Why in pulseless VT defibrillaton given although in pulseless electrical activity is non shockable rhythm

why in pulseless VT defibrillaton given although in pulseless electrical activity is non shockable rhythm

In cardiac arrest situations, the rhythm of the heart can be classified into shockable and non-shockable rhythms. Ventricular tachycardia (VT) without a pulse is considered a shockable rhythm, while pulseless electrical activity (PEA) is classified as a non-shockable rhythm. The distinction between shockable and non-shockable rhythms is important in determining the appropriate treatment.

Defibrillation, which involves delivering an electric shock to the heart, is primarily indicated for shockable rhythms, such as pulseless VT and ventricular fibrillation (VF). These are abnormal rhythms characterized by chaotic electrical activity in the ventricles, resulting in ineffective pumping of blood. The goal of defibrillation is to restore a normal rhythm by depolarizing the myocardium and allowing the heart’s natural pacemaker to regain control.

On the other hand, non-shockable rhythms, including PEA, are characterized by organized electrical activity in the heart but without effective mechanical pumping. In PEA, there is sufficient electrical activity, but the heart is unable to generate an adequate pulse or blood pressure. Non-shockable rhythms like PEA are typically caused by underlying factors such as severe hypovolemia, tension pneumothorax, cardiac tamponade, or profound metabolic disturbances.

In cases of PEA, the treatment focuses on identifying and addressing the underlying cause, rather than defibrillation. This involves performing high-quality cardiopulmonary resuscitation (CPR), administering medications, addressing reversible causes, and providing appropriate supportive care.

Therefore, defibrillation is indicated in pulseless VT because it is considered a shockable rhythm, while PEA, despite the absence of a pulse, requires a different approach as it is a non-shockable rhythm. It is important for healthcare professionals to accurately identify the rhythm and follow the appropriate guidelines and protocols for the management of each specific rhythm during cardiac arrest.