Ventricular fibrillation (VF), pulseless ventricular tachycardia (VT) and asystole may all be diagnosed immediately based on the monitoring in the catheter lab (figure 1). There is no need to routinely look, listen and feel for 10 s.IC
Many cases of pulseless electrical activity (PEA) may also be diagnosed by the absence of pulsatile traces but if in doubt then either look, listen and feel or use echocardiography to look for a cardiac output.IIaC
If a patient has circulatory collapse with a rate less than 30/min then we define this as extreme bradycardia as this may respond to percussion, external or temporary wire pacing and thus we recommend following the asystole pathway.IC
If a patient has an arrhythmia above a rate of 140 /min without a discernible cardiac output then we recommend following the pathway for VF/pulseless VT as this may respond to defibrillation.IIaC