STAT ECG Diagnoses: Post-cardiac arrest ECG with this pattern, what is the most likely cause of arrest and would you activate the cath lab?

ECG Weekly Workout with Dr. Amal Mattu


An elderly male with no known past medical history is brought into the ED via EMS s/p cardiac arrest. He was found to be unresponsive with a weak pulse at 20 bpm prior to the arrest. He received chest compressions and 2 rounds of epinephrine before arrival. On arrival, a faint pulse is palpable and the following ECG is obtained:

Before watching this week’s video, ask yourself these questions:

  1. What ECG abnormalities do you notice and what is your differential?
  2. What is the rate & rhythm?
  3. Would you activate the cath lab in this patient?