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Abstract 4139677: A rare case of ventriculobronchial fistula caused by an epicardial defibrillator patch

Circulation

Background:Epicardial patch defibrillators (EPDs) were commonly implanted in the 1990s for secondary prevention of sudden cardiac death. Circulation, Volume 150, Issue Suppl_1 , Page A4139677-A4139677, November 12, 2024. Despite being largely obsolete, some EPDs remain in patients and can cause late complications.

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1 hour of CPR, then ECMO circulation, then successful defibrillation.

Dr. Smith's ECG Blog

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.

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Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Dr. Smith's ECG Blog

She was defibrillated and resuscitated. MINOCA may be due to: coronary spasm, coronary microvascular dysfunction, plaque disruption, spontaneous coronary thrombosis/emboli , and coronary dissection. Even in patients whose moderate stenosis undergoes thrombosis, most angiograms show greater than 50% stenosis after the event.

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A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

Dr. Smith's ECG Blog

It was reportedly a PEA arrest; there was no recorded V Fib and no defibrillation. He reportedly told his family "I think I'm having a heart attack", then they immediately drove him to the ED, and he was able to ambulate into the triage area before he collapsed and became unresponsive. CPR was initiated immediately.

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Patient is informed of her husband's death: is it OMI or it stress cardiomyopathy?

Dr. Smith's ECG Blog

Several 200 J shocks did not terminate the VF, so a second defibrillator was applied for double sequential defibrillation with 400 J. She was defibrillated perhaps 25 times. Propranolol versus Metoprolol for treatment of electrical storm in patients with implantable cardioverter-defibrillator. SanzRuiz, R., Solis, J., &