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A new observational study suggests the position in which responders initially place the two defibrillator pads on the body may make a significant difference in returning spontaneous blood circulation after shock from a defibrillator.
Circulation, Volume 150, Issue Suppl_1 , Page ASu505-ASu505, November 12, 2024. The targeted Automated External Defibrillator (AED) program in the Sao Paulo Metro has yielded promising results in improving survival rates for individuals experiencing out-of-hospital cardiac arrest (OHCA) due to ventricular arrhythmias.
She was unable to be defibrillated but was cannulated and placed on ECMO in our Emergency Department (ECLS - extracorporeal life support). After good ECMO flow was established, she was successfully defibrillated. Here is a case of ECMO defibrillation with near shark fin that was due to proximal LAD occlusion. The K was normal.
BackgroundIn-hospital cardiac arrest (IHCA) refers to the occurrence of cardiac arrest in hospitalized patients requiring chest compressions and/or defibrillation, with only about one-third of patients achieving return of spontaneous circulation (ROSC) after cardiopulmonary resuscitation.
A UT Southwestern Medical Center quality improvement team led a large-scale, multispecialty project in partnership with the Parkland Center of Innovation and Value to help patients with implantable cardioverter defibrillators (ICDs) better understand their devices and make choices about their care.
Circulation, Volume 150, Issue Suppl_1 , Page ASu404-ASu404, November 12, 2024. Double sequential external defibrillation (DSED) represents an alternative treatment for OHCA patients, but the use is currently reserved for patients in refractory ventricular fibrillation.
Circulation, Volume 150, Issue Suppl_1 , Page ASu507-ASu507, November 12, 2024. Background:Most out-of-hospital cardiac arrest (OHCA) patients who are initially treated with an automated external defibrillator (AED) and present in a non-shockable rhythm never receive a shock. Application of any medication during AED use was unlikely.
BackgroundPublic access defibrillation (PAD) programs have been implemented globally over the past decade. The primary outcomes were the rate of bystander PAD use, sustained return of spontaneous circulation, survival to discharge, and favorable neurological outcomes. Journal of the American Heart Association, Ahead of Print.
Circulation, Ahead of Print. This scientific statement focuses on 2030 AHA emergency cardiovascular care priorities, with a specific focus on bystander cardiopulmonary resuscitation, early defibrillation, and neurologically intact survival.
Circulation, Ahead of Print. Patient and resuscitation data, including time-synchronized automated external defibrillator and manual defibrillator data, were analyzed to determine VF termination at 5 seconds after the first shock. This may explain the worse outcomes in patients with a long delay to defibrillation.
Circulation, Ahead of Print. The rapid technological advancements in cardiac implantable electronic devices such as pacemakers, implantable cardioverter defibrillators, and loop recorders, coupled with a rise in the number of patients with these devices, necessitate an updated clinical framework for periprocedural management.
Circulation, Volume 150, Issue Suppl_1 , Page ASu203-ASu203, November 12, 2024. Prior studies showed that thoracic bioimpedance, recorded by the LifePak 12 defibrillator device, can be used to count ventilations with a tidal volume at least 250 mL during CPR. ohm for males and the median bioimpedance amplitude was 0.8 (0.6,
The clinical outcomes including mechanical ventilation time, intensive care unit stay time, hospital stay time, postoperative stroke, postoperative new-onset atrial fibrillation, postoperative heart failure requiring intra-aortic balloon pump mechanical circulation support, and in-hospital mortality of both are comparable.
Today's case reminds us of the intuitive logic that if a patient has a shockable arrest ( ie, VFib ) — and following successful defibrillation shows evidence of acute OMI ( even if STEMI criteria are not necessarily fulfilled ) — that such patients have much to gain from immediate cath with PCI. (
Circulation, Volume 150, Issue Suppl_1 , Page A4143264-A4143264, November 12, 2024. She was externally defibrillated with 200J and received magnesium and an IV amiodarone bolus. She was successfully defibrillated with 360J. This can initiate ventricular arrhythmias like polymorphic ventricular tachycardia (PMVT).
Circulation, Volume 150, Issue Suppl_1 , Page A4137905-A4137905, November 12, 2024. Background:In out-of-hospital cardiac arrest (OHCA) patients with an initial shockable rhythm, epinephrine increases the likelihood of return of spontaneous circulation (ROSC), but its effect on neurological outcome remains uncertain.
The outcome measure was prehospital return of spontaneous circulation (ROSC). Defibrillation, endotracheal intubation, and epinephrine administration were significantly associated with prehospital ROSC in all subgroups. The W+B+ group exhibited the highest prehospital ROSC rate (14.0%).
Circulation, Volume 148, Issue 24 , Page e187-e280, December 12, 2023. The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science.
Circulation: Arrhythmia and Electrophysiology, Ahead of Print. BACKGROUND:There is no specific treatment for sudden cardiac arrest (SCA) manifesting as pulseless electric activity (PEA) and survival rates are low; unlike ventricular fibrillation (VF), which is treatable by defibrillation.
Edited by Bracey, Meyers, Grauer, and Smith A 50-something-year-old female with a history of an unknown personality disorder and alcohol use disorder arrived via EMS following cardiac arrest with return of spontaneous circulation. She was successfully revived after several rounds of ACLS including defibrillation and amiodarone.
We can, therefore, put down the defibrillation pads, set aside the amiodarone, and look further at the ECG. Circulation, Vol 137, No 11, 1192-94. Circulation, Vol 139, No 16, 1974-76. Paradoxically, though, the third green arrow identifies a QRS that is more narrow than the RBBB complexes surrounding it. Saini, A., 40, 1234-41.
A patient had a cardiac arrest with ventricular fibrillation and was successfully defibrillated. IF the initial ECG following successful defibrillation shows evidence of acute OMI — such patients have much to gain from immediate cath with PCI. What percent of shockable arrests without STE have an OMI? 5% vs. 58%!!
When the ICD was finally interrogated, the syncopal events and shocks correlated with two VF events that were defibrillated successfully. In this case, the vessel supplied a portion of the posterior LV circulation. The vessel was likely patent or nearly patent at the time of this ECG.
We examined the effect of ibutilide, a class III antiarrhythmic agent, on the energy requirement for atrial defibrillation and assessed the value of this agent in facilitating cardioversion in patients with atrial fibrillation that is resistant to conventional transthoracic cardioversion.
mEq of K pushed fast and circulated theoretically would raise serum K immediately by 1.0 Here are other posts on hyperK, large calcium doses for hyperK, and ventricular tachycardia in hyperK Weakness, prolonged PR interval, wide complex, ventricular tachycardia Very Wide and Very Fast, What is it? How would you treat? mEq/L, from 1.9
She was defibrillated and resuscitated. Circulation [Internet] 2017;135(16):1481–9. Circulation. Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting." It is apparently fortunate that she had a cardiac arrest; otherwise, her ECG would have been ignored.
Circulation, Volume 150, Issue Suppl_1 , Page A4139677-A4139677, November 12, 2024. Background:Epicardial patch defibrillators (EPDs) were commonly implanted in the 1990s for secondary prevention of sudden cardiac death. Despite being largely obsolete, some EPDs remain in patients and can cause late complications.
It cannot be treated with a defibrillator and often leads to death. Ventricular fibrillation is a type of irregular heartbeat that can cause the heart to stop beating, but an electric shock from a defibrillator can trigger the beating again.
Circulation: Arrhythmia and Electrophysiology, Ahead of Print. BACKGROUND:Over the past decades, hypertrophic cardiomyopathy has become a contemporary treatable disease.
Implantable Cardioverter-Defibrillator (ICD) to help manage dangerous heart rhythms. Regular physical activity can strengthen the heart and improve circulation. Coronary Artery Bypass Surgery for those with blocked arteries, improving blood flow to the heart muscle. Avoid smoking and limit alcohol intake.
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. Some episodes of PMVT would terminate spontaneously — but on many occasions, the PMVT degenerated to VFib, requiring defibrillation.
Circulation, Ahead of Print. The primary end point was AEs, defined as sudden cardiac death, sudden cardiac arrest, appropriate implantable cardioverter defibrillator shock, and arrhythmic syncope. mg/kg per day [interquartile range, 1.7–3.1]) 3.1]) were included. mg/kg per day [interquartile range, 1.7–3.1]) 3.1]) were included.
Tackling SCD was in God’s domain, until the brilliance of Dr. Michel Mirowski shrunk the defibrillator and implanted it under the chest in 1980. (Dr. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. Defibrillator Implantation in Patients with Nonischemic Systolic Heart Failure.
Circulation, Volume 150, Issue Suppl_1 , Page A4142952-A4142952, November 12, 2024. In the subgroup with Class 3 of recommendation for implantable cardioverter defibrillator, patients with absolute LV-GLS ≤ 9% showed significantly worse prognosis than those with absolute LV-GLS > 9% (p =.002 vs -266.2; vs -264.9;
Circulation, Ahead of Print. to 28%, mainly because of increased bystander cardiopulmonary resuscitation and defibrillation rates. BACKGROUND:Declining cardiovascular mortality rates have been well-documented, yet temporal trends of sudden cardiac death (SCD) in young individuals remain unclear.
Circulation, Volume 150, Issue Suppl_1 , Page A4120434-A4120434, November 12, 2024. Ultimately the patient underwent implantation of secondary prevention implantable cardioverter-defibrillator and initiation of sotalol.Discussion:The prevalence of MAD is approximately 30% in those with MVP and 8% in the general population.
Circulation, Ahead of Print. Background:Device-detected atrial fibrillation (AF) (also known as subclinical AF or atrial high-rate episodes) is a common finding in patients with an implanted cardiac rhythm device and is associated with an increased risk of ischemic stroke.
Both the Comparison of Medical Therapy, Pacing and Defibrillation in Heart Failure (COMPANION) and the Cardiac Resynchronisation—Heart Failure (CARE-HF) trials [3,4], which were the cornerstone of electrotherapy in HF patients, showed up to a 36% reduction in mortality, an effect size rarely seen in trials today [5]. Heart Fail.
Guidance for integrating risk markers with tools to estimate an individual patient’s SCD risk score is recommended to aid in the patient/clinician shared decision-making regarding implantable cardioverter defibrillator placement, incorporating a patient’s personal level of risk tolerance and specific treatment goals including quality of life.
She was given CRT-D (Cardiac Resynchronization Therapy-Defibrillator). The physiologic reason for this — is thought to be the result of momentarily increased circulation from mechanical contraction arising from the "sandwiched in" QRS complex. The biopsy was consistent with cardiac sarcoidosis. The QRS complex in ECG #1 is wide.
CASTLE-AF randomized 363 patients with atrial fibrillation and left ventricular ejection fraction of 35% or less, NYHA class II-IV heart failure and having an implanted defibrillator to either catheter ablation or medical therapy with rate or rhythm control [5]. Circulation. Circulation. N Engl J Med. doi: 10.1056/NEJMoa0708789.
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