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Double defibrillation

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...
October 17, 2016: JAMA Internal Medicine
Girish Manjunath, Prakash Rao, Nagendra Prakash, B K Shivaram
Recent data from landmark trials suggest that the indications for cardiac pacing and implantable cardioverter defibrillators (ICDs) are set to expand to include heart failure, sleep-disordered breathing, and possibly routine implantation in patients with myocardial infarction and poor ventricular function.[1] This will inevitably result in more patients with cardiac devices undergoing surgeries. Perioperative electromagnetic interference and their potential effects on ICDs pose considerable challenges to the anesthesiologists...
October 2016: Annals of Cardiac Anaesthesia
Eric Cortez, William Krebs, James Davis, David P Keseg, Ashish R Panchal
INTRODUCTION: Survival from out of hospital cardiac arrest (OHCA) is highest in victims with shockable rhythms when early CPR and rapid defibrillation are provided. However, a subset of individuals present with ventricular fibrillation (VF) that does not respond to defibrillation (refractory VF). One intervention that may be a possible option in refractory VF is double sequential external defibrillation (DSD). The objective of this case series was to describe the outcome of prehospital victims with refractory VF treated with DSD in the out-of-hospital setting...
August 10, 2016: Resuscitation
Laura A Hatfield, Daniel B Kramer, Rita Volya, Matthew R Reynolds, Sharon-Lise T Normand
BACKGROUND: Cardiac implantable electric devices are commonly used to treat heart failure. Little is known about temporal and geographic variation in use of cardiac resynchronization therapy (CRT) devices in usual care settings. METHODS AND RESULTS: We identified new CRT with pacemaker (CRT-P) or defibrillator generators (CRT-D) implanted between 2008 and 2013 in the United States from a commercial claims database. For each implant, we characterized prior medication use, comorbidities, and geography...
August 2016: Journal of the American Heart Association
Roman Steckiewicz, Dariusz A Kosior, Marek Rosiak, Elżbieta Świętoń, Przemysław Stolarz, Marcin Grabowski
INTRODUCTION: The vast majority of cardiac implantable electronic device (CIED) recipients require transvenous lead insertion, which may be hindered by the presence of venous anomalies. The aim of this study was to determine the prevalence and variations of persistent left superior vena cava (PLSVC) and to conduct subsequent outpatient follow-up in terms of device function and the clinical condition of the recipients using data from CIED placement procedures conducted over a 12-year period...
March 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Francisca Tatiana Moreira Pereira, Eduardo Arrais Rocha, Marcelo de Paula Martins Monteiro, Neiberg de Alcantara Lima, Carlos Roberto Martins Rodrigues Sobrinho, Roberto da Justa Pires Neto
BACKGROUND: The outcome of Chagas disease patients after receiving implantable cardioverter defibrillator (ICD) is still controversial. OBJECTIVE: To compare clinical outcomes after ICD implantation in patients with chronic Chagas cardiomyopathy (CCC) and ischemic heart disease (IHD). METHODS: Prospective study of a population of 153 patients receiving ICD (65 with CCC and 88 with IHD). The devices were implanted between 2003 and 2011. Survival rates and event-free survival were compared...
August 2016: Arquivos Brasileiros de Cardiologia
David Neubert
Double sequential defibrillation is currently being employed in a number of EMS systems across the United States, including Wake County, N.C.; Fort Worth, Texas; and New Orleans. Even though there isn't a large body of literature surrounding this technique, it's been demonstrated successful in the electrophysiology lab, ED and prehospital settings. Since access to procainamide--another treatment for refractory v fib--is limited, this may be the only available option when faced with a patient who's failed standard ACLS defibrillation and medication administration...
May 2016: JEMS: a Journal of Emergency Medical Services
Martin Johnston, Sheldon Cheskes, Garry Ross, P Richard Verbeek
BACKGROUND: Patients who present in ventricular fibrillation are typically treated with cardiopulmonary resuscitation (CPR), epinephrine, antiarrhythmic medications, and defibrillation. Although these therapies have shown to be effective, some patients remain in a shockable rhythm. Double sequential external defibrillation has been described as a viable option for patients in refractory ventricular fibrillation. OBJECTIVE: To describe the innovative use of two defibrillators used to deliver double sequential external defibrillation by paramedics in a case of refractory ventricular fibrillation resulting in prehospital return of spontaneous circulation and survival to hospital discharge with good neurologic function...
September 2016: Prehospital Emergency Care
Amit N Patel, Timothy D Henry, Arshed A Quyyumi, Gary L Schaer, R David Anderson, Catalin Toma, Cara East, Ann E Remmers, James Goodrich, Akshay S Desai, David Recker, Anthony DeMaria
BACKGROUND: Ixmyelocel-T is an expanded, multicellular therapy produced from a patient's own bone marrow by selectively expanding two key types of bone marrow mononuclear cells: CD90+ mesenchymal stem cells and CD45+ CD14+ auto-fluorescent+ activated macrophages. Early phase clinical trials suggest that intramyocardial delivery of ixmyelocel-T might improve clinical, functional, symptomatic, and quality-of-life outcomes in patients with heart failure due to ischaemic dilated cardiomyopathy...
June 11, 2016: Lancet
Steven M Bradley, Wenhui Liu, Paul S Chan, Brahmajee K Nallamothu, Gary K Grunwald, Alyssa Self, Comilla Sasson, Paul D Varosy, Monique L Anderson, Preston M Schneider, P Michael Ho
OBJECTIVE: To describe temporal trends in the time interval between first and second attempts at defibrillation and the association between this time interval and outcomes in patients with persistent ventricular tachycardia or ventricular fibrillation (VT/VF) arrest in hospital. DESIGN: Retrospective cohort study SETTING: 172 hospitals in the United States participating in the Get With The Guidelines-Resuscitation registry, 2004-12. PARTICIPANTS: Adults who received a second defibrillation attempt for persistent VT/VF arrest within three minutes of a first attempt...
2016: BMJ: British Medical Journal
David Wampler, Chetan Kharod, Scotty Bolleter, Alison Burkett, Caitlin Gabehart, Craig Manifold
INTRODUCTION: Chest compressions and defibrillation are the only therapies proven to increase survival in cardiac arrest. Historically, rescuers must remove hands to shock, thereby interrupting chest compressions. This hands-off time results in a zero blood flow state. Pauses have been associated with poorer neurological recovery. METHODS: This was a blinded randomized control cadaver study evaluating the detection of defibrillation during manual chest compressions...
June 2016: Resuscitation
Timothy D Henry, Gary L Schaer, Anthony DeMaria, David Recker, Ann E Remmers, James Goodrich, Amit Patel
Ixmyelocel-T is an investigational patient-specific, expanded, multicellular therapy produced from a patient's own bone marrow. It is produced by selectively expanding two key types of bone marrow mononuclear cells, CD90+ mesenchymal stem cells and CD45+CD14+ autofluorescent alternatively activated macrophages. Earlier clinical trials suggested that intramyocardial ixmyelocel-T might improve clinical, functional, symptomatic, and quality of life outcomes in patients with ischemic dilated cardiomyopathy (IDCM)...
March 22, 2016: Cell Transplantation
William L Baker, Jeffrey Kluger, Craig I Coleman, C Michael White
BACKGROUND: We evaluated the antiarrhythmic efficacy and quality of life (QoL) impact of oral magnesium Llactate on patients with an implantable cardioverter defibrillator (ICD). METHODS: This prospective, double-blind, placebo-controlled trial randomized 70 patients with an ICD to receive oral magnesium L-lactate 3 tablets twice daily (504mg elemental magnesium daily) or matching placebo for 12 months. Patients were seen at baseline, 12, 24, 36, and 52 weeks. The primary endpoints were the cumulative occurrence of ICD therapy [either shock or anti-tachycardia pacing (ATP)] or QoL between the groups...
2015: Open Cardiovascular Medicine Journal
Mariana Faustino, Francisco Madeira, Carlos Morais
Ventricular oversensing in patients with defibrillators is an infrequent but deleterious condition. We report a patient with a cardiac resynchronization-defibrillation device that presented with hyperkalemia and syncope. Device interrogation revealed ventricular double-counting within the QRS of a slow ventricular tachycardia, resulting detection of the slow ventricular tachycardia in the ventricular fibrillation zone, and delivery of an effective therapy, below device programmed detection rate. This case of defibrillator inappropriate detection emphasizes the relevance of device electrogram interrogation in order to minimize inappropriate therapies...
May 2015: Indian Pacing and Electrophysiology Journal
Akash Dadlani, Jonathan W Dukes, Nitish Badhwar
This case shows the complexity of arrhythmia management in patients with implantable cardioverter-defibrillators (ICDs) who present with hyperkalemia. In order to prevent inappropriate ICD shock, consideration should be given to the suspension of ICD therapies while intensive care treatment of extreme electrolyte derangements is being pursued. Patients in these setting should be closely monitored until their electrocardiograms have normalized, after which the device can safely be reactivated.
March 2016: Cardiac Electrophysiology Clinics
David K Singh, Nitish Badhwar
This article reports a typical case of incessant double-fire tachycardia resulting in implantable cardioverter-defibrillator discharge caused by the device's misdiagnosis of ventricular tachycardia. At electrophysiology study, the presence of double-fire physiology was confirmed, and modification of the slow pathway resulted in elimination of repetitive double fires. Although this is an unusual entity, it is important to recognize, because it may be misdiagnosed as atrial fibrillation, resulting in inappropriate anticoagulation and/or antiarrhythmic therapy...
March 2016: Cardiac Electrophysiology Clinics
Christine I Nichols, Joshua G Vose, Suneet Mittal
BACKGROUND: Inadvertent damage to leads for transvenous pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy defibrillators is an important complication associated with generator-replacement procedures. We sought to estimate the incidence and costs associated with transvenous lead damage following cardiac implantable electronic device replacement. METHODS AND RESULTS: Using the Truven Health Analytics MarketScan Commercial Research Database, we identified health care claims between 2009 and 2013 for lead damage following generator replacement...
February 2016: Journal of the American Heart Association
Mark A Merlin, Ammundeep Tagore, Robert Bauter, Faizan H Arshad
INTRODUCTION: Double Sequence Defibrillation or Double Simultaneous Defibrillation (DSD) is the use of two defibrillators almost simultaneously at their highest allowed energy setting to treat refractory ventricular fibrillation (RVF). One set of pads is placed in the Anterior-Posterior position and the other set of pads is placed in the Anterior-Lateral Position. Both defibrillation buttons are pressed simultaneously. We sought to determine ROSC and survival rates in a large EMS system when DSD is routinely utilized for RVF...
July 2016: Prehospital Emergency Care
Giuseppe Limongelli, Daniele Masarone, Giulia Frisso, Maria Iacomino, Ilaria Ferrara, Alessandra Rea, Rita Gravino, Eduardo Bossone, Francesco Salvatore, Raffaele Calabro, Perry Elliott, Giuseppe Pacileo
AIMS: Prevalence and clinical significance of right atrial enlargement (RAE) has been poorly characterized in hypertrophic cardiomyopathy. METHODS: One hundred and sixty consecutive patients with hypertrophic cardiomyopathy (35.5 ± 20 years; 64% men) were studied. They underwent clinical examination, standard ECG, M-mode, 2D and Doppler echocardiography, stress test and ECG Holter monitoring. Major adverse cardiac events were considered: cardiac death (sudden death, heart failure death); cardiac transplant; resuscitated cardiac arrest or appropriate implantable cardioverter defibrillator discharge...
January 23, 2016: Journal of Cardiovascular Medicine
Jakub Sroubek, Vincent Probst, Andrea Mazzanti, Pietro Delise, Jesus Castro Hevia, Kimie Ohkubo, Alessandro Zorzi, Jean Champagne, Anna Kostopoulou, Xiaoyan Yin, Carlo Napolitano, David J Milan, Arthur Wilde, Frederic Sacher, Martin Borggrefe, Patrick T Ellinor, George Theodorakis, Isabelle Nault, Domenico Corrado, Ichiro Watanabe, Charles Antzelevitch, Giuseppe Allocca, Silvia G Priori, Steven A Lubitz
BACKGROUND: The role of programmed ventricular stimulation in identifying patients with Brugada syndrome at the highest risk for sudden death is uncertain. METHODS AND RESULTS: We performed a systematic review and pooled analysis of prospective, observational studies of patients with Brugada syndrome without a history of sudden cardiac arrest who underwent programmed ventricular stimulation. We estimated incidence rates and relative hazards of cardiac arrest or implantable cardioverter-defibrillator shock...
February 16, 2016: Circulation
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