Publication Name	World Journal of Clinical Cases
Manuscript ID	120233
Country	India

Category	Critical Care Medicine
Manuscript Type	Minireviews
Article Title	Pseudo-pulseless electrical activity: A distinct hemodynamic state in cardiac arrest and its implications for resuscitation
Manuscript Source	Invited Manuscript
All Author List	Sahil Kataria, Sargam Goel and Deven Juneja
Funding Agency and Grant Number
Corresponding Author	Deven Juneja, Director, MD, Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, 1 Press Enclave Road, New Delhi 110017, India. devenjuneja@gmail.com
Key Words	Pulseless electrical activity with cardiac mechanical activity; Pulseless electrical activity; Cardiac arrest; Point-of-care ultrasound; End-tidal carbon dioxide; Coronary perfusion pressure; Physiology-guided cardiopulmonary resuscitation
Core Tip	Pulseless electrical activity (PEA) is traditionally treated as a uniform non-shockable cardiac arrest rhythm. Yet, bedside ultrasound and perfusion monitoring increasingly reveal a subgroup with residual cardiac mechanical activity called PEA with cardiac mechanical activity. This review reframes PEA with cardiac mechanical activity as a low-flow arrest state rather than true electromechanical dissociation, summarizes prognostic and physiological evidence supporting this distinction, and highlights the limitations of rhythm-based resuscitation algorithms. We propose a structured, physiology-guided resuscitation strategy that integrates time-limited ultrasound with perfusion targets to guide treatment escalation while preserving the quality of cardiopulmonary resuscitation.
Citation	Kataria S, Goel S, Juneja D. Pseudo-pulseless electrical activity: A distinct hemodynamic state in cardiac arrest and its implications for resuscitation. World J Clin Cases 2026; In press

Received	2026-02-24 06:41
Peer-Review Started	2026-02-24 06:47
First Decision by Editorial Office Director	2026-04-08 08:31
Return for Revision	2026-04-08 08:31
Revised	2026-04-10 15:16
Publication Fee Transferred
Second Decision by Editor	2026-06-01 02:41
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-06-01 06:29
Articles in Press	2026-06-01 06:29
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2307-8960 (online)
Open Access	This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
Copyright	©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
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