Pulseless electrical activity (PEA)

Pulseless electrical activity (PEA)

Any rhythm without a pulse can be called a pulseless electrical activity (PEA).  Usually it is a fast ventricular tachycardia, especially the polymorphic variety which causes PEA. Supraventricular tachycardia (SVT) is less likely to cause a PEA. Untreated, the PEA soon progresses to ventricular fibrillation or asystole. The treatment of PEA is same as that cardiac arrest. Immediate cardiopulmonary resuscitation (CPR) is needed. Once the ACLS (advanced cardiac life support) team arrives, if it is a shockable rhythm like ventricular tachycardia or fibrillation, a DC shock will restore normal sinus rhythm. Both arrhythmias are likely to recur and needs pharmacological therapy for prevention. Correction of metabolic abnormalities like acidosis, hypokalemia and hypomagnesemia also helps in the prevention of recurrence. A treatable cause like a recent coronary occlusion or cardiac tamponade should also be diligently sought for and treated.