Near-death Experiences in Planned Circulatory Arrest During Cardiac Surgery: A Comprehensive Review

Near-death Experiences in Planned Circulatory Arrest During Cardiac Surgery: A Comprehensive Review

1 Ana Filipan
2 Petar Pavlović
1,3 Vedran Hostić
1,4 Ante Silić
1,5 Josipa Josipović
1,6 Ivo Darko Gabrić

1 Catholic University of Croatia, School of Medicine, Zagreb, Croatia
2 Institute for Cosmology and Philosophy of Nature, Križevci, Croatia
3 Division of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
4 Department of Psychiatry, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
5 Department of Internal Medicine, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
6 Department of Cardiovascular Diseases, Institute for Cardiomyopathies, Heart Failure and Valvular Diseases, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia

Abstract
Near-death experiences (NDEs) are profound subjective events reported by individuals who have come close to death. In Western cultures, they often involve outofbody perceptions (OBEs), feelings of peace, moving through a tunnel, and encountering lights or figures. While traditionally studied in unpredictable cardiac arrest or trauma, planned circulatory arrest during hypothermic cardiac surgery offers a unique, controlled model to investigate NDEs. This review summarizes definitions, incidence, typologies, and cultural variations of NDEs and OBEs, emphasizing cardiac arrest research. We describe the literature search methodology and synthesize findings: typical NDE features, which vary by culture, occur in roughly 10–20% of survivors, with OBEs in ~2%. Planned hypothermic circulatory arrest (e.g., aortic arch repair) precisely times cardiac arrest and reperfusion, enabling systematic observation and interview. We discuss limitations of prior studies (anaesthetic effects, recall bias) and how induced arrest may improve control over physiological and temporal variables. Emerging tools such as virtual reality (VR) simulations can help patients articulate NDE memories and reduce trauma. Including the medical staff’s timeline and patient monitoring (ECG, blood gases, drug records)
can corroborate subjective reports. We conclude that planned cardiac arrest settings could advance understanding of NDE mechanisms and support patient care particularly when an adequate number of patients are included.

Keywords:
near-death experience, out-of-body experience, hypothermic circulatory arrest, cardiac surgery, aortic arch, consciousness
Article received: 03.09.2025.
Article accepted: 31.01.2026.
https://doi.org/10.24141/1/12/2/7