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 (fast rhythm originating from the lower chambers of the heart), especially the polymorphic (changing form) variety which causes PEA. Supraventricular tachycardia (SVT: fast rhythm originating from the upper chambers of the heart) is less likely to cause a pulseless electrical activity. Untreated, the PEA soon progresses to ventricular fibrillation or asystole.

Treatment of pulseless electrical activity

The treatment of pulseless electrical activity 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 (low pH of blood), hypokalemia (low levels of potassium in the blood) and hypomagnesemia (low levels of magnesium in the blood) also helps in the prevention of recurrence. A treatable cause like a recent coronary occlusion or cardiac tamponade (compression of the heart by fluid within its covering) should also be diligently sought for and treated.