Sustained ventricular fibrillation in an alert patient: preserved hemodynamics with a left ventricular assist device.
Prehosp Emerg Care
; 15(4): 533-6, 2011.
Article
em En
| MEDLINE
| ID: mdl-21806468
ABSTRACT
Emergency medical services (EMS) encountered an alert patient with sustained ventricular fibrillation with preserved hemodynamics via a left ventricular assist device (LVAD). Multiple firings of the patient's implantable defibrillator were the only sign that this patient was experiencing the usually fatal ventricular arrhythmia. Initial attempts at rhythm conversion with amiodarone and 200-J biphasic shocks were unsuccessful. The patient was finally defibrillated to normal sinus rhythm after a 360-J biphasic shock. This case conference highlights the increasing prevalence of LVADs. These devices are used not only as a bridge to cardiac transplantation, but also as definitive therapy for patients in end-stage cardiac failure. Ventricular fibrillation has been shown to be well tolerated in patients with LVADs, and we discuss a standard of care for these patients. The occurrence of sustained ventricular fibrillation in patients with ventricular assist devices represents a challenging situation for EMS and emergency department providers and one that will be increasingly encountered in the future.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Ventricular
/
Cardioversão Elétrica
/
Desfibriladores Implantáveis
/
Amiodarona
Tipo de estudo:
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
Idioma:
En
Revista:
Prehosp Emerg Care
Assunto da revista:
MEDICINA DE EMERGENCIA
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Estados Unidos