Saw a case of relatively symptomless Vtach with a malfunctioning ventricular pacemaker. I was astounded because they were talking and had no complaints of Angina, Dyspnea, or Syncope. HR was 201 < 220. Unfortunately, about an hour later the pt. coded. Gained ROSC and conciousness. Pt. then stated they wanted a DNR DNI. Coded again about 15 minutes later.
People often think that there is an electrophysiology reason to Unsynchronize pulseless V-tach. There is not. It is just a matter of time delay. The American Heart Association and American College of Cardiology just feel that here would be a delay to synchronize. If you could synchronize just as fast as unsynchonized from an EP perspective, it would be preferable or at least just as good. I don't think a lot of people understand that.
Pulseless V tach is a chaotic electrical rhythm that needs to be stopped (hence shock) PEA has ORGANIZED electrical activity therefore should not be shocked.
![XO (Only If You Say Yes) - ENHYPEN エンハイプン 엔하이픈 [Music Bank] | KBS WORLD TV 240712](http://i.ytimg.com/vi/wBT1bKKwPTo/mqdefault.jpg)
Saw a case of relatively symptomless Vtach with a malfunctioning ventricular pacemaker. I was astounded because they were talking and had no complaints of Angina, Dyspnea, or Syncope. HR was 201 < 220. Unfortunately, about an hour later the pt. coded. Gained ROSC and conciousness. Pt. then stated they wanted a DNR DNI. Coded again about 15 minutes later.
People often think that there is an electrophysiology reason to Unsynchronize pulseless V-tach. There is not. It is just a matter of time delay. The American Heart Association and American College of Cardiology just feel that here would be a delay to synchronize. If you could synchronize just as fast as unsynchonized from an EP perspective, it would be preferable or at least just as good. I don't think a lot of people understand that.
Thanks Doctor
I had sustained v tach back in April, not fun. Was cardioverted but thankfully I was put under for that, heard it's quite the painful experience.
Why did it happened to you?
Why would a pulseless v tach be shocked but not pea? Both are pulseless
Pulseless V tach is a chaotic electrical rhythm that needs to be stopped (hence shock)
PEA has ORGANIZED electrical activity therefore should not be shocked.
4:46 PEA