Cardiac arrest, though not common during coronary angiography, is increasingly occurring in the catheterization laboratory because of the expanding complexity of percutaneous interventions (PCI) and the patient population being treated. Manual chest compression in the cath lab is not easily performed, often interrupted, and can result in the provider experiencing excessive radiation exposure. Mechanical
cardiopulmonary resuscitation (
CPR) provides unique advantages over manual performance of chest compression for treating
cardiac arrest in the cardiac cath lab. Such advantages include the potential for uninterrupted chest compressions, less radiation exposure, better quality chest compressions, and less crowded conditions around the catheterization table, allowing more attention to ongoing PCI efforts during
CPR.
Out-of-hospital cardiac arrest patients not responding to standard ACLS
therapy can be transported to the hospital while mechanical
CPR is being performed to provide safe and continuous chest compressions en route. Once at the hospital, advanced circulatory support can be instituted during ongoing mechanical
CPR. This article summarizes the epidemiology, pathophysiology and nature of
cardiac arrest in the cardiac cath lab and discusses the mechanics of
CPR and defibrillation in that setting. It also reviews the various types of mechanical
CPR and their potential roles in and on the way to the laboratory. (Circ J 2016; 80: 1292-1299).