• Am J Emerg Med · Jul 2015

    Case Reports

    Successful use of intra-arrest thrombolysis for electrical storm due to acute myocardial infarction.

    • Karina Reyner, Alan C Heffner, J Lee Garvey, and Vivek S Tayal.
    • Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC.
    • Am J Emerg Med. 2015 Jul 1;33(7):990.e5-8.

    AbstractAcute vascular thrombotic disease, including acute myocardial infarction and pulmonary embolism, accounts for 70% of sudden outpatient cardiac arrest. The role of intra-arrest thrombolytic administration aimed at reversing the underlying cause of cardiac arrest remains an area of debate with recent guidelines advising against routine use. We present a case of prolonged refractory ventricular fibrillation electrical storm in a patient who demonstrated intra-arrest electrocardiographic and sonographic markers confirming acute myocardial infarction. Return of spontaneous circulation was rapidly achieved after rescue intra-arrest bolus thrombolysis.Highlights of this case are discussed in the context of the current evidence for thrombolytic therapy in cardiac arrest with specific attention to the issue of patient selection.

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