Article
Critical Care Medicine
Maria Hoybye, Nikola Stankovic, Kasper G. Lauridsen, Mathias J. Holmberg, Lars W. Andersen, Asger Granfeldt
Summary: This observational cohort study found that there were no major differences in patient demographics and comorbidities among in-hospital cardiac arrest patients presenting with PEA or asystole. Initial PEA was associated with a higher risk of ROSC, but there was no difference in 30-day and 1-year survival rates.
Article
Critical Care Medicine
Romolo Gaspari, Anthony Weekes, Srikar Adhikari, Vicki E. Noble, Jason T. Nomura, Daniel Theodoro, Michael Y. Woo, Paul Atkinson, David Blehar, Samuel M. Brown, Terrell Caffery, Christine Haines, Samuel Lam, Michael Lanspa, Margaret Lewis, Otto Liebmann, Alexander Limkakeng, Elke Platz, Christopher Moore, Christopher Raio
Summary: This study aims to measure the discordance between electrical activity recorded by ECG and myocardial activity visualized by echo in patients after cardiac arrest, and compare survival outcomes among different cohorts. The results showed significant differences between ECG and echo-defined myocardial activities, highlighting the need for further research in defining cardiac activity during cardiac arrest for better outcome comparisons.
Article
Emergency Medicine
Young-Min Kim, Jong Eun Park, Sung Yeon Hwang, Se Uk Lee, Taerim Kim, Hee Yoon, Min Seob Sim, Ik Joon Jo, Gun Tak Lee, Tae Gun Shin
Summary: The study found a significant association between wide QRS PEA and hyperkalemia in cardiac arrest patients, suggesting that the management of hyperkalemia should be emphasized when dealing with PEA cardiac arrest patients.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Daniel Ambinder, Kaustubha D. Patil, Hikmet Kadioglu, Pace S. Wetstein, Richard S. Tunin, Sarah J. Fink, Susumu Tao, Giulio Agnetti, Henry R. Halperin
Summary: In patients with acute coronary occlusion, those with severe left ventricular dysfunction are more likely to develop pulseless electrical activity (PEA) rather than ventricular fibrillation as their initial rhythm, due to acute pump failure occurring almost immediately after the coronary occlusion. This suggests that individuals with baseline left ventricular dysfunction should be evaluated for acute coronary occlusion if they develop PEA.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2021)
Article
Critical Care Medicine
L. Holmstrom, H. Chugh, A. Uy-Evanado, A. Salvucci, J. Jui, K. Reinier, S. S. Chugh
Summary: The proportion of sudden cardiac arrests (SCA) presenting with pulseless electrical activity (PEA) has increased. Key determinants of survival from PEA-SCA were found to be young age, witnessed status, public location, and pre-existing COPD/asthma.
Article
Critical Care Medicine
A. Norvik, J. T. Kvaloy, GW. Skjeflo, D. Bergum, T. Nordseth, J. P. Loennechen, E. Unneland, D. G. Buckler, A. Bhardwaj, T. Eftestol, E. Aramendi, BS. Abella, E. Skogvoll
Summary: This study aimed to assess the predictive ability of QRSd and HR as biomarkers for the immediate outcome of patients with PEA. The results showed that higher and rising HR were associated with a higher transition intensity to ROSC, and lower and shrinking QRSd were associated with an increased transition intensity to ROSC. These findings provide guidance for tailoring individual treatment by the emergency team.
Article
Cardiac & Cardiovascular Systems
David C. C. Parish, Hemant Goyal, Erskine James, Francis C. C. Dane
Summary: Pulseless electrical activity (PEA) is considered an enigmatic phenomenon in resuscitation research, with survival rates of PEA patients varying based on patients' illness spectrum and intensity of monitoring. Therefore, studies on the mechanisms of PEA development offer prospects for improving survival rates.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2021)
Article
Critical Care Medicine
Rongzi Shan, Jason Yang, Alan Kuo, Randall Lee, Xiao Hu, Noel G. Boyle, Duc H. Do
Summary: Patients with IHCA of respiratory etiology exhibit a pattern of tachycardia followed by rapid heart rate decrease prior to arrest. Escape rhythms and sinus arrest are common electrocardiographic manifestations. Right ventricular strain ECG pattern may occur prior to the onset of heart rate decrease.
Article
Cardiac & Cardiovascular Systems
Lauri Holmstrom, Shiva Salmasi, Harpriya Chugh, Audrey Uy-Evanado, Chad Sorenson, Ziana Bhanji, Madison Seifer, Arayik Sargsyan, Angelo Salvucci, Jonathan Jui, Kyndaron Reinier, Sumeet S. Chugh
Summary: This study investigated the clinical profile, triggers, and long-term prognosis in survivors of sudden cardiac arrest (SCA) presenting with pulseless electrical activity (PEA). The findings showed that PEA-SCA survivors are a heterogeneous group with a high prevalence of multiple comorbidities, especially heart failure. Surprisingly, young individuals had a good long-term prognosis, but the majority of triggers remained undetermined.
JACC-CLINICAL ELECTROPHYSIOLOGY
(2022)
Article
Physics, Multidisciplinary
Jon Urteaga, Elisabete Aramendi, Andoni Elola, Unai Irusta, Ahamed Idris
Summary: This study aimed to develop a machine learning model to differentiate PEA with favorable and unfavorable evolution to ROSC using ECG and TI signals. After signal processing and feature extraction, a random forest classifier showed higher accuracy and AUC, improving upon previous solutions.
Article
Emergency Medicine
Jung Ho Kim, Hyun Wook Ryoo, Jong-Yeon Kim, Jae Yun Ahn, Sungbae Moon, Dong Eun Lee, You Ho Mun, Jang Won Son
Summary: This study found that in patients with OHCA-P, higher QRS amplitude or narrower width of the initial QRS complex were associated with increased chances of survival to hospital discharge and favorable neurological outcomes.
EMERGENCY MEDICINE JOURNAL
(2021)
Article
Critical Care Medicine
Luke Andrea, Ariel L. Shiloh, Mai Colvin, Marjan Rahmanian, Maneesha Bangar, Anne Grossestreuer, Katherine M. Berg, Michelle N. Gong, Ari Moskowitz
Summary: PEA and asystole are common rhythms in IHCA, but they have distinct features in terms of location, resuscitation measures, and outcomes.
Article
Critical Care Medicine
Michael Crickmer, Ian R. Drennan, Linda Turner, Sheldon Cheskes
Summary: Our study found a positive linear relationship between the change in ETCO2 and ROSC in patients with PEA cardiac arrest, with a delta ETCO2 value > 20 mmHg being highly specific for predicting ROSC. Patients with rising ETCO2 values should continue to receive resuscitation unless there is overwhelming clinical evidence to the contrary.
Article
Critical Care Medicine
A. Norvik, E. Unneland, D. Bergum, D. G. Buckler, A. Bhardwaj, T. Eftestol, E. Aramendi, T. Nordseth, B. S. Abella, J. T. Kvaloy, E. Skogvoll
Summary: This study explores and quantifies the evolution from PEA to ROSC during in-hospital cardiac arrest. The research found that different presentations of PEA have different transition intensities, and resuscitative efforts should continue when PEA occurs.
Article
Emergency Medicine
Carmelle Tsai, Maria Quidgley-Martin, Natalie Laub, Tracey G. Polsky, Kevin C. Osterhoudt
Summary: This case report describes a 19-month-old female who presented in cardiac arrest after exposure to methamphetamine. Despite initial negative urine screening, further analysis revealed positive results for amphetamine, highlighting the challenges of urine screening in cases of suspected poisoning syndromes. The case also suggests Pulseless Electrical Activity (PEA) as a possible presentation of methamphetamine toxicity in children.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2021)
Article
Multidisciplinary Sciences
Emma Sandgren, Cecilia Rorsman, Nils Edvardsson, Johan Engdahl
Editorial Material
Cardiac & Cardiovascular Systems
Ulf Stromberg, Anders Holmen, Johan Engdahl
EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY
(2019)
Article
Cardiac & Cardiovascular Systems
Katrin Kemp Gudmundsdottir, Tove Fredriksson, Emma Svennberg, Faris Al-Khalili, Leif Friberg, Viveka Frykman, Ziad Hijazi, Marten Rosenqvist, Johan Engdahl
Article
Cardiac & Cardiovascular Systems
Adriano Atterman, Leif Friberg, Kjell Asplund, Johan Engdahl
Article
Cardiac & Cardiovascular Systems
Tove Fredriksson, Katrin Kemp Gudmundsdottir, Viveka Frykman, Leif Friberg, Faris Al-Khalili, Johan Engdahl, Emma Svennberg
CLINICAL CARDIOLOGY
(2020)
Article
Cardiac & Cardiovascular Systems
Tove Fredriksson, Katrin Kemp Gudmundsdottir, Viveka Frykman, Leif Friberg, Faris Al-Khalili, Johan Engdahl, Emma Svennberg
BMC CARDIOVASCULAR DISORDERS
(2020)
Article
Medicine, General & Internal
A. Atterman, K. Asplund, L. Friberg, J. Engdahl
JOURNAL OF INTERNAL MEDICINE
(2020)
Article
Public, Environmental & Occupational Health
Katrin Kemp Gudmundsdottir, Anders Holmen, Tove Fredriksson, Emma Svennberg, Faris Al-Khalili, Johan Engdahl, Ulf Stromberg
Summary: The participation rate in atrial fibrillation screening is influenced by socio-demographic factors such as education level, income, immigrant status, and marital status. Adding screening sites can significantly improve participation rate, especially in low-income areas.
JOURNAL OF MEDICAL SCREENING
(2021)
Review
Medicine, General & Internal
J. Engdahl, M. Rosenqvist
Summary: Atrial fibrillation is a common disease with growing prevalence, especially among asymptomatic individuals. Treatment with oral anticoagulation can reduce risk, but there are still knowledge gaps that require further research.
JOURNAL OF INTERNAL MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Maria Tomasdottir, Claes Held, Nermin Hadziosmanovic, Johan Westerbergh, Johan Lindback, Philip E. Aylward, Andrzej Budaj, Christopher P. Cannon, Johan Engdahl, Christopher B. Granger, Wolfgang Koenig, Athanasios J. Manolis, Jonas Oldgren, Ralph A. H. Stewart, Emma Svennberg, Dragos Vinereanu, Harvey D. White, Agneta Siegbahn, Lars Wallentin, Ziad Hijazi
Summary: In patients with optimally treated CHD, the incidence of new AF was 1.2% per year. Age, NT-proBNP as a marker of impaired cardiac function, and BMI were the strongest factors, independently and consistently associated with incident AF. Male sex and low physical activity may also contribute to the risk of AF in patients with CHD.
AMERICAN HEART JOURNAL
(2021)
Article
Cardiac & Cardiovascular Systems
Johan Lyth, Emma Svennberg, Lars Bernfort, Mattias Aronsson, Viveka Frykman, Faris Al-Khalili, Leif Friberg, Marten Rosenqvist, Johan Engdahl, Lars-Ake Levin
Summary: This study aimed to evaluate the cost-effectiveness of population-based screening for atrial fibrillation (AF) using clinical outcomes. The analysis showed that the screening intervention group had higher gained life years and gained quality-adjusted life years at a lower cost.
EUROPEAN HEART JOURNAL
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Johan Engdahl, Katrin Kemp Gudmundsdottir, Marten Rosenqvist
Article
Critical Care Medicine
Anna Thoren, Araz Rawshani, Johan Herlitz, Johan Engdahl, Thomas Kahan, Linnea Gustafsson, Therese Djarv
Article
Cardiac & Cardiovascular Systems
Faris Al-Khalili, Katrin Kemp-Gudmundsdottir, Emma Svennberg, Tove Fredriksson, Viveka Frykman, Leif Friberg, Marten Rosenqvist, Johan Engdahl
Article
Cardiac & Cardiovascular Systems
Emma Sandgren, Cecilia Rorsman, Nils Edvardsson, Johan Engdahl
IJC HEART & VASCULATURE
(2019)
Article
Critical Care Medicine
Veerle Heesters, Janneke Dekker, Timothy J. R. Panneflek, Kristel L. A. M. Kuypers, Stuart B. Hooper, Remco Visser, Arjan B. te Pas
Summary: This study visualized the closure of vocal cords during apnea, in between breaths, and during breath holds in preterm infants using ultrasonography. The closure of vocal cords impaired the effect of respiratory support.