Electromechanical decoupling

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The electro-mechanical decoupling , synonym electromechanical dissociation ( EMD ), or pulseless electrical activity ( PEA ), is a special form of cardiac arrest , in which in spite of electrical activity of the heart no cardiac output in the form of a pulse is provided. If left untreated, it leads to death in a short time.

The causes of the development are often potentially reversible and can be treated successfully. Possible reasons for this are: acute myocardial infarction , pulmonary embolism (occlusion of pulmonary vessels), tension pneumothorax (excess air pressure in the lungs), intoxication (poisoning), drug abuse , electrical accidents , cardiac tamponade (blood accumulation in the pericardium), hypoxia (lack of oxygen), potassium dysregulation Hyperkalaemia / hypokalaemia ), acid-base regulation disorder ( acidosis (hyperacidity) or alkalosis ), hypovolemia (lack of volume) or hypothermia (hypothermia).

A PEA must not be defibrillated . With constant cardiopulmonary resuscitation , it is initially treated with adrenaline medication. Whenever possible, the underlying cause needs to be treated. The use of an external cardiac pacemaker is also an option .


  • JP Nolan, CD Deakin, J. Soar et al .: European Resuscitation Council guidelines for resuscitation 2005. Section 4. Adult advanced life support. (2005) Resuscitation. 67 Suppl 1, pp. S39-S86. PMID 16321716

Individual evidence

  1. Heiner Greten , Tim Greten, Franz Rinninger: Internal medicine . Georg Thieme Verlag, 2010, ISBN 978-3-13-162183-2 ( limited preview in Google Book Search [accessed June 4, 2016]).