Remove 2022 Remove Cardiogenic Shock Remove Defibrillator
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A man in his 50s with unwitnessed VF arrest, defibrillated to ROSC, and no STEMI criteria on post ROSC ECG. Should he get emergent angiogram?

Dr. Smith's ECG Blog

15 minutes after EMS arrival, after at least 6 defibrillations, the patient achieved sustained ROSC. Meyers and Smith in the October 15, 2022 post of Dr. Smith's ECG Blog ). 15, 2022 post — I like to focus on the ST-T wave appearance in leads V1 and V6 to facilitate recognition of Precordial Swirl. 15, 2022 post).

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What are treatment options for this rhythm, when all else fails?

Dr. Smith's ECG Blog

The patient in today’s case presented in cardiogenic shock from proximal LAD occlusion, in conjunction with a subtotally stenosed LMCA. He required multiple defibrillations within a period of a few hours. This time, the arrhythmia did not spontaneously terminate — but rather degenerated to VFib, requiring defibrillation.

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Noisy, low amplitude ECG in a patient with chest pain

Dr. Smith's ECG Blog

Tachycardia is unusual for OMI, unless the patient is in cardiogenic shock (or getting close). Rhythm C: This telemetry strip from an older adult was initially thought to need defibrillation. The October 21, 2022 post — for " artifactual VT". We can see enough to make out that the rhythm is sinus tachycardia.

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Can you localize the culprit lesion on angiogram without taking ECG findings into account?

Dr. Smith's ECG Blog

In the second case, the patient never converted meaning the shock did not do its job at all. In this case, you should get a second defibrillator and perform double sequential external defibrillation (DSED). Simply attach a second defibrillator as shown in the diagram below and deliver max shocks from both devices simultaneously.

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Midterm outcomes of patients with native heart recovery after Impella 5+ for cardiogenic shock

European Journal of Heart Failure

Abstract Aims Left ventricular unloading by percutaneous microaxial flow-pump devices has been shown to improve survival in patients with cardiogenic shock (CS). Between June 2022 and April 2024, 20 patients with CS (64 ± 8.9 years, Summary of key study outcomes. The objective of the study is to examine whether Impella 5.0/5.5