Near-death experiences and electrocardiogram patterns in out-of-hospital cardiac arrest survivors: a prospective observational study

Aim. To determine the effect of several factors, that are a part of cardiac arrest and resuscitation, on the incidence of near-death experiences (NDEs).

Methods. We conducted a prospective observational study in the three largest hospitals in Slovenia in a consecutive sample of patients after out-of-hospital primary cardiac arrest. The presence of NDE was assessed with the self-administered Greyson’s near-death experiences scale. The electrocardiogram pattern at the beginning of resuscitation was recorded. Main outcome measure was the presence of near-death experiences. Univariate analysis was used.

Results. The study included 52 patients. There were 42 (80.8%) males in the sample; median age ± standard deviation of the patients was 53.1 ± 14.5 years. Near-death experiences were reported by 11 (21.2%) patients. Patients with ventricular fibrillation had significantly less NDEs than other patients (12.2% vs. 54.5%, P = 0.006). Patients with pulseless electrical activity had significantly more NDEs than others (60.0% vs. 11.9%, P = 0.003). Patients with asystole and pulseless electrical fibrillation had significantly more NDEs than patients who had ventricular fibrillation and ventricular tachycardia (60.0% vs. 11.9%, P = 0.003). Patients with at least one defibrillation attempt had significantly less near-death experiences than others (62.5% vs. 13.6%, P = 0.007).

Conclusion. Our study found a possible correlation between electrocardiogram pattern in cardiac arrest patients and the incidence of near-death experiences. Further studies should address this problem in larger samples.

near-death experienc-es, electrocardiogram, heart arrest, incidence, prospective study, resus-citation

1. Greyson B. A typology of near-death experiences. Am J Psychiatry 1985;142:967-9.

2. van Lommel P, van Wees R, Meyers V, Elferich I. Near-death experience in survivors of cardiac arrest: a prospective study in the Nether-lands. Lancet 2001;358:2039-45.

3. Parnia S. Do reports of consciousness during cardiac arrest hold the key to discovering the nature of consciousness? Medical Hypotheses 2007;69:933-7.

4. Parnia S, Waller DG, Yeates R, Fenwick P. A qualitative and quantitative study of the incidence, features and aetiology of near death expe-riences in cardiac arrest survivors. Resuscitation 2001;48:149-56.

5. Schwaninger J, Eisenberg PR, Schechtman KB, Weiss AN. A prospective analysis of near-death experiences in cardiac arrest patients. J Near-Death Studies 2002;20:215-32.

6. Greyson B. Incidence and correlates of near-death experiences in a cardiac care unit. Gen Hosp Psychiatry 2003;25:269-76.

7. Greyson B. Dissociation in people who have near-death experiences: out of their bodies or out of their minds? Lancet 2000;355:460-3.

8. Whinnery J. Psychophysiologic correlates of unconsciousness and near-death experiences. J Near Death Stud 1997;15:231-58.

9. Blackmore SJ. Near-death experiences. J R Soc Med 1996;89:73-6.

10. Judson IR, Wiltshaw E. A near-death experience. Lancet 1983;3:561-2.

11. Morse ML, Venecia D, Milstein J. Near-death experiences: a neurophysiological explanatory model. J Near-Death Stud 1989;8:45-53.

12. Jansen KLR. The ketamine model of the near-death experience: a central role for the N-methyl-D-aspartate receptor. J Near Death Stud 1997;16:79-95.

13. Bates BC, Adrian Stanley BA. The epidemiology and differential diagnosis of near-death experience. Am J Orthopsychiatry 1985;55:542-9.

14. French CC. Near-death experiences in cardiac arrest survivors. Prog Brain Res 2005;150:351-67.

15. Blanke O, Ortigue S, Landis T, Seeck M. Stimulating illusory own-body perceptions. Nature 2002;419:269-70.

16. Klemenc-Ketis Z, Kersnik J, Grmec S. The effect of carbon dioxide on near-death experiences in out-of-hospital cardiac arrest survivors: a prospective observational study. Crit Care 2010;14:R56.

17. Safar P. Resuscitation after brain ischemia. In: Grenvik A, Safar P, editors. Brain failure and resuscitation. New York: Churchill Livingstone; 1981. pp. 155-84.

18. Greyson B. The near-death experience scale: construction, reliability, and validity. J Nerv Ment Dis 1983;171:369-75.

19. Blacher RS. To sleep, perchance to dream. J Am Med Assoc 1979;242:2291.

20. Idris AH, Becker LB, Fuerst RS, Wenzel V, Rush WJ, et al. Effect of ventilation on on resuscitationin an animal model of cardiac arrest. Circulation 1994;90:3063-9.

21. Bhende MS, Karasic DG, Karasic RB. End-tidal carbon dioxide changes during cardiopulmonary resuscitation after experimental asphyxial cardiac arrest. Am J Emerg Med 1996;14:349-50.

22. Berg RA, Henry C, Otto CW, Sandres AB, Kern KB, Hilwig RW, et al. Initial end-tidal CO2 is markedly elevated during cardiopulmonary resuscitation after asphyxial cardiac arrest. Pediatr Emerg Care 1996;12:245-8.

23. Kolar M, Krizmaric M, Klemen P, Grmec S. Partial pressure of end-tidal carbon dioxide successful predicts cardiopulmonary resuscitation in the field: a prospective observational study. Crit Care 2008;12:R115.

24. Grmec S, Lah K, Tusek-Bunc K. Difference in end-tidal CO2 between asphyxia cardiac arrest and ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest in the prehospital setting. Crit Care 2003;7:R139-44.

25. Claesson A, Svensson L, Silfverstolpe J, Herlitz J. Characteristics and outcome among patients suffering out-ofhospital cardiac arrest due to drowning. Resuscitation 2008;76:381-7.

26. Engdahl J, Bång A, Karlson BW, Lindqvist J, Herlitz J. Characteristics and outcome among patients suffering from out of hospital cardiac arrest of non-cardiac aetiology. Resuscitation 2003;57:33-41.

27. Gropper MA, Wiener-Kronish JP, Hashimoto S. Acute cardiogenic pulmonary oedema. Clin Chest Med 1994;15:501-15.

28. Meaney PA, Nadkarni VM, Kern KB, Indik JH, Halperin HR, Berg RA. Rhythms and outcomes of adult in-hospital cardiac arrest. Crit Care Med 2010;38:101-8.

29. Hollenberg J, Herlitz J, Lindqvist J, Riva G, Bohm K, Rosenqvist M, et al. Improved survival after out-of-hospital cardiac arrest is associated with an increase in proportion emergency crew-witnessed cases and bystander cardiopulmonary resuscitation. Circulation 2008;118:389-96.

30. Nolan JP, Deakin CD, Soar J, Böttiger BW, Smith G. European resuscitation council guidelines for resuscitation 2005. Section 4. Adult advanced life support. Resuscitation 2005;67S1:S39-S86.