Defibrillator charging before rhythm analysis causes peri-shock pauses exceeding guideline recommended maximum 5  s : A randomized simulation trial.

This study was carried out to confirm the safety and feasibility of the anticipatory method. It was hypothesized that this anticipatory method results in shorter total no-flow times, while other parameters of defibrillation efficacy including defibrillator safety and minimization of peri-shock pauses are unchanged. METHODS: This manikin study assigned 243 medical students randomly to study groups, 121 to the anticipatory method and 122 to the recommended European Resuscitation Council (ERC) algorithm. Of these 237 students ultimately underwent training (112 anticipatory method vs. 125 ERC algorithm). Participants were assessed and video recorded during a simulated cardiac arrest scenario which included three different heart rhythms (ventricular fibrillation [VF], pulseless ventricular tachycardia [pVT], asystole) in randomized order. Video and software analyses were performed. Defibrillation safety was assessed using a 17-item checklist defined beforehand. RESULTS: A total of 203 simulated cardiac arrests (75 anticipatory method and 128 ERC 2010 algorithm) were analyzed. The anticipatory method did not significantly reduce no-flow time (25.8 s, standard deviation, SD 7.4 s vs. 27.4 s SD 8.4 s, p = 0.19); however, peri-shock pauses were significantly longer in the anticipatory group compared to the ERC 2010 group (9.5 s SD 2.8 s vs. 3.3 s SD 1.9 s, p 
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research

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We report on an 63-year-old man who presented for repair of an ascending aortic dissection. After cardiopulmonary bypass separation assisted with high-dose epinephrine, ES developed requiring over 40 defibrillatory shocks. The epinephrine infusion was held and within 5 min, the ES self-terminated. ES in the context of cardiovascular surgery with the use of epinephrine for hemodynamic support has not be previously reported. Clinicians need to be cognizant of the seemingly paradoxical effect of epinephrine to induce ES. Initial ES treatment involves acute stabilization (treating or removing exacerbating factors (i.e., excess catecholamines)).
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
ConclusionsThe reperfusion VT/VFs were independently predicted by increased Tp ‐Te dispersion, which suggests the importance of multi‐lead evaluation of Tp‐Te intervals.
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: ORIGINAL ‐ EXPERIMENTAL Source Type: research
ConclusionsThe reperfusion VT/VFs were independently predicted by increased Tp ‐Te dispersion, which suggests importance of multi‐lead evaluation of Tp‐Te intervals.This article is protected by copyright. All rights reserved.
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: ORIGINAL ‐ EXPERIMENTAL Source Type: research
A 64 year-old man (155 cm, 56 kg) presented to hospital with an ST-elevation myocardial infarction after experiencing 6 hours of chest pain. He was taken to the cardiac catheterization laboratory where he suffered a ventricular tachycardia cardiac arrest requiring 2 minutes of cardiopulmonary resuscitation, endotracheal intubation, mechanical ventilation, and placement of an intraaortic balloon pump. Coronary angiography demonstrated severe multivessel coronary artery disease with acutely occluded left anterior descending and right coronary arteries and a large post-infarction ventricular septal defect (VSD).
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Diagnostic Dilemma Source Type: research
AbstractBackgroundSympathetic neural activation plays a key role in the incidence and maintenance of acute myocardial infarction (AMI) induced ventricular arrhythmia (VA). Furthermore, previous studies showed that AMI might induce microglia and sympathetic activation and that microglial activation might contribute to sympathetic activation. Recently, studies showed that light emitting diode (LED) therapy might attenuate microglial activation. Therefore, we hypothesized that LED therapy might reduce AMI ‐induced VA by attenuating microglia and sympathetic activation.MethodsThirty anesthetized rats were randomly divided in...
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: ORIGINAL ‐ EXPERIMENTAL Source Type: research
THE BURDEN OF cardiac arrest out of hospital is substantial, with an estimated 424,000 cardiac arrests occurring each year in the United States and 275,000 in Europe.1,2 As few as 1 in 12 victims of cardiac arrest out of hospital survive to return home.3,4 Cardiac arrest secondary to a ventricular fibrillation (VF)/pulseless ventricular tachycardia (pVT) commonly employs the use of antiarrhythmic medications and interventions such as electrical defibrillation and chest compressions. If these medications have any effect on overall outcomes, neurological sequela in recovered victims, or discharge time, is still very nebulous.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Expert Review Source Type: research
Authors: Abe N, Go M, Nakai K, Kato M, Tanaka K Abstract Transcatheter closure with an Amplatzer Septal Occluder (ASO) has become the standard treatment for secundum atrial septal defect (ASD). However, this procedure is associated with complications, such as device dislodgement. A 52-year-old woman was admitted with exertional dyspnea. Transesophageal echocardiography showed an ASD involving a 29 mm defect. Calculated Qp/Qs was 5.6 and all the rims were ?5 mm, with the exception of the posterior rim, which was 3 mm. Transcatheter ASD closure with an ASO was performed under general anesthesia. During emergence from...
Source: Journal of Medical Investigation - Category: General Medicine Tags: J Med Invest Source Type: research
Ventricular tachycardia (VT) or ventricular fibrillation (VF) storm is a life-threatening condition that is often managed by antiarrhythmic drug therapies, catheter ablation, general anesthesia, and ventricular support devices. Radiotherapy for VT has shown early promise as a noninvasive therapy to reduce risk of recurrent VT. No data exist on the role of radiotherapy for VF storm. Scholz et  al (DOI: https://doi.org/10.1016/j.hrcr.2019.03.004) shared a case of a 53-year-old man who presented with VF storm after a recent presentation with anterior myocardial infarction.
Source: Heart Rhythm - Category: Cardiology Authors: Tags: EP News Source Type: research
In conclusion, the impaired in situ activity of RyR2 may also account for the poor overall cardiac outcome reported in MetS patients; hence, the SERCA pump and RyR2 are both attractive potential targets for future therapies. Introduction Metabolic syndrome (MetS) is a cluster of biochemical and physiological risk factors for cardiovascular disease and diabetes mellitus type 2 (DM2); it represents a severe public health problem around the world (Alberti et al., 2009). Risk factors for MetS include obesity (particularly central obesity), elevated triglyceride (TG) levels, low high-density lipoprotein cholesterol (HDL...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
Conclusion and Perspectives Since their cloning 20 years ago, the physiological importance of TREK-1 channels has continued to grow (Figure 3). Today, TREK-1 channels have been shown to be important and their presence is essential in a number of physiopathological processes. Their involvement in these different processes demonstrate the necessity to design pharmacological modulators, activators or inhibitors, of these channels to correct any TREK-1-related dysfunctions. Despites a number of studies and many molecule screenings, only few putative new drugs were identified. The activators belonging to the ML and BL series ...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
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