services agency study, neither PEA electrical rate nor QRS width correlated with survival or neurologic outcome.
OBJECTIVES:Cardiac arrest is a leading cause of death in the United States, with pulseless electrical activity (PEA) as a common initial arrest rhythm. We sought to determine if rate of electrical activity and QRS width correlate with survival in patients who present with PEA out-of-hospital cardiac arrest. METHODS AND RESULTS: This is a retrospective review of patients with PEA out-of-hospital cardiac arrest with first documented cardiac rhythm of PEA from January 2010 to September 2013. Demographic, arrest and initial rhythm characteristics, and patient outcome were abstracted via systematic chart review. The initial 20 seconds of each rhythm strip were used to ascertain electrical rate and QRS width. Primary outcome was survival to hospital discharge. Four hundred fourteen patients were eligible for the study. One hundred fifty-two patients did not have sufficient data for analysis. Two hundred sixty-two patients were included in the final analysis with mean age, 66 years. There were 23 (8.8%) survivors and 17 (6.5%) neurologically intact survivors. Mean heart rate was 58 (confidence interval, 54-63) beats per minute, and mean QRS interval was 100 (confidence interval, 95-106) milliseconds. Twenty-nine point seven percent of patients had wide QRS complexes, and 70.3% were narrow. There was no difference in survival in patients based on heart rate (13.1% vs 7.4%, P = .16) or QRS interval (8.7% vs 7.7%, P = .79). CONCLUSIONS: In this single emergency medical services agency study, neither PEA electrical rate nor QRS width correlated with survival or neurologic outcome.
Authors: Anne Lee Solevåg; Deandra Luong; Tze-Fun Lee; Megan O'Reilly; Po-Yin Cheung; Georg M Schmölzer Journal: PLoS One Date: 2019-04-04 Impact factor: 3.240
Authors: Sini Saarinen; Ari Salo; James Boyd; Päivi Laukkanen-Nevala; Catharina Silfvast; Ilkka Virkkunen; Tom Silfvast Journal: Scand J Trauma Resusc Emerg Med Date: 2018-11-19 Impact factor: 2.953