Atrial to Ventricular Fibrillation
Report:
CPR massage artefact throughout
Supraventricular bradycardia, probably atrial fibrillation with slow response
ST segment elevation consistent with infarction or ischæmia
VEB
Ventricular fibrillation
Comment:
The CPR artefact during AF means that the patient is in electromechanical dissociation (EMD)142.
We know that VF starts after the VEB (partially obscured by chest compression artefact) in the third strip because no formed QRS complexes are seen again.
Below (Fig 207a), following DC defibrillation, the ST segment elevation is so extreme that it mimics broad QRS complexes63. The resumption of CPR artefact implies that, ominously, EMD is still present. Alternatively, it may imply the medical attendants are unable to feel the pulse, perhaps bounding in the groin while they are feeling for it in the neck!
207a. VF abolished (second strip), QRSs appear with massive ST segment elevation. They are soon joined by CPR artefacts. The artefacts could be mistaken for native complexes, perhaps VEBs. What precludes it?
208. 62 year old woman with septicæmia and acute coronary insufficiency.
If you have any suggestions for or feedback on this report, please let us know.
Hi, can we chat about some terms and conditions?
The library and its records are licensed under the Creative Commons Attribution 4.0 International license.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
By clicking agree below, you are agreeing to adhere to CC BY 4.0.