Terminal electrocardiographic changes in brain-dead patients.
We analyzed ECGs of 18 brain-dead patients from the time of termination of ventilation until cessation of electrocardiographic activity. Gradual slowing of the atrial mechanism was followed by AV block or a gradually slowing junctional escape rhythm. Despite progressive failure of atrial and junctional pacemakers, none had a ventricular escape rhythm. There were three terminal rhythms: (1) atrial activity only, (2) slow junctional rhythm or sinus bradycardia, or (3) ventricular tachycardia (VT). A prolonged QT interval, corrected for rate, was related to later development of VT. One hypothermic and three euthermic patients had J waves.
D001926:Brain Death; D004569:Electroencephalography; D006327:Heart Block / Q000209:etiology; D006352:Heart Ventricles; D006801:Humans; D007275:Injections, Intravenous; D010656:Phenylephrine / Q000009:adverse effects; D012121:Respiration, Artificial; D013312:Stress, Physiological / Q000209:etiology / Q000503:physiopathology; D013610:Tachycardia / Q000139:chemically induced / Q000209:etiology; D014693:Ventricular Fibrillation / Q000209:etiology
D010656:Phenylephrine