J Korean Med Sci.  2022 Dec;37(48):e334. 10.3346/jkms.2022.37.e334.

Delayed Presentation of Spontaneous Shockable Rhythm After Death: Another Subtype of Lazarus Phenomenon?

Affiliations
  • 1Department of Emergency Medicine, Dankook University Hospital, College of Medicine, Dankook University, Cheonan, Korea
  • 2Department of Emergency Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea

Abstract

Lazarus phenomenon was defined as spontaneous circulatory restoration after death. It is important because survival discharge is possible. A 44-year-old woman developed traumatic cardiac arrest. She was declared dead after 30 minutes of resuscitation. Suddenly, pulseless ventricular tachycardia was shown after 6 minutes of death declaration. Resuscitation with epinephrine injection was resumed but was terminated after 7 minutes, and she was declared dead once more. A case where an electrocardiography appears spontaneously should be classified as a subtype of the Lazarus phenomenon. If the transition from asystole to spontaneous shockable rhythm follows a mechanism similar to that of the Lazarus phenomenon, active resuscitation and monitoring for a period of time following death declaration should be considered.

Keyword

Autoresuscitation; Lazarus Phenomenon; Return of Spontaneous Circulation; Out-of-Hospital Cardiac Arrest

Figure

  • Fig. 1 Pulseless ventricular tachycardia was developed after 6 minutes of the initial death declaration.ECG = electrocardiography.

  • Fig. 2 Supraventricular tachycardia without pulsation (pulseless electrical activity) was noted after defibrillation.

  • Fig. 3 No return of circulation was achieved after additional 7 minutes of CPR. Asystole developed.CPR = cardiopulmonary resuscitation.


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