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Double defibrillation

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https://www.readbyqxmd.com/read/29124430/oversensing-of-the-wearable-cardioverter-defibrillator-during-bipolar-ventricular-stimulation
#1
Martin Manninger, Tanja Odeneg, Friedrich Fruhwald, Helmut Brussee, Daniel Scherr
The wearable cardioverter defibrillator (WCD) is a temporary treatment option for patients with potentially reversible risk of sudden cardiac death. This case demonstrates a pitfall during WCD usage in a pacemaker-dependent patient as well as a possible solution allowing continuation of WCD therapy. Bipolar stimulation may lead to double counting of the WCD detection algorithm resulting in false alarm or inappropriate therapy.
November 9, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28978402/double-sequential-defibrillation-for-refractory-ventricular-fibrillation
#2
Chady El Tawil, Sandra Mrad, Basem F Khishfe
A 54-year-old suffered from an out-of-hospital cardiac arrest. Compressions were started within minutes and the patient was in refractory ventricular fibrillation despite multiple asynchronized shocks and maximal doses of antiarrhythmic agents. Double sequential defibrillation was attempted with successful Return Of Spontaneous Circulation (ROSC) after a total of 61min of cardiac arrest. The patient was discharged home neurologically intact. Double sequential defibrillation could be a simple effective approach to patients with refractory ventricular fibrillation...
September 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28955086/twiddlers-syndrome-presenting-as-life-threatening-electrical-storm
#3
Shahrukh Hashmani, Aamir Hameed Khan
A 75-year-old man underwent implantation of a single chamber implantable cardioverter defibrillator (ICD) for primary prevention of his underlying severe non-ischaemic cardiomyopathy. Thirteen months later, he presented to the emergency room(ER) with inappropriate ICD shocks as a result of over sensing of the right ventricular lead and double counting of the right atrial signals. The chest X-ray (CXR) revealed a right ventricular ICD lead displaced into the right atrium with coiling in the pocket. The right ventricular shocking coil was noted at the tricuspid annulus...
October 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28760205/probing-oral-anticoagulation-in-patients-with-atrial-high-rate-episodes-rationale-and-design-of-the-non-vitamin-k-antagonist-oral-anticoagulants-in-patients-with-atrial-high-rate-episodes-noah-afnet-6-trial
#4
RANDOMIZED CONTROLLED TRIAL
Paulus Kirchhof, Benjamin F Blank, Melanie Calvert, A John Camm, Gregory Chlouverakis, Hans-Christoph Diener, Andreas Goette, Andrea Huening, Gregory Y H Lip, Emmanuel Simantirakis, Panos Vardas
Oral anticoagulation prevents ischemic strokes in patients with atrial fibrillation (AF). Early detection of AF and subsequent initiation of oral anticoagulation help to prevent strokes in AF patients. Implanted cardiac pacemakers and defibrillators allow seamless detection of atrial high rate episodes (AHRE), but the best antithrombotic therapy in patients with AHRE is not known. RATIONALE: Stroke risk is higher in pacemaker patients with AHRE than in those without, but the available data also show that stroke risk in patients with AHRE is lower than in patients with AF...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28639949/comet-assay-in-evaluating-deoxyribonucleic-acid-damage-after-out-of-hospital-cardiac-arrest
#5
Radka Hazuková, Martina Rezácová, Renata Köhlerová, Tomáš Tomek, Eva Cermáková, Jaromír Kocí, Miloslav Pleskot
OBJECTIVE: This study aimed to investigate whether out-of-hospital cardiac arrest (OHCA) may induce severe DNA damage measured using comet assay in successfully resuscitated humans and to evaluate a short-term prognostic role. METHODS: In this prospective, controlled, blinded study (1/2013-1/2014), 41 patients (age, 63±14 years) successfully resuscitated from non traumatic OHCA and 10 healthy controls (age, 53±17 years) were enrolled. DNA damage [double-strand breaks (DSBs) and single-strand breaks (SSBs)] was measured using comet assay in peripheral lymphocytes sampled at admission...
July 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28636098/repeated-procedures-at-the-generator-pocket-are-a-determinant-of-implantable-cardioverter-defibrillator-infection
#6
Eduardo Arana-Rueda, Alonso Pedrote, Manuel Frutos-López, Juan Acosta, Beatriz Jauregui, Lorena García-Riesco, Álvaro Arce-León, Federico Gómez-Pulido, Juan A Sánchez-Brotons, Encarnación Gutiérrez-Carretero, Arístides de Alarcón-González
BACKGROUND: Rates of cardiac-device infections have increased in recent years, but the current incidence and risk factors for infection in patients with implantable cardioverter-defibrillators (ICDs) are not well known. HYPOTHESIS: The increasing number of ICD infections is related to accumulated pocket manipulations over time. METHODS: This single-center, prospective study included patients that underwent ICD implantation from 2008 to 2015...
June 21, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28625370/rationale-and-design-of-the-apixaban-for-the-reduction-of-thrombo-embolism-in-patients-with-device-detected-sub-clinical-atrial-fibrillation-artesia-trial
#7
RANDOMIZED CONTROLLED TRIAL
Renato D Lopes, Marco Alings, Stuart J Connolly, Heather Beresh, Christopher B Granger, Juan Benezet Mazuecos, Giuseppe Boriani, Jens C Nielsen, David Conen, Stefan H Hohnloser, Georges H Mairesse, Philippe Mabo, A John Camm, Jeffrey S Healey
BACKGROUND: Device-detected subclinical atrial fibrillation (AF) refers to infrequent, short-lasting, asymptomatic AF that is detected only with long-term continuous monitoring. Subclinical AF is common and associated with an increased risk of stroke; however, the risk of stroke with subclinical AF is lower than for clinical AF, and very few patients with subclinical AF alone have been included in large AF anticoagulation trials. The net benefit of anticoagulation in patients with subclinical AF is unknown...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28624593/double-sequential-defibrillation-therapy-for-out-of-hospital-cardiac-arrests-the-london-experience
#8
Amber C Emmerson, Mark Whitbread, Rachael T Fothergill
BACKGROUND: Despite advances in treatment for out-of-hospital cardiac arrest (OHCA), a subgroup of patients remain in refractory ventricular fibrillation (RVF) during resuscitation. Recent evidence suggests that double sequential defibrillation (DSD), where two shocks are delivered to the patient in quick succession, may provide an effective therapy for RVF. This study describes the characteristics and survival outcomes of OHCA patients treated by ambulance clinicians using a local DSD protocol in an attempt to resolve RVF...
August 2017: Resuscitation
https://www.readbyqxmd.com/read/28482353/haemodynamic-findings-in-obstructive-hypertrophic-cardiomyopathy-pulsus-bisferiens-and-brockenbrough-braunwald-morrow-sign
#9
Andrea Barison, Annamaria Del Franco, Giancarlo Todiere
: A 55-year-old gentleman with hypertrophic obstructive cardiomyopathy and heart failure symptoms underwent cardiac catheterization, which confirmed a significant pressure drop (60 mmHg) across the left ventricular outflow tract, a double-peaked pulse (pulsus bisferiens) and an absent postextrasystolic potentiation (Brockenbrough-Braunwald-Morrow sign) in the left ventricular outflow tract and the aorta. He was treated with medical therapy optimization and intracardiac defibrillator implantation. Cardiac catheterization may provide characteristic clues not only to diagnose obstructive hypertrophic cardiomyopathy, but also to understand its pathophysiological correlates...
December 2016: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28411139/the-quidam-study-hydroquinidine-therapy-for-the-management-of-brugada-syndrome-patients-at-high-arrhythmic-risk
#10
Antoine Andorin, Jean-Baptiste Gourraud, Jacques Mansourati, Swanny Fouchard, Hervé le Marec, Philippe Maury, Philippe Mabo, Jean-Sylvain Hermida, Jean-Claude Deharo, Béatrice Delasalle, Simon Esnault, Nicolas Sadoul, Jean-Marc Davy, Antoine Leenhardt, Didier Klug, Pascal Defaye, Dominique Babuty, Frédéric Sacher, Vincent Probst
BACKGROUND: Although the implantable cardioverter-defibrillator (ICD) remains the main therapy for Brugada syndrome (BrS), it does not reduce life-threatening ventricular arrhythmia. Based on pathophysiologic mechanisms, hydroquinidine (HQ) has been suggested for effective prevention of arrhythmia. OBJECTIVE: The purpose of this study was to provide evidence-based data supporting HQ use to prevent life-threatening ventricular arrhythmia in high-risk patients with BrS...
August 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28373784/left-ventricular-noncompaction-a-rare-form-of-cardiomyopathy-revelation-modes-and-predictors-of-mortality-in-adults-through-23-cases
#11
Iliyasse Asfalou, Sanae Boulaamayl, Maha Raissouni, Najat Mouine, Mohamed Sabry, Jamal Kheyi, Nawal Doghmi, Aatif Benyass
OBJECTIVES: To describe modes of clinical presentation and echocardiographic, angiographic, and rhythmic features, and prognostic characteristics of left ventricular noncompaction cardiomyopathy (LVNC) in North African adults, through one of the first series in Morocco. BACKGROUND: LVNC is a rare congenital disorder, described for the first time by Engberding in 1984. The suspected diagnosis in thromboembolic, hemodynamic, or rhythm events requires both echocardiography and cardiovascular magnetic resonance (CMR)...
April 2017: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/28267474/results-of-a-curtailed-randomized-controlled-trial-evaluating-the-efficacy-and-safety-of-azimilide-in-patients-with-implantable-cardioverter-defibrillators-the-shield-2-trial
#12
RANDOMIZED CONTROLLED TRIAL
Victoria M Robinson, David B Bharucha, Kenneth W Mahaffey, Paul Dorian, Peter R Kowey
BACKGROUND: Frequent hospital attendances in patients with implantable cardioverter-defibrillators (ICDs) result in significant morbidity and health care costs. Current drugs to reduce ICD shocks and hospital visits have limited efficacy and considerable toxicity. We evaluated the efficacy and safety of azimilide, a novel oral class III antiarrhythmic, for use in ICD patients. METHODS: A total of 240 patients were enrolled in a prospective, randomized, double-blind, placebo-controlled trial to evaluate the effect of oral azimilide 75 mg daily in ICD patients with previously documented ventricular tachycardia or ventricular fibrillation, and a left ventricular ejection fraction ≤40%...
March 2017: American Heart Journal
https://www.readbyqxmd.com/read/28098197/dantrolene-versus-amiodarone-for-cardiopulmonary-resuscitation-a-randomized-double-blinded-experimental-study
#13
Thomas Wiesmann, Dennik Freitag, Wolfgang Dersch, Daphne Eschbach, Marc Irqsusi, Thorsten Steinfeldt, Hinnerk Wulf, Carsten Feldmann
Dantrolene was introduced for treatment of malignant hyperthermia. It also has antiarrhythmic properties and may thus be an alternative to amiodarone for the treatment of ventricular fibrillation (VF). Aim of this study was to compare the return of spontaneous circulation (ROSC) with dantrolene and amiodarone in a pig model of cardiac arrest. VF was induced in anesthetized pigs. After 8 min of untreated VF, chest compressions and ventilation were started and one of the drugs (amiodarone 5 mg kg(-1), dantrolene 2...
January 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/27996097/prevention-of-cardiac-implantable-electronic-device-infections-single-operator-technique-with-use-of-povidone-iodine-double-gloving-meticulous-aseptic-antiseptic-measures-and-antibiotic-prophylaxis
#14
Antonis S Manolis, Helen Melita
BACKGROUND: Cardiac implantable electronic device (CIED) implantation is complicated by infection still at a worrisome rate of 2-5%. Since early on during device implantation procedures, we have adopted an infection-preventive technique which has hitherto resulted in effective prevention of infections. Herein we present our results of applying this technique by a single operator in a prospective series of 762 consecutive patients undergoing device implantation. METHODS: A meticulous search for and treatment of active, occult, or smoldering infection was undertaken preoperatively...
January 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27881566/association-of-bystander-cardiopulmonary-resuscitation-and-survival-according-to-ambulance-response-times-after-out-of-hospital-cardiac-arrest
#15
Shahzleen Rajan, Mads Wissenberg, Fredrik Folke, Steen Møller Hansen, Thomas A Gerds, Kristian Kragholm, Carolina Malta Hansen, Lena Karlsson, Freddy K Lippert, Lars Køber, Gunnar H Gislason, Christian Torp-Pedersen
BACKGROUND: Bystander-initiated cardiopulmonary resuscitation (CPR) increases patient survival after out-of-hospital cardiac arrest, but it is unknown to what degree bystander CPR remains positively associated with survival with increasing time to potential defibrillation. The main objective was to examine the association of bystander CPR with survival as time to advanced treatment increases. METHODS: We studied 7623 out-of-hospital cardiac arrest patients between 2005 and 2011, identified through the nationwide Danish Cardiac Arrest Registry...
December 20, 2016: Circulation
https://www.readbyqxmd.com/read/27865189/screening-entire-healthcare-system-ecg-database-association-of-deep-terminal-negativity-of-p-wave-in-lead-v1-and-ecg-referral-with-mortality
#16
Allison Junell, Jason Thomas, Lauren Hawkins, Jiri Sklenar, Trevor Feldman, Charles A Henrikson, Larisa G Tereshchenko
BACKGROUND: Each encounter of asymptomatic individuals with the healthcare system presents an opportunity for improvement of cardiovascular disease (CVD) awareness and sudden cardiac death (SCD) risk assessment. ECG sign deep terminal negativity of the P wave in V1 (DTNPV1) was shown to be associated with an increased risk of SCD in the general population. OBJECTIVE: To evaluate association of DTNPV1 with all-cause mortality and newly diagnosed atrial fibrillation (AFib) in the large tertiary healthcare system patient population...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27863358/temporal-trends-and-long-term-follow-up-of-implantable-cardioverter-defibrillator-therapy-for-secondary-prevention-a-15-year-single-centre-experience
#17
Maria Luce Caputo, François Regoli, Giulio Conte, Boris Adjibodou, Stefano Svab, Alessandro Del Bufalo, Tiziano Moccetti, Moreno Curti, Catherine Klersy, Angelo Auricchio
BACKGROUND: The aim of this study was to determine overall and aetiology-related incidence of secondary prevention ICD implantation over the last 15years in Canton Ticino and to assess clinical outcome according to time period of implantation. METHODS AND RESULTS: Consecutive patients treated by implantation of an ICD for secondary prevention from 2000 to 2015 were included in the current study and compared between 5-year cohorts (2000/2004; 2005/2009; 2010/2015)...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27836874/assessment-of-cardiac-resynchronisation-therapy-in-patients-with-wide-qrs-and-non-specific-intraventricular-conduction-delay-rationale-and-design-of-the-multicentre-randomised-nicd-crt-study
#18
Romain Eschalier, Sylvain Ploux, Bruno Pereira, Nicolas Clémenty, Antoine Da Costa, Pascal Defaye, Stéphane Garrigue, Jean-Baptiste Gourraud, Daniel Gras, Benoît Guy-Moyat, Christophe Leclercq, Pierre Mondoly, Pierre Bordachar
INTRODUCTION: Cardiac resynchronisation therapy (CRT) was initially developed to treat patients with left bundle branch block (LBBB). However, many patients with heart failure have a widened QRS but neither left-BBB nor right-BBB; this is called non-specific intraventricular conduction delay (NICD). It is unclear whether CRT is effective in this subgroup of patients. METHODS AND ANALYSIS: The NICD-CRT study is a prospective, double-blind, randomised (1:1), parallel-arm, multicentre trial comparing the effects of CRT in patients with heart failure, a reduced left ventricular ejection fraction (LVEF <35%) and NICD, who have been implanted with a device (CRT-pacemaker or CRT-defibrillator) that has or has not been activated...
November 11, 2016: BMJ Open
https://www.readbyqxmd.com/read/27791428/cpr-induced-consciousness-during-out-of-hospital-cardiac-arrest-a-case-report-on-an-emerging-phenomenon
#19
Joshua Pound, P Richard Verbeek, Sheldon Cheskes
BACKGROUND: High quality cardiopulmonary resuscitation (CPR) has produced a relatively new phenomenon of consciousness in patients with vital signs absent. Further research is necessary to produce a viable treatment strategy during and post resuscitation. OBJECTIVE: To provide a case study done by paramedics in the field illustrating the need for sedation in a patient whose presentation was consistent with CPR induced consciousness. Resuscitative challenges are provided as well as potential future treatment options to minimize harm to both patients and prehospital providers...
March 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27749954/short-term-effects-of-high-dose-caffeine-on-cardiac-arrhythmias-in-patients-with-heart-failure-a-randomized-clinical-trial
#20
RANDOMIZED CONTROLLED TRIAL
Priccila Zuchinali, Gabriela C Souza, Maurício Pimentel, Diego Chemello, André Zimerman, Vanessa Giaretta, Joyce Salamoni, Bianca Fracasso, Leandro I Zimerman, Luis E Rohde
Importance: The presumed proarrhythmic action of caffeine is controversial. Few studies have assessed the effect of high doses of caffeine in patients with heart failure due to left ventricular systolic dysfunction at high risk for ventricular arrhythmias. Objective: To compare the effect of high-dose caffeine or placebo on the frequency of supraventricular and ventricular arrhythmias, both at rest and during a symptom-limited exercise test. Design, Setting, and Participants: Double-blinded randomized clinical trial with a crossover design conducted at the heart failure and cardiac transplant clinic of a tertiary-care university hospital...
December 1, 2016: JAMA Internal Medicine
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