Saw a case of relatively symptomless Vtach with a malfunctioning ventricular pacemaker. I was astounded because they were talking and had no complaints of Angina, Dyspnea, or Syncope. HR was 201 < 220. Unfortunately, about an hour later the pt. coded. Gained ROSC and conciousness. Pt. then stated they wanted a DNR DNI. Coded again about 15 minutes later.
Pulseless V tach is a chaotic electrical rhythm that needs to be stopped (hence shock) PEA has ORGANIZED electrical activity therefore should not be shocked.
People often think that there is an electrophysiology reason to Unsynchronize pulseless V-tach. There is not. It is just a matter of time delay. The American Heart Association and American College of Cardiology just feel that here would be a delay to synchronize. If you could synchronize just as fast as unsynchonized from an EP perspective, it would be preferable or at least just as good. I don't think a lot of people understand that.
Saw a case of relatively symptomless Vtach with a malfunctioning ventricular pacemaker. I was astounded because they were talking and had no complaints of Angina, Dyspnea, or Syncope. HR was 201 < 220. Unfortunately, about an hour later the pt. coded. Gained ROSC and conciousness. Pt. then stated they wanted a DNR DNI. Coded again about 15 minutes later.
Why would a pulseless v tach be shocked but not pea? Both are pulseless
Pulseless V tach is a chaotic electrical rhythm that needs to be stopped (hence shock)
PEA has ORGANIZED electrical activity therefore should not be shocked.
People often think that there is an electrophysiology reason to Unsynchronize pulseless V-tach. There is not. It is just a matter of time delay. The American Heart Association and American College of Cardiology just feel that here would be a delay to synchronize. If you could synchronize just as fast as unsynchonized from an EP perspective, it would be preferable or at least just as good. I don't think a lot of people understand that.
I had sustained v tach back in April, not fun. Was cardioverted but thankfully I was put under for that, heard it's quite the painful experience.
Why did it happened to you?
Thanks Doctor