Get Rhythm, when you get the Blues…

Roughly 40 year old man. No personal history. Out of hospital VF arrest. ACLS: CPR, shock > asystole, more CPR, adrenaline 1mg x4 > VT/ VF, more shocks > PEA, more CPR, then ROSC in ?AF. This is his post ROSC ECG rhythm strip. Thoughts anyone? What’s going on? To be continued…


About dreapadoir

Emergency Physician, author of Emergency Medicine blog, photographer at
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5 Responses to Get Rhythm, when you get the Blues…

  1. dreapadoir says:

    A bit of discussion pertinent to this post happened on Twitter between @Eleytherius, @antidoped and myself (@dreapadoirtas). Check it out on Twitter by following us.

  2. dreapadoir says:

    And I should say, he wasn’t hypothermic at the time! (He is now of course, iatrogenically!).
    [i.e., they aren’t J-waves]

  3. dreapadoir says:

    Unfortunately this man never made it out of ICU – he had hypoxic neurological injury and died. The underlying cause of his arrest remains undiagnosed. My suspicion of congenital short QT is only that, a suspicion. It is possible his QT changes were secondary, and related to “irritable myocardium” post arrest, however, a later ECG also suggested a shortish QT…

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