Determining when to perform cardiac catheterization

Coronary ischemia is the most common cause of ventricular dysrhythmias. In this video, from our Resuscitation Essentials course, we'll cover the critical actions that need to be taken when dealing with cardiac arrest patients or unexplained ventricular dysrhythmias.

Optimize the likelihood of patient recovery after cardiac arrest with our Resuscitation Essentials course. Resuscitation is all about making rapid, life-saving decisions in the face of uncertainty. Algorithms provide structure, but can’t cover every possible scenario. In this course, you’ll avoid one-size-fits-all algorithms and build a deep understanding of the pathophysiology and critical actions applicable to resuscitation, learning a step-by-step approach for managing any patient experiencing cardiac arrest.

[00:00:00] Coronary ischemia is the most common cause for ventricular dysrhythmias. For patients with ventricular tachycardia or ventricular fibrillation, without an apparent alternate cause, emergent coronary angiography should be considered in order to potentially open an occluded vessel. Patients with cardiac arrest following an ST-elevation myocardial infarction should be taken emergently for percutaneous coronary intervention as soon as possible, just as those

[00:00:30] without arrest. Some patients will continue to remain unstable until their coronary occlusion is opened so it may be necessary to continue to provide circulatory support. Reperfusion after cardiac arrest may cause a variety of EKG abnormalities, which may be confusing. However, even among patients without definitive evidence of ST-elevation after cardiac arrest, more than 25% of them may benefit from a percutaneous coronary intervention. Regional and

[00:01:00] institutional practice patterns should help guide intervention but it's important to maintain a high suspicion for an acute coronary lesion in all patients with an unexplained ventricular dysrhythmia.