1/44. A practical approach to atrial fibrillation.Management of atrial fibrillation is still an individualized proposition, requiring considerable clinical judgment to select the most effective means of controlling cardiac rate and rhythm and preventing thromboembolism and stroke. The advantages and disadvantages of electric shock cardioversion, catheter ablation, and several medicinal and mechanical agents are discussed.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
2/44. Cardiogenic shock due to coronary narrowings one day after a MAZE III procedure.A MAZE III procedure was performed on a patient with a small body surface area. On the first postoperative day, the patient developed severe dysfunction of the left ventricle, due to significant narrowings of the right and circumflex coronary arteries in the areas that were cryoablated during the MAZE III procedure. The coronary narrowings were treated by percutaneous transluminal coronary angioplasty (PTCA). At discharge the coronary anatomy was normal again with an almost normal left ventricular function.- - - - - - - - - - ranking = 4keywords = shock (Clic here for more details about this article) |
3/44. Implantable atrial defibrillator and detection of atrial flutter.The implantable atrial defibrillator (IAD) is designed to detect and treat atrial fibrillation (AF) with low energy synchronized shocks. A patient with a history of persistent AF was implanted with an IAD after ineffective treatment with procainamide and sotalol. Through four months of follow-up, the IAD performed appropriate detection and treatment of AF. During the fifth month, the patient was put on flecainide in an attempt to minimize the AF recurrence rate. On flecainide the patient experienced typical atrial flutter which required IAD reprogramming for appropriate detection and therapy delivery. This case report examines the optimization of the IAD to detect atrial flutter. Six months of follow-up after optimization the IAD has shown appropriate detection of both atrial flutter and AF. During the entire follow-up period the IAD had appropriate detection of sinus rhythm (no false positive detection, i.e. sinus rhythm as AF).- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
4/44. atrial fibrillation and continuous hypotension induced by sildenafil in an intermittent WPW syndrome patient.A 55-year-old Japanese man was hospitalized for palpitations and severe chest oppression one hour after he ingested about 1500 ml of beer and sildenafil (Viagra) 50 mg. At 43 years of age, he had been diagnosed with intermittent WPW syndrome following a paroxysmal supraventricular tachycardia (PSVT) attack. He took a 1 mg tablet of doxazosin daily for mild hypertension. On admission, his blood pressure was 90/54 mmHg and his heart beat was weak and irregular with a rate of about 220/min. Since atrial fibrillation (Af) was diagnosed on an electrocardiogram (minimum RR interval; 0.22 seconds), direct current shock was performed with 100 joules and 150 joules but conversion to sinus rhythm failed. Sinus rhythm returned spontaneously from Af four hours after taking sildenafil. Since blood pressure was 50/17 mmHg despite the return to sinus rhythm, blood pressure was maintained by dopamine for twelve hours after sinus rhythm returned. The patient underwent catheter ablation for curative therapy and thereafter has not had any further episodes of tachycardia.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
5/44. Cardiogenic shock triggered by verapamil and atenolol: a case report of therapeutic experience with intravenous calcium.Cardiogenic shock developed in a 72-year-old Japanese woman during combination therapy with verapamil and atenolol for recurrent supraventricular arrhythmia. She had coronary atherosclerosis, liver cirrhosis and bradycardia-tachycardia syndrome. Despite of the high-dose catecholamines and counterpulsation, she progressively deteriorated. Bolus administration of intravenous calcium chloride (CaCl2) immediately resolved her hemodynamic collapse.- - - - - - - - - - ranking = 5keywords = shock (Clic here for more details about this article) |
6/44. Fulminant pneumonia due to aeromonas hydrophila in a man with chronic renal failure and liver cirrhosis.A 40-year-old man on hemodialysis was admitted due to dyspnea and chest pain and was diagnosed with pneumonia and pericarditis. ampicillin was administered, but thereafter severe septic shock developed. The fulminant type of pneumonia progressed rapidly, and he died only 48 hours after the onset of symptoms. The autopsy and sputa culture revealed pneumonia due to aeromonas hydrophila. The source of this infection remained unkown. Interestingly, there were two types of A. hydrophila found during such a short period. The physician should suspect this disease by questioning the patient's history. Early treatment with adequate antibiotics is the only means of saving such a patient's life.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
7/44. Pulmonary vein orifice isolation for eliminating paroxysmal atrial fibrillation after ICD implantation.We treated a patient with dilated cardiomyopathy (DCM) and sustained ventricular tachycardia by an implantable cardioverter defibrillator (ICD). He then suffered from inappropriate ICD shocks triggered by paroxysmal atrial fibrillation (AF). We successfully performed pulmonary vein orifice isolation to eliminate paroxysmal AF. The pulmonary vein orifice isolation was a simple and useful procedure for eliminating paroxysmal AF in patient with decreased left ventricular (LV) function after ICD implantation.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
8/44. Pseudoventricular fibrillation.A case of atrial fibrillation with asystole was diagnosed as ventricular fibrillation because of the autogain feature of the electrocardiographic monitor. Direct current shock therapy was withheld only because the patient regained consciousness.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
9/44. Left atrial free floating ball thrombus in hypertrophic cardiomyopathy: a case report.In this article we reported a 33-year-old female patient who was referred to our emergency department with atrial fibrillation, congestive heart failure, and cardiogenic shock. In her transthoracic echocardiography, a free-floating ball-type mass was seen in the left atrial cavity with a hypertrophic cardiomyopathy. An emergency open-heart surgery was performed. The mass was removed, and pathologic examination confirmed the thrombotic material.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
10/44. Radiofrequency catheter ablation of the AV node to improve the function of an antitachycardia implantable defibrillator.A case of coexisting atrial fibrillation and ventricular tachycardia in a patient with an implantable cardioverter defibrillator is described. Despite careful reprogramming, the device was not always able to distinguish between the two arrhythmias and continued to deliver inappropriate antitachycardia therapy including DC shocks. Attempts to pharmacologically control the atrial fibrillation were unsuccessful so radiofrequency ablation of the atrioventricular node was performed. Following successful ablation, there have been no further false detections no episodes of further ventricular tachycardia.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
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