ABSTRACT
This case report describes our first experience performing percutaneous epicardial catheter ablation for Burugada syndrome in our hospital. We describe the good results achieved in this case. The patient was a man in his 30s with no remarkable medical history. However, his family history was notable for the sudden death of his grandfather at age 37 years and his father at age 27 years. While asleep, the patient experienced convulsions and lost consciousness. During emergency transportation, defibrillation was performed 7 times by the ambulance crew. When the patient arrived at our hospital, sinus rhythm was observed on ECG. During resuscitation, Burugada syndrome was diagnosed based on ECG findings. On hospital day 6, an internal cardioverter defibrillator was implanted. After discharge, the defibrillator operated 10 times, so we opted for ablation treatment. Fractionated potential of over 150 ms was confirmed in the right ventricular outflow tract. A low voltage zone of <1 mV could be mapped, and the same site was cauterized a total of 46 times. As a result, ST segment amplitude decreased significantly in lead V1 on ECG. Percutaneous epicardial catheter ablation performed with reference to Nademanee’s report achieved good results in this case of Burugada syndrome.
ABSTRACT
Continuous blood purification (CBP) therapy, chiefly represented by continuous hemodiafiltration (CHDF), is performed mainly in the field of intensive care and is a vital component of acute blood purification therapy. In addition to renal indications, the scope of indications for CBP has been expanded to include non-renal conditions such as severe acute pancreatitis and liver failure. However, at present, hospitals carry out CBP on a trial and error basis. Here, we conducted the tenth questionnaire survey (2019) to investigate the current status of CBP in the Tokai and Hokuriku regions. The 30-item questionnaire included questions on the number of cases managed per year, type of membranes used, set up conditions, management during set up, activated clotting time, and clinical engineer duty system. A total of 83 facilities participated in the survey, including 69 in Tokai (Aichi, Gifu, Mie, and Shizuoka) and 14 in Hokuriku. It appears that many hospitals depend on the clinical engineer duty system for exchange of drug solutions, adjusting CBP conditions, and trouble-shooting issues in CBP management. Our findings suggest the importance of continued proactive involvement in the 24-h management system and in the standardization of CBP therapy.
ABSTRACT
Hyperbaric oxygen (HBO) therapy for acute carbon monoxide (CO) poisoning is performed after oxygen therapy and breathing therapy. The usefulness of HBO therapy in emergency treatment has been reported. In this study, we examined the effectiveness of HBO for CO poisoning that was performed at our hospital over the past 5 years. Subjects were 23 patients who had HBO therapy for CO poisoning in the period January 2008-November 2013. The male to female ratio of the cases was 14:9 and the mean age was 54.6±20.8 years. The cause was suicide in 39.1% of cases and accident in 60.9%. The mean number of treatments was 5.4±6.8. The atmosphere absolute was 2ATA:2.8ATA=12:11. The ratio of direct conveyance of the patient to our hospital to indirect conveyance of the patient from another hospital was 15:8. The effectiveness of HBO therapy at the time of discharge was 73.9%. However, delayed neuropsychiatric sequelae (DNS) was detected in 3 of the 23 cases of CO poisoning. No correlations were found between elapsed time after CO inhalation and various blood parameters. However, time to start of therapy is important for DNS, and our results suggest that early treatment at a hospital with a hyperbaric chamber is necessary.