Peri-mortem arrhythmias in the non-cardiac intensive care unit.
Iva Okaj, Maria E Vadakken, Emilie P Belley-Côté and 5 others
PMID 38828923WHAT IT FOUND
In dying ICU patients monitored at the end of life, 56% had a sustained arrhythmia lasting at least 30 seconds in the final hour.
Several rhythm types were seen, but the study cannot show they caused death.
Key findings
01Among 39 dying ICU patients monitored at the time of death, 56% had a clinically significant rhythm lasting at least 30 seconds in the final hour.
02In the monitored deaths, the recorded rhythms included nine instances of VF/PMVT (23%), seven sinoatrial pauses (18%), six AF (15%), and five high-grade AV blocks (13%).
03AF was a terminal arrhythmia in all three participants with intracranial haemorrhage, and VF co-occurred with several causes of death, most often multi-organ failure (33%).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only some deaths were monitored at the time of death, so the results do not describe every dying ICU patient. The sample was small. Some patches were removed because of patient or family preference at the end of life. The study was mainly descriptive and could not tell whether arrhythmias caused death or were only markers of imminent death.
Declared interests
The AFOTS Incidence Study was funded in part by peer. The remaining authors disclosed that they do not have any potential conflicts of interest.
The easy way to misread this
Do not read a new arrhythmia as proof that it caused death or as a validated bedside sign of imminent death. This was a small descriptive analysis, and the authors state they cannot tell which rhythms were markers of death and which were causative.