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Primary endpoint was the incidence of patients with new onset supraventricular arrhythmia (AF, atrialflutter or any supraventricular tachycardia) lasting >30s, post PFO closure.ResultsA total of 59 patients met the inclusion criteria.
She underwent cardiopulmonary resuscitation for VT/VFib — with ROSC ( R eturn O f S pontaneous C irculation ) following defibrillation and treatment with Epinephrine and Amiodarone. PEARL # 3: At this point — the most time-efficient step for solving today's rhythm will be to determine the nature of atrial activity.
Here is a representative CXR from a different patient showing a typical CRT-D The blue dotted line overlies the right atrial lead The red dotted line overlies the RV lead. This is the shock coil and identifies this device as a defibrillator. CRT-D is cardiac resynchronization therapy with defibrillation capability, like the CXR above.
Smith comments : Wide complex tachycardia. The differential diagnosis of WCT is: 1) Sinus tachycardia with "aberrancy" (in this case RBBB and LAFB), but there are no P-waves and the QRS morphology is not typical of simple RBBB/LAFB. Also, if the rate is constant, not wavering up and down, it is highly unlikely to be sinus tachycardia.
During observation in the ED the patient had multiple self-terminating runs of Non-Sustained monomorphic Ventricular Tachycardia (NSVT). This patient very likely has some form of idiopathic ventricular tachycardia. Of the ventricular outflow tract tachycardias (RVOT-VT) makes up 80-90%.
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