Cardiac Arrest Treatment

Cardiac Arrest Treatment

Once in the emergency department, intravenous (IV) lines are started to administer fluids and medications. After the individual is resuscitated, anti-arrhythmic drugs (beta-blockers, angiotensin converting enzyme inhibitors, calcium channel blockers, amiodarone) are used to prevent future episodes of ventricular fibrillation. The individual is connected to an ECG machine (electrocardiography) and placed under continuous cardiac monitoring. Oxygen, aspirin, and nitroglycerin are administered. Individuals deemed at high risk for a recurrence may need to be fitted with an implantable cardioverter-defibrillator (ICD), an internal device that monitors the heart rhythm, delivering a shock at the first sign of ventricular fibrillation.
The complete absence of heart electrical activity (asystole or “flat-line”) is more difficult to reverse than cardiac arrest caused by ventricular fibrillation. Asystole may respond to IV administration of epinephrine, vasopressin, or atropine. In extreme cases, medication may be injected directly into the heart. Once the individual is stabilized, a pacemaker, which monitors the cardiac rhythm and stimulates the heart if it fails to beat, may need to be implanted.
Patients who have blockage of a heart valve or vessel caused by a blood clot (thrombus) may receive medication to break down the clot (thrombolytics) and help restore normal blood flow.
Once an individual’s condition has stabilized, he or she is transferred to a cardiac care unit (CCU) for continuous cardiac monitoring and further treatment.
Other treatments that may be used, depending on the underlying cause of cardiac arrest, include coronary angioplasty to open blocked coronary arteries, coronary bypass surgery, electrophysiology studies to map conduction pathways, radiofrequency catheter ablation to eliminate an abnormal electrical pathway, or heart surgery to correct abnormalities (valves, congenital deformities).