What does pulseless electrical activity (PEA) indicate?

Pulseless electrical activity (PEA) indicates a state where there is electrical activity observed on the electrocardiogram (ECG), but this activity is not accompanied by effective mechanical contractions of the heart, resulting in the absence of a detectable pulse. In PEA, the heart may show signs of rhythm, but these rhythms do not translate into effective heartbeats or an adequate perfusion of blood to the body's tissues.

This condition often arises in various clinical scenarios, including severe hypovolemia, cardiac tamponade, or metabolic disturbances, where the heart's ability to contract is compromised despite the electrical activity showing normal or even abnormal rhythms. Thus, the presence of electrical activity without a corresponding mechanical heartbeat ultimately defines PEA, highlighting the critical need for immediate intervention to restore effective cardiac function to revive the patient.