Cardiac arrest arrhythmias

Abstract

Cardiac arrest (CA) is a clinical condition defined by the absence of an effective circulatory blood flow due to the inability of the heart to provide consistent hemodynamic support. Two main characteristics challenge the treatment of CA: its unpredictable onset and the very short time in which to intervene in order to avoid irreversible and dramatic organ damage. The cardiology community has attempted to address the difficulties related to the management of CA through the development of standardized protocols aimed at treating CA. The current guidelines place strong consideration on the initial rhythm and the restoration of spontaneous circulation with resuscitation. What is not sufficiently emphasized in the current approach to CA is the dynamic transition of different cardiac rhythms during the acute event. In this chapter, the temporal sequence of different cardiac arrhythmias during CA and their prognostic significance are described. The proarrhythmic effects of pharmacological and electrical treatment utilized during the resuscitation are also discussed. In recent years, therapeutic hypothermia has been introduced for the treatment of survivors of CA in an effort to reduce neurological damage. Electrocardiographic abnormalities associated with therapeutic hypothermia are briefly described.