Skip to main content

Etiology, Electrophysiology, Myocardial Energy Mechanics, and Treatment of Bradyasystole

  • Chapter
Cardiopulmonary Resuscitation

Part of the book series: Contemporary Cardiology ((CONCARD))

  • 1342 Accesses

Abstract

Bradyasystole is a term encompassing many different types of rhythms meeting the following definition: any electrical rhythm that has a ventricular rate below 60 beats per minute (bpm) in adults and/or periods of absent heart rhythm (asystole). A bradyasystolic state is a clinical condition in which the predominant cardiac rhythm can be classified as bradyasystole. Bradyasystolic rhythms other than asystole may be accompanied by a pulse. A bradyasystolic rhythm even with a pulse is frequently a precursor to cardiac arrest (CA) and requires prompt intervention. Some of the causes of bradyasystole are the same whether or not a pulse is present. More commonly bradyasystole occurs without a pulse. Bradycardic rhythms without a pulse are one group of many different types of rhythms described as pulseless electrical activity (PEA).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 259.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Atkins DL, Hartley LL, York DK. Accurate recognition and effective treatment of ventricular fibrillation by automated external defibrillators in adolescents. Pediatrics 1998; 101(Pt 1):393–397.

    Article  PubMed  CAS  Google Scholar 

  2. Cummins RO, Eisenberg MS, Hallstrom AP, Litwin PE. Survival of out-of-hospital cardiac arrest with early initiation of cardiopulmonary resuscitation. Am J Emerg Med 1985; 3:114–119.

    Article  PubMed  CAS  Google Scholar 

  3. Denes P, Gabster A, Huang SK. Clinical, electrocardiographic and follow-up observations in patients having ventricular fibrillation during Holter monitoring. Role of quinidine therapy. Am J Cardiol 1981; 48:9–16.

    Article  PubMed  CAS  Google Scholar 

  4. Edgren E, Kelsey S, Sutton K, Safar P. The presenting ECG pattern in survivors of cardiac arrest and its relation to the subsequent long-term survival. Brain Resuscitation Clinical Trial I Study Group. Acta Anaesthesiol Scand 1989; 33:265–271.

    PubMed  CAS  Google Scholar 

  5. Eisenberg MS, Horwood BT, Cummins RO, Reynolds-Haertle R, Hearne TR. Cardiac arrest and resuscitation: a tale of 29 cities. Ann Emerg Med 1990; 19:179–186.

    Article  PubMed  CAS  Google Scholar 

  6. Gradman AH, Bell PA, DeBusk RF. Sudden death during ambulatory monitoring. Clinical and electrocardiographic correlations. Report of a case. Circulation 1977; 55:210–211.

    PubMed  CAS  Google Scholar 

  7. Hinkle LE, Jr., Argyros DC, Hayes JC, et al. Pathogenesis of an unexpected sudden death: role of early cycle ventricular premature contractions. Am J Cardiol 1977; 39:873–879.

    Article  PubMed  Google Scholar 

  8. Kempf FC, Jr., Josephson ME. Cardiac arrest recorded on ambulatory electrocardiograms. Am J Cardiol 1984; 53:1577–1582.

    Article  PubMed  Google Scholar 

  9. Lahiri A, Balasubramanian V, Raftery EB. Sudden death during ambulatory monitoring. Br Med J 1979; 1:1676–1678.

    PubMed  CAS  Google Scholar 

  10. Mogayzel C, Quan L, Graves JR, Tiedeman D, Fahrenbruch C, Herndon P. Out-of-hospital ventricular fibrillation in children and adolescents: causes and outcomes. Ann Emerg Med 1995; 25:484–491.

    Article  PubMed  CAS  Google Scholar 

  11. Myerburg RJ, Conde CA, Sung RJ, et al. Clinical, electrophysiologic and hemodynamic profile of patients resuscitated from prehospital cardiac arrest. Am J Med 1980; 68:568–576.

    Article  PubMed  CAS  Google Scholar 

  12. Myerburg RJ, Estes D, Zaman L, et al. Outcome of resuscitation from bradyarrhythmic or asystolic prehospital cardiac arrest. J Am Coll Cardiol 1984; 4:1118–1122.

    PubMed  CAS  Google Scholar 

  13. Myerburg RJ. Sudden cardiac death: epidemiology, causes, and mechanisms. Cardiology 1987; 74(Suppl 2):2–9.

    PubMed  Google Scholar 

  14. Nikolic G, Bishop RL, Singh JB. Sudden death recorded during Holter monitoring. Circulation 1982; 66:218–225.

    PubMed  CAS  Google Scholar 

  15. Panidis IP, Morganroth J. Sudden death in hospitalized patients: cardiac rhythm disturbances detected by ambulatory electrocardiographic monitoring. J Am Coll Cardiol 1983; 2:798–805.

    PubMed  CAS  Google Scholar 

  16. Salerno D, Hodges M, Graham E, Asinger RW, Mikell FL. Fatal cardiac arrest during continuous ambulatory monitoring. N Engl J Med 1981; 305:700.

    PubMed  CAS  Google Scholar 

  17. Savage DD, Castelli WP, Anderson SJ, Kannel WB. Sudden unexpected death during ambulatory electrocardiographic monitoring. The Framingham Study. Am J Med 1983; 74:148–152.

    Article  PubMed  CAS  Google Scholar 

  18. Scott RP. Cardiopulmonary resuscitation in a teaching hospital. A survey of cardiac arrests occurring outside intensive care units and emergency rooms. Anaesthesia 1981; 36:526–530.

    Article  PubMed  CAS  Google Scholar 

  19. Stueven HA, Waite EM, Troiano P, Mateer JR. Prehospital cardiac arrest—a critical analysis of factors affecting survival. Resuscitation 1989; 17:251–259.

    Article  PubMed  CAS  Google Scholar 

  20. Walsh CK, Krongrad E. Terminal cardiac electrical activity in pediatric patients. Am J Cardiol 1983; 51:557–561.

    Article  PubMed  CAS  Google Scholar 

  21. Guidelines for cardiopulmonary resuscitation and emergency cardiac care. Emergency Cardiac Care Committee and Subcommittees, American Heart Association. Part I. Introduction. JAMA 1992; 268:2171–2183.

    Google Scholar 

  22. Bayes dL, Coumel P, Leclercq JF. Ambulatory sudden cardiac death: mechanisms of production of fatal arrhythmia on the basis of data from 157 cases. Am Heart J 1989; 117:151–159.

    Article  Google Scholar 

  23. Pool J, Kunst K, van Wermeskerken JL. Two monitored cases of sudden death outside hospital. Br Heart J 1978; 40:627–629.

    Article  PubMed  CAS  Google Scholar 

  24. Eisenberg MS, Hadas E, Nuri I, et al. Sudden cardiac arrest in Israel: factors associated with successful resuscitation. Am J Emerg Med 1988; 6:319–323.

    Article  PubMed  CAS  Google Scholar 

  25. Iseri LT, Humphrey SB, Siner EJ. Prehospital brady-asystolic cardiac arrest. Ann Intern Med 1978; 88:741–745.

    PubMed  CAS  Google Scholar 

  26. Iseri LT, Siner EJ, Humphrey SB, Mann S. Prehospital cardiac arrest after arrival of the Paramedic Unit. JACEP 1977; 6:530–535.

    PubMed  CAS  Google Scholar 

  27. Chiche P, Lellouch A, Denizeau JP. Autonomic influences and cardiac conduction in patients with sinus node disease. Cardiology 1976; 61(Suppl 1):98–112.

    PubMed  Google Scholar 

  28. Rosen KM, Loeb HS, Sinno MZ, Rahimtoola SH, Gunnar RM. Cardiac conduction in patients with symptomatic sinus node disease. Circulation 1971; 43:836–844.

    PubMed  CAS  Google Scholar 

  29. Lenegre J. Etiology and pathology of bilateral bundle branch block in relation to complete heart block. Prog Cardiovasc Dis 1964; 6:409.

    Article  PubMed  CAS  Google Scholar 

  30. Lev M. The pathology of complete atrioventricular block. Prog Cardiovasc Dis 1964; 6:317.

    Article  PubMed  CAS  Google Scholar 

  31. Lev M. Anatomic basis for atrioventricular block. Am J Med 1964; 37:742.

    Article  PubMed  CAS  Google Scholar 

  32. York RC, Coleridge ST. Cardiopulmonary arrest following intravenous phenytoin loading. Am J Emerg Med 1988; 6:255–259.

    Article  PubMed  CAS  Google Scholar 

  33. Sadjadi SA, Leghari RU, Berger AR. Prolongation of the PR interval induced by methyldopa. Am J Cardiol 1984; 54:675–676.

    Article  PubMed  CAS  Google Scholar 

  34. Antonelli D, Barzilay J. Complete atrioventricular block after sublingual isosorbide dinitrate. Int J Cardiol 1986; 10:71–73.

    Article  PubMed  CAS  Google Scholar 

  35. Brandes W, Santiago T, Limacher M. Nitroglycerin-induced hypotension, bradycardia, and asystole: report of a case and review of the literature. Clin Cardiol 1990; 13:741–744.

    Article  PubMed  CAS  Google Scholar 

  36. Michael TA, Arivazzadek S. The effects of acute chloroquine poisoning with special reference to the heart. Am Heart J 1970; 79:831.

    Article  CAS  Google Scholar 

  37. Montalescot G, Levy Y, Farge D, et al. Lithium causing a serious sinus-node dysfunction at therapeutic doses. Clin Cardiol 1984; 7:617–620.

    PubMed  CAS  Google Scholar 

  38. Ong AC, Handler CE. Sinus arrest and asystole due to severe lithium intoxication. Int J Cardiol 1991; 30:364–366.

    Article  PubMed  CAS  Google Scholar 

  39. Pentel P, Peterson CD. Asystole complicating physostigmine treatment of tricyclic antidepressant overdose. Ann Emerg Med 1980; 9:588–590.

    Article  PubMed  CAS  Google Scholar 

  40. Honey M. The effects of sodium antimony tartrate on the myocardium. Br Heart J 1960; 22:601.

    Article  PubMed  CAS  Google Scholar 

  41. Henretig FM. Lead. In: Goldrank LR, ed. Goldfrank’s Toxicologic Emergencies, sixth edition. New York, NY: McGraw-Hill, 1998, pp. 1277–1309.

    Google Scholar 

  42. Ledbetter MK, Cannon AB, Costa AF. The electrocardiogram in diphtheritic myocarditis. Am Heart J 1964; 68:599.

    Article  PubMed  CAS  Google Scholar 

  43. Weiser E, Wollberg Z, Kochva E, Lee SY. Cardiotoxic effects of the venom of the burrowing asp. Toxicology 1984; 22:767.

    CAS  Google Scholar 

  44. Shih RD, Goldfrank LR. Plants. In: Goldfrank LR, ed. Goldfrank’s Toxicologic Emergencies, sixth edition. McGraw-Hill, New York, 1998, pp. 1243–1259.

    Google Scholar 

  45. Woo OF. Plants and herbal medicines. In: Olson KR, ed. Poisoning and drug overdose, third edition. Stamford: Appleton and Lange, 1999, pp. 265–274.

    Google Scholar 

  46. Thron CD, McCann FV. Studies on the bradycardia and periodic rhythm caused by veratramine in the sinoatrial node of the guinea pig. J Electrocardiol 1998; 31:257–268.

    Article  PubMed  CAS  Google Scholar 

  47. Lampe KF. Rhododendrons, mountain laurel, and mad honey. JAMA 1988; 259:2009.

    Article  PubMed  CAS  Google Scholar 

  48. von Malottki K, Wiechmann HW. [Acute life-threatening bradycardia: food poisoning by Turkish wild honey]. Dtsch Med Wochenschr 1996; 121:936–938.

    Google Scholar 

  49. Lehmann KG, Lane JG, Piepmeier JM, Batsford WP. Cardiovascular abnormalities accompanying acute spinal cord injury in humans: incidence, time course and severity. J Am Coll Cardiol 1987; 10:46–52.

    PubMed  CAS  Google Scholar 

  50. Kewalramani LS. Autonomic dysreflexia in traumatic myelopathy. Am J Phys Med 1980; 59:1–21.

    PubMed  CAS  Google Scholar 

  51. Gold RS, Pollard Z, Buchwald IP. Asystole due to the oculocardiac reflex during strabismus surgery: a report of two cases. Ann Ophthalmol 1988; 20:473–475, 477.

    PubMed  CAS  Google Scholar 

  52. Lang S, Lanigan DT, Van der WM. Trigeminocardiac reflexes: maxillary and mandibular variants of the oculocardiac reflex. Can J Anaesth 1991; 38:757–760.

    PubMed  CAS  Google Scholar 

  53. Precious DS, Skulsky FG. Cardiac dysrhythmias complicating maxillofacial surgery. Int J Oral Maxillofac Surg 1990; 19:279–282.

    Article  PubMed  CAS  Google Scholar 

  54. Valladares BK, Lemberg L. Use of the “diving reflex” in paroxysmal atrial tachycardia. Heart Lung 1983; 12:202–205.

    PubMed  CAS  Google Scholar 

  55. Whitman V, Sakeosian GM. The diving reflex in termination of supraventricular tachycardia in childhood. J Pediatr 1976; 89:1032–1033.

    Article  PubMed  CAS  Google Scholar 

  56. Wildenthal K, Leshin SJ, Atkins JM, Skelton CL. The diving reflex used to treat paroxysmal atrial tachycardia. Lancet 1975; 1:12–14.

    Article  PubMed  CAS  Google Scholar 

  57. Wildenthal K. Treatment of paroxysmal atrial tachycardia by diving reflex. Lancet 1978; 1:1042.

    Article  PubMed  CAS  Google Scholar 

  58. Weiss S., Baker J.P. The carotid sinus reflex in health and disease: its role in the causation of fainting and convulsions. Medicine 1933; 12:297.

    Google Scholar 

  59. Antonelli D, Rosenfeld T. Deglutition syncope associated with carotid sinus hypersensitivity. Pacing Clin Electrophysiol 1997; 20(Pt 1):2282–2283.

    Article  PubMed  CAS  Google Scholar 

  60. Bilbro RH. Syncope after prostatic examination. N Engl J Med 1970; 282:167–168.

    Article  PubMed  CAS  Google Scholar 

  61. Klotz PG. Syncope during prostatic examination. N Engl J Med 1970; 282:1046.

    PubMed  CAS  Google Scholar 

  62. Lieberman A. Syncope after prostatic massage. N Engl J Med 1970; 282:515.

    PubMed  CAS  Google Scholar 

  63. Sakakibara R, Hattori T, Kita K, Yamanishi T, Yasuda K. Urodynamic and cardiovascular measurements in patients with micturition syncope. Clin Auton Res 1997; 7:219–221.

    Article  PubMed  CAS  Google Scholar 

  64. Bhatnagar HN, Shah DR, Gupta RC. Sick sinus syndrome associated with cerebrovascular accident. J Indian Med Assoc 1978; 70:158–160.

    PubMed  CAS  Google Scholar 

  65. Boggs JG, Painter JA, DeLorenzo RJ. Analysis of electrocardiographic changes in status epilepticus. Epilepsy Res 1993; 14:87–94.

    Article  PubMed  CAS  Google Scholar 

  66. Kiok MC, Terrence CF, Fromm GH, Lavine S. Sinus arrest in epilepsy. Neurology 1986; 36:115–116.

    PubMed  CAS  Google Scholar 

  67. Kushner M, Peters RW. Prolonged sinus arrest complicating a thrombotic stroke. Pacing Clin Electrophysiol 1986; 9:248–249.

    Article  PubMed  CAS  Google Scholar 

  68. Myers MG, Norris JW, Hachinski VC, Weingert ME, Sole MJ. Cardiac sequelae of acute stroke. Stroke 1982; 13:838–842.

    PubMed  CAS  Google Scholar 

  69. Weintraub BM, McHenry LC, Jr. Cardiac abnormalities in subarachnoid hemorrhage: a resume. Stroke 1974; 5:384–392.

    PubMed  CAS  Google Scholar 

  70. Greenland P, Griggs RC. Arrhythmic complications in the Guillain-Barre syndrome. Arch Intern Med 1980; 140:1053–1055.

    Article  PubMed  CAS  Google Scholar 

  71. Dickey RP, Ziter FA, Smith RA. Emery-Dreifuss muscular dystrophy. J Pediatr 1984; 104:555–559.

    Article  PubMed  CAS  Google Scholar 

  72. Fairfax AJ, Lambert CD. Neurological aspects of sinoatrial heart block. J Neurol Neurosurg Psychiatry 1976; 39:576–580.

    PubMed  CAS  Google Scholar 

  73. Gottdiener JS, Sherber HS, Hawley RJ, Engel WK. Cardiac manifestations in polymyositis. Am J Cardiol 1978; 41:1141–1149.

    Article  PubMed  CAS  Google Scholar 

  74. Griggs RC, Davis RJ, Anderson DC, Dove JT. Cardiac conduction in myotonic dystrophy. Am J Med 1975; 59:37–42.

    Article  PubMed  CAS  Google Scholar 

  75. Hassan Z., Fastabend CP, Mohanty PK, Isaacs ER. Atrioventricular block and supraventricular arrhythmias with X-linked muscular dystrophy. Circulation 1979; 60:1365–1369.

    Google Scholar 

  76. Meier C, Gertsch M, Zimmerman A, Voellmy W, Geissbuhler J. Nemaline myopathy presenting as cardiomyopathy. N Engl J Med 1983; 308:1536–1537.

    PubMed  CAS  Google Scholar 

  77. Roberts NK, Perloff JK, Kark RA. Cardiac conduction in the Kearns-Sayre syndrome (a neuromuscular disorder associated with progressive external ophthalmoplegia and pigmentary retinopathy). Report of 2 cases and review of 17 published cases. Am J Cardiol 1979; 44:1396–1400.

    Article  PubMed  CAS  Google Scholar 

  78. Rtinov G, Baker WP, Swaiman KF. McArdle’s syndrome with previously unreported electrocardiographic and serum enzyme abnormalities. Ann Intern Med 1965; 62:328.

    Google Scholar 

  79. Bashour T, Hsu I, Gorfinkel HJ, Wickramesekaran R, Rios JC. Atrioventricular and intraventricular conduction in hyperkalemia. Am J Cardiol 1975; 35:199–203.

    Article  PubMed  CAS  Google Scholar 

  80. Vanhaelst L, Neve P, Chailly P, Bastenie PA. Coronary-artery disease in hypothyroidism. Observations in clinical myxoedema. Lancet 1967; 2:800–802.

    Article  PubMed  CAS  Google Scholar 

  81. Rossi L, Thiene G, Caragaro L, Giordano R, Lauro S. Dysrhythmias and sudden death in acromegalic heart disease. A clinicopathologic study. Chest 1977; 72:495–498.

    Article  PubMed  CAS  Google Scholar 

  82. Krug JJ. Cardiac arrest secondary to Addison’s disease. Ann Emerg Med 1986; 15:735–737.

    Article  PubMed  CAS  Google Scholar 

  83. Walker C, Butt W. A case of cardiovascular collapse due to adrenal insufficiency. Aust Paediatr J 1988; 24:197–198.

    PubMed  CAS  Google Scholar 

  84. Gibbs MA, Wolfson AB, Tayal VS. Electrolyte disturbances. In: Emergency Medicine Concepts and Clinical Practice. 4th edition. Rosen P, Ed. St Louis, MO: Mosby, 1998, pp. 2432–2456.

    Google Scholar 

  85. Bashour TT, Antonini C, Sr., Fisher J. Severe sinus node dysfunction in obstructive jaundice. Ann Intern Med 1985; 103:384–385.

    PubMed  CAS  Google Scholar 

  86. Ornato JP. Special resuscitation situations: near drowning, traumatic injury, electric shock, and hypothermia. Circulation 1986; 74(Pt 2):IV23–IV26.

    PubMed  CAS  Google Scholar 

  87. Anzi M, Ippoliti B, Zamperetti N. [Inter-atrial dissociation. Description of a case]. Folia Cardiol 1968; 27:113–119.

    PubMed  CAS  Google Scholar 

  88. Arita M, Ueno Y, Masuyama Y. Complete heart block in mumps myocarditis. Br Heart J 1981; 46:342–344.

    Article  PubMed  CAS  Google Scholar 

  89. Bairan AC, Cherry JD, Fagan LF, Codd JE, Jr. Complete heart block and respiratory syncytial virus infection. Am J Dis Child 1974; 127:264–265.

    PubMed  CAS  Google Scholar 

  90. Bell H. Cardiac manifestations of viral hepatitis. JAMA 1971; 218:387–391.

    Article  PubMed  CAS  Google Scholar 

  91. Marc MO, Anconina J, Dodinot B, et al. [Irreversible auriculo-ventricular block of viral origin]. Ann Cardiol Angeiol (Paris) 1993; 42:23–24.

    CAS  Google Scholar 

  92. Verel D, Warrack AJ, Potter CW, Ward C, Rickards DF. Observations on the A2 England influenza epidemic: a clinicopathological study. Am Heart J 1976; 92:290–296.

    Article  PubMed  CAS  Google Scholar 

  93. Obeyesekere I, Hermon Y. Myocarditis and cardiomyopathy after arbovirus infections (dengue and chikungunya fever). Br Heart J 1972; 34:821–827.

    Article  PubMed  CAS  Google Scholar 

  94. Wallis PJ, Branfoot AC, Emerson PA. Sudden death due to myocardial tuberculosis. Thorax 1984; 39:155–156.

    PubMed  CAS  Google Scholar 

  95. Caraco J, Arnon R, Raz I. Atrioventricular block complicating acute streptococcal tonsillitis. Br Heart J 1988; 59:389–390.

    Article  PubMed  CAS  Google Scholar 

  96. Sandler MA, Pincus PS, Weltman MD, et al. Meningococcaemia complicated by myocarditis. A report of 2 cases. S Afr Med J 1989; 75:391–393.

    PubMed  CAS  Google Scholar 

  97. Thanopoulos BD, Rokas S, Frimas CA, Mantagos SP, Beratis NG. Cardiac involvement in postnatal rubella. Acta Paediatr Scand 1989; 78:141–144.

    PubMed  CAS  Google Scholar 

  98. Kirchner GI, Krug N, Bleck JS, Fliser D, Manns MP, Wagner S. [Fulminant course of leptospirosis complicated by multiple organ failure]. Z Gastroenterol 2001; 39:587–592.

    Article  PubMed  CAS  Google Scholar 

  99. Nicolas G, Leborgne P, Menuet JC, Bouhour JB, Pony JC, Godin JF. [A case of complete atrioventricular block caused by syphilitic gumma of the interventricular septum]. Arch Mal Coeur Vaiss 1973; 66:925–933.

    PubMed  CAS  Google Scholar 

  100. Wengrower D, Knobler H, Gillis S, Chajek-Shaul T. Myocarditis in tick-borne relapsing fever. J Infect Dis 1984; 149:1033.

    PubMed  CAS  Google Scholar 

  101. Steere AC, Batsford WP, Weinberg M, et al. Lyme carditis: cardiac abnormalities of Lyme disease. Ann Intern Med 1980; 93:8–16.

    PubMed  CAS  Google Scholar 

  102. Veyssier P, Davous N, Kaloustian E, Maitre B, Lallement PY, Serret A. [Cardiac involvement in Lyme disease. 2 cases]. Rev Med Interne 1987; 8:357–360.

    PubMed  CAS  Google Scholar 

  103. Pimenta J, Miranda M, Pereira CB. Electrophysiologic findings in long-term asymptomatic chagasic individuals. Am Heart J 1983; 106:374–380.

    Article  PubMed  CAS  Google Scholar 

  104. Hall JC, Giltman LI. Candida myocarditis in a patient with chronic active hepatitis and macronodular cirrhosis. J Tenn Med Assoc 1986; 79:473–476.

    PubMed  CAS  Google Scholar 

  105. Bognolo DA, Rabow FI, Vijayanagar RR, Eckstein PF. Traumatic sinus node dysfunction. Ann Emerg Med 1982; 11:319–321.

    Article  PubMed  CAS  Google Scholar 

  106. Friedman HS, Gomes JA, Tardio AR, Haft JI. The electrocardiographic features of acute cardiac tamponade. Circulation 1974; 50:260–265.

    PubMed  CAS  Google Scholar 

  107. Vestri A, D’Intino S, Mazzacurati G. [Electrophysiological repercussions of pericardial effusion on the activity of the artificial pacemaker]. Policlinico [Med ] 1966; 73:246–256.

    CAS  Google Scholar 

  108. Applefeld M.M., Pollock S.H. Cardiac disease in patients who have malignancies. Curr Prob Cardiol 1980; 4:5.

    Article  Google Scholar 

  109. Cole TO, Attah EB, Onyemelukwe. Burkitt’s lymphoma presenting with heart block. Br Heart J 1975; 37:94–97.

    Article  PubMed  CAS  Google Scholar 

  110. Nishida K, Kamijima G, Nagayama T. Mesothelioma of the atrioventricular node. Br Heart J 1985; 53:468–470.

    Article  PubMed  CAS  Google Scholar 

  111. Anzai N, Akiyama K, Tsuchida K, Yamada M, Kito S, Yamamura Y. Treatment by pacemaker in familial amyloid polyneuropathy. Chest 1989; 96:80–84.

    Article  PubMed  CAS  Google Scholar 

  112. Bharati S, Lev M, Denes P, et al. Infiltrative cardiomyopathy with conduction disease and ventricular arrhythmia: electrophysiologic and pathologic correlations. Am J Cardiol 1980; 45:163–173.

    Article  PubMed  CAS  Google Scholar 

  113. Aronow WS, Meister L, Kent JR. Atrioventricular block in familial hemochromatosis treated by permanent synchronous pacemaker. Arch Intern Med 1969; 123:433–435.

    Article  PubMed  CAS  Google Scholar 

  114. Rosenqvist M, Hultcrantz R. Prevalence of a haemochromatosis among men with clinically significant bradyarrhythmias. Eur Heart J 1989; 10:473–478.

    PubMed  CAS  Google Scholar 

  115. Ahern M, Lever JV, Cosh J. Complete heart block in rheumatoid arthritis. Ann Rheum Dis 1983; 42:389–397.

    Article  PubMed  CAS  Google Scholar 

  116. Maisch B, Lotze U, Schneider J, Kochsiek K. Antibodies to human sinus node in sick sinus syndrome. Pacing Clin Electrophysiol 1986; 9(Pt 2):1101–1109.

    Article  PubMed  CAS  Google Scholar 

  117. Ohkawa S, Miyao M, Chida K, et al. Extensive involvement of the myocardium and the cardiac conduction system in a case of Wegener’s granulomatosis. Jpn Heart J 1999; 40:509–515.

    Article  PubMed  CAS  Google Scholar 

  118. Sairanen E, Paronen I, Mahonen H. Reiter’s syndrome: a follow-up study. Acta Med Scand 1969; 185:57–63.

    Article  PubMed  CAS  Google Scholar 

  119. Zipes DP. Genesis of cardia arrhythmias: electrophysiological considerations. In: Heart Disease, 5th edition. Braunwald E, ed. Philadelphia, PA: W. B. Saunders Company, 1997, pp. 548–592.

    Google Scholar 

  120. James TN. The coronary circulation and conduction system in acute myocardial infarction. Prog Cardiovasc Dis 1968; 10:410–449.

    Article  PubMed  CAS  Google Scholar 

  121. Wesley RC, Jr., Belardinelli L. Role of endogenous adenosine in postdefibrillation bradyarrhythmia and hemodynamic depression. Circulation 1989; 80:128–137.

    PubMed  CAS  Google Scholar 

  122. Belardinelli L, Linden J, Berne RM. The cardiac effects of adenosine. Prog Cardiovasc Dis 1989; 32: 73–97.

    Article  PubMed  CAS  Google Scholar 

  123. Schrader J, Baumann G, Gerlach E. Adenosine as inhibitor of myocardial effects of catecholamines. Pflugers Arch 1977; 372:29–35.

    Article  PubMed  CAS  Google Scholar 

  124. Belardinelli L, Isenberg G. Isolated atrial myocytes: adenosine and acetylcholine increase potassium conductance. Am J Physiol 1983; 244:H734–H737.

    PubMed  CAS  Google Scholar 

  125. Belardinelli L, Giles WR, West A. Ionic mechanisms of adenosine actions in pacemaker cells from rabbit heart. J Physiol 1988; 405:615–633.

    PubMed  CAS  Google Scholar 

  126. West GA, Belardinelli L. Correlation of sinus slowing and hyperpolarization caused by adenosine in sinus node. Pflugers Arch 1985; 403:75–81.

    Article  PubMed  CAS  Google Scholar 

  127. Clemo HF, Belardinelli L. Effect of adenosine on atrioventricular conduction. I: Site and characterization of adenosine action in the guinea pig atrioventricular node. Circ Res 1986; 59:427–436.

    PubMed  CAS  Google Scholar 

  128. Lloyd HG, Deussen A, Wuppermann H, Schrader J. The transmethylation pathway as a source for adenosine in the isolated guinea-pig heart. Biochem J 1988; 252:489–494.

    PubMed  CAS  Google Scholar 

  129. Olsson RA, Gentry MK, Townsend RS. Adenosine metabolism: properties of dog heart microsomal 5′-nucleotidase. Adv Exp Med Biol 1973; 39:27–39.

    PubMed  CAS  Google Scholar 

  130. Kaseda S, Zipes DP. Supersensitivity to acetylcholine of canine sinus and AV nodes after parasympathetic denervation. Am J Physiol 1988; 255(Pt 2):H534–H539.

    PubMed  CAS  Google Scholar 

  131. Ellenbogen KA, Thames MD, DiMarco JP, Sheehan H, Lerman BB. Electrophysiological effects of adenosine in the transplanted human heart. Evidence of supersensitivity. Circulation 1990; 81:821–828.

    PubMed  CAS  Google Scholar 

  132. Malliani A, Schwartz PJ, Zanchetti A. A sympathetic reflex elicited by experimental coronary occlusion. Am J Physiol 1969; 217:703–709.

    PubMed  CAS  Google Scholar 

  133. Malliani A, Recordati G, Schwartz PJ. Nervous activity of afferent cardiac sympathetic fibres with atrial and ventricular endings. J Physiol 1973; 229:457–469.

    PubMed  CAS  Google Scholar 

  134. Recordati G, Schwartz PJ, Pagani M, Malliani A, Brown AM. Activation of cardiac vagal receptors during myocardial ischemia. Experientia 1971; 27:1423–1424.

    Article  PubMed  CAS  Google Scholar 

  135. Thoren PN. Activation of left ventricular receptors with nonmedullated vagal afferent fibers during occlusion of a coronary artery in the cat. Am J Cardiol 1976; 37:1046–1051.

    Article  PubMed  CAS  Google Scholar 

  136. Herre JM, Wetstein L, Lin YL, Mills AS, Dae M, Thames MD. Effect of transmural versus nontransmural myocardial infarction on inducibility of ventricular arrhythmias during sympathetic stimulation in dogs. J Am Coll Cardiol 1988; 11:414–421.

    PubMed  CAS  Google Scholar 

  137. Inoue H, Skale BT, Zipes DP. Effects of ischemia on cardiac afferent sympathetic and vagal reflexes in dog. Am J Physiol 1988; 255(Pt 2):H26–H35.

    PubMed  CAS  Google Scholar 

  138. Engel GL. Sudden and rapid death during psychological stress. Folklore or folk wisdom? Ann Intern Med 1971; 74:771–782.

    PubMed  CAS  Google Scholar 

  139. Lown B, Verrier RL. Neural activity and ventricular fibrillation. N Engl J Med 1976; 294:1165–1170.

    Article  PubMed  CAS  Google Scholar 

  140. Lown B, Verrier RL, Rabinowitz SH. Neural and psychologic mechanisms and the problem of sudden cardiac death. Am J Cardiol 1977; 39:890–902.

    Article  PubMed  CAS  Google Scholar 

  141. Lown B. Sudden cardiac death—1978. Circulation 1979; 60:1593–1599.

    PubMed  CAS  Google Scholar 

  142. Wolf S. The end of the rope: the role of the brain in cardiac death. Can Med Assoc J 1967; 97:1022–1025.

    PubMed  CAS  Google Scholar 

  143. Brown CG, Werman HA. Adrenergic agonists during cardiopulmonary resuscitation. Resuscitation 1990; 19:1–16.

    Article  PubMed  CAS  Google Scholar 

  144. Lewin NA. Cardiac glycosides. In: Goldfrank’s Toxicologic Emergencies, sixth edition. Goldfrank LR, ed. New York, NY: McGraw Hill, 1998, pp. 801–807.

    Google Scholar 

  145. Howland MA. Cardiac glycosides: digoxin-specific antibody fragments. In: Goldfrank’s Toxicologic Emergencies. 6th edition. Goldfrank LR, ed. New York, NY: McGraw Hill, 1998, pp. 801–807.

    Google Scholar 

  146. Brubacher JR, Howland MA. Beta-adrenergic antagonists. In: Goldfrank’s Toxicologic Emergencies, sixth edition. Goldfrank LR, ed. New York, NY: McGraw Hill, 1998, pp. 809–828.

    Google Scholar 

  147. Saitz R, Williams BW, Farber HW. Atenolol-induced cardiovascular collapse treated with hemodialysis. Crit Care Med 1991; 19:116–118.

    Article  PubMed  CAS  Google Scholar 

  148. Boehnert MT, Lovejoy FH, Jr. Value of the QRS duration versus the serum drug level in predicting seizures and ventricular arrhythmias after an acute overdose of tricyclic antidepressants. N Engl J Med 1985; 313:474–479.

    Article  PubMed  CAS  Google Scholar 

  149. Benowitz NL. Lithium. In: Poisoning and Drug Overdose, third edition. Olson KR, ed. Stamford: Appleton and Lange, 1999, pp. 204–206.

    Google Scholar 

  150. Part 6: Advanced cardiovascular life support, section 5: Pharmacology I: Agents for arrhythmias. Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2000; 102:I-112–I-128.

    Google Scholar 

  151. Brown DC, Lewis AJ, Criley JM. Asystole and its treatment: the possible role of the parasympathetic nervous system in cardiac arrest. JACEP 1979; 8:448–452.

    PubMed  CAS  Google Scholar 

  152. Gupta K, Lichstein E, Chadda KD. Transient atrioventricular standstill. Etiology and management. JAMA 1975; 234:1038–1042.

    Article  PubMed  CAS  Google Scholar 

  153. DeBehnke DJ, Swart G, Spreng D, Aufderheide T. Effects of atropine on resuscitation from pulseless electrical activity. Crit Care Med 1995; 23:A175 (abstract).

    Google Scholar 

  154. Engdahl J, Bang A, Lindqvist J, Herlitz J. Can we define patients with no and those with some chance of survival when found in asystole out of hospital? Am J Cardiol 2000; 86:610–614.

    Article  PubMed  CAS  Google Scholar 

  155. Paradis NA, Martin GB, Rivers EP, et al. Coronary perfusion pressure and the return of spontaneous circulation in human cardiopulmonary resuscitation. JAMA 1990; 263:1106–1113.

    Article  PubMed  CAS  Google Scholar 

  156. Sanders AB, Ogle M, Ewy GA. Coronary perfusion pressure during cardiopulmonary resuscitation. Am J Emerg Med 1985; 3:11–14.

    Article  PubMed  CAS  Google Scholar 

  157. Part 6: Advanced cardiovascular life support, section 7C: A guide to the international ACLS algorithms. Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2000; 102:I-142–I-157.

    Google Scholar 

  158. Brown CG, Werman HA, Davis EA, Hamlin R, Hobson J, Ashton JA. Comparative effect of graded doses of epinephrine on regional brain blood flow during CPR in a swine model. Ann Emerg Med 1986; 15:1138–1144.

    Article  PubMed  CAS  Google Scholar 

  159. Brown CG, Werman HA, Davis EA, Hobson J, Hamlin RL. The effects of graded doses of epinephrine on regional myocardial blood flow during cardiopulmonary resuscitation in swine. Circulation 1987; 75:491–497.

    PubMed  CAS  Google Scholar 

  160. Brunette DD, Jameson SJ. Comparison of standard versus high-dose epinephrine in the resuscitation of cardiac arrest in dogs. Ann Emerg Med 1990; 19:8–11.

    Article  PubMed  CAS  Google Scholar 

  161. Kosnik JW, Jackson RE, Keats S, Tworek RM, Freeman SB. Dose-related response of centrally administered epinephrine on the change in aortic diastolic pressure during closed-chest massage in dogs. Ann Emerg Med 1985; 14:204–4208.

    Article  PubMed  CAS  Google Scholar 

  162. Lindner KH, Ahnefeld FW, Prengel AW. Comparison of standard and high-dose adrenaline in the resuscitation of asystole and electromechanical dissociation. Acta Anaesthesiol Scand 1991; 35:253–256.

    PubMed  CAS  Google Scholar 

  163. Paradis NA, Martin GB, Rosenberg J, et al. The effect of standard-and high-dose epinephrine on coronary perfusion pressure during prolonged cardiopulmonary resuscitation. JAMA 1991; 265:1139–1144.

    Article  PubMed  CAS  Google Scholar 

  164. Brown CG, Katz SE, Werman HA, Luu T, Davis EA, Hamlin RL. The effect of epinephrine versus methoxamine on regional myocardial blood flow and defibrillation rates following a prolonged cardiorespiratory arrest in a swine model. Am J Emerg Med 1987; 5:362–369.

    Article  PubMed  CAS  Google Scholar 

  165. Brown CG, Werman HA, Davis EA, Katz S, Hamlin RL. The effect of high-dose phenylephrine versus epinephrine on regional cerebral blood flow during CPR. Ann Emerg Med 1987; 16:743–748.

    Article  PubMed  CAS  Google Scholar 

  166. Brown CG, Davis EA, Werman HA, Hamlin RL. Methoxamine versus epinephrine on regional cerebral blood flow during cardiopulmonary resuscitation. Crit Care Med 1987; 15:682–686.

    Article  PubMed  CAS  Google Scholar 

  167. Brown CG, Taylor RB, Werman HA, Luu T, Ashton J, Hamlin RL. Myocardial oxygen delivery/consumption during cardiopulmonary resuscitation: a comparison of epinephrine and phenylephrine. Ann Emerg Med 1988; 17:302–308.

    Article  PubMed  Google Scholar 

  168. Robinson LA, Brown CG, Jenkins J, et al. The effect of norepinephrine versus epinephrine on myocardial hemodynamics during CPR. Ann Emerg Med 1989; 18:336–340.

    Article  PubMed  CAS  Google Scholar 

  169. Silfvast T, Saarnivaara L, Kinnunen A, et al. Comparison of adrenaline and phenylephrine in out-of-hospital cardiopulmonary resuscitation. A double-blind study. Acta Anaesthesiol Scand 1985; 29: 610–613.

    Article  PubMed  CAS  Google Scholar 

  170. Hoffman BB. Adrenoceptro-Activating and Other Sympathomimetic Drugs. In: Basic and Clinical Pharmacology, sixth edition. Katzungl BG, ed. Norwalk: Appleton and Lange, 1995, pp. 115–131.

    Google Scholar 

  171. Jaffe R, Weiss AT, Rosenheck S. Combined isoproterenol and epinephrine for the resuscitation of patients with cardiac asystole secondary to coronary artery disease. Am J Cardiol 1996; 77:194–195.

    Article  PubMed  CAS  Google Scholar 

  172. Part 8: Advanced challenges in resuscitation, section 1: Life threatening electrolyte abnormalities. Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2000; 102:I-217–I-222.

    Google Scholar 

  173. Berenyi KJ, Wolk M, Killip T. Cerebrospinal fluid acidosis complicating therapy of experimental cardiopulmonary arrest. Circulation 1975; 52:319–324.

    PubMed  CAS  Google Scholar 

  174. Kette F, Weil MH, von Planta M, Gazmuri RJ, Rackow EC. Buffer agents do not reverse intramyocardial acidosis during cardiac resuscitation. Circulation 1990; 81:1660–1666.

    PubMed  CAS  Google Scholar 

  175. Kette F, Weil MH, Gazmuri RJ. Buffer solutions may compromise cardiac resuscitation by reducing coronary perfusion presssure. JAMA 1991; 266:2121–2126.

    Article  PubMed  CAS  Google Scholar 

  176. Part 6: Advanced cardiovascular life support, section 6: Pharmacology II: Agents to optimize cardiac output and blood pressure. Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2000; 102:I-129–I-135.

    Google Scholar 

  177. Benowitz NL. Tricycylic Antidepressants. In: Poisoning and Drug Overdose, third edition. Olson KR, ed. Stamford: Appleton and Lange, 1999, pp. 310–312.

    Google Scholar 

  178. Barthell E, Troiano P, Olson D, Stueven HA, Hendley G. Prehospital external cardiac pacing: a prospective, controlled clinical trial. Ann Emerg Med 1988; 17:1221–1226.

    Article  PubMed  CAS  Google Scholar 

  179. Cummins RO, Graves JR, Larsen MP, et al. Out-of-hospital transcutaneous pacing by emergency medical technicians in patients with asystolic cardiac arrest. N Engl J Med 1993; 328:1377–1382.

    Article  PubMed  CAS  Google Scholar 

  180. Manning JE, Zoll P.M. Therapy of bradyasystolic arrest. In: Cardiac Arrest: The Science and Practice of Resuscitation Medicine. Paradis NA, Halperin HR, Nowak RM, eds. Baltimore: Williams and Wilkins, 1996, p. 627.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Cady, C.E., Aufderheide, T.P. (2005). Etiology, Electrophysiology, Myocardial Energy Mechanics, and Treatment of Bradyasystole. In: Ornato, J.P., Peberdy, M.A. (eds) Cardiopulmonary Resuscitation. Contemporary Cardiology. Humana Press. https://doi.org/10.1385/1-59259-814-5:123

Download citation

  • DOI: https://doi.org/10.1385/1-59259-814-5:123

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-283-4

  • Online ISBN: 978-1-59259-814-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics