Post-cardiac arrest ECGs: the value of the post return of spontaneous circulation (ROSC) ECG and when it should be repeated

ECG Weekly Workout with Dr. Amal Mattu


A 74-year-old man is brought into the emergency department by EMS for witnessed cardiac arrest. Initial rhythm was ventricular fibrillation s/p defibrillation with subsequent PEA. He received standard prehospital ACLS with multiple rounds of epinephrine prior to ROSC. The following ECG was obtained immediately post arrest:

Before watching the video, look closely at this ECG and ask yourself:

  1. What is your formal EGC interpretation?
  2. What would you plan to do next?