Successful use of intra-arrest thrombolysis for electrical storm due to acute myocardial infarction

The American Journal of Emergency Medicine
Karina ReynerVivek S Tayal

Abstract

Acute vascular thrombotic disease, including acute myocardial infarction and pulmonary embolism, accounts for 70% of sudden outpatient cardiac arrest. The role of intra-arrest thrombolytic administration aimed at reversing the underlying cause of cardiac arrest remains an area of debate with recent guidelines advising against routine use. We present a case of prolonged refractory ventricular fibrillation electrical storm in a patient who demonstrated intra-arrest electrocardiographic and sonographic markers confirming acute myocardial infarction. Return of spontaneous circulation was rapidly achieved after rescue intra-arrest bolus thrombolysis.Highlights of this case are discussed in the context of the current evidence for thrombolytic therapy in cardiac arrest with specific attention to the issue of patient selection.

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Citations

Oct 30, 2016·Resuscitation·Danelle HidanoThomas Rea
Aug 5, 2020·The American Journal of Emergency Medicine·Joseph A HameraDavid A Berger

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