Abstract 12757: ECG Patterns in Early Pulseless Electrical Activity and the Etiologies of In-Hospital Cardiac Arrest

Introduction: The defibrillator is a mandatory diagnostic and therapeutic tool for the treatment of cardiac arrest (CA). The diagnostic potential of the defibrillator may not be fully utilized. Pulseless electrical activity (PEA) is increasingly common as the first presenting rhythm for a range of etiologies, in particular the ‘reversible causes 4H4T’ (figure). We investigated the etiology and its relation to the QRS duration and heart rate during PEA. Method: We conducted a prospective observational study of all CA episodes treated by an in-hospital emergency team (ET) at St.Olav University Hospital in Trondheim/Norway during 4.5 years. Two cardiologists independently examined the ECG recorded during the first compression pause after attachment of the defibrillator, and measured the duration of three consecutive QRS complexes. The averaged QRS duration was defined as normal if shorter than 120ms and the heart rate (HR) was defined as normal if between 59 and 100/minute, leading to six simple ‘patterns’ o...