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1.
Medicine (Baltimore) ; 98(44): e17790, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689853

RESUMO

RATIONALE: Stellate Ganglion Block (SGB) provides a blockade of sympathetic signals from the sympathetic chain and appears to be a promising method of controlling refractory ventricular arrhythmias, but there are scanty data in the literature. PATIENT CONCERNS: Herein, we describe a 59-year-old male patient with a history of non-ischemic cardiomyopathy and suffering from frequent VT episodes, who received ICD implantation and regular amiodarone medication control. DIAGNOSES: Monomorphic VT refractory to standard medication control and focal extensive catheter ablation. INTERVENTIONS: Left Stellate Ganglion Block (LSGB) was performed under ultrasound-assisted injection at the C6 level using a 10 ml solution of 0.4% lidocaine and 0.5% bupivacaine. OUTCOMES: In our case, refractory VT subsided and sinus rhythm was retained immediately after LSGB. There were no VT episodes for at least 3 hours during the inter-hospital transfer, which did not involve any specific complications. LESSONS: LSGB may provide effective VT control and play an important role in rescue and bridge therapy before catheter ablation.


Assuntos
Bloqueio Nervoso Autônomo/métodos , Cardiomiopatias/terapia , Gânglio Estrelado , Taquicardia Ventricular/terapia , Cardiomiopatias/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Taquicardia Ventricular/complicações , Resultado do Tratamento
2.
Med Clin North Am ; 103(5): 881-895, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31378332

RESUMO

Ventricular tachycardia is commonly seen in medical practice. It may be completely benign or portend high risk for sudden cardiac death. Therefore, it is important that clinicians be familiar with and able to promptly recognize and manage ventricular tachycardia when confronted with it clinically. In many cases, curative therapy for a given ventricular arrhythmia may be provided after a thorough understanding of the underlying substrate and mechanism. In this article, the authors broadly review the current classification of the different ventricular arrhythmias encountered in medical practice, provide brief background regarding the different mechanisms, and discuss practical diagnosis and management scenarios.


Assuntos
Morte Súbita Cardíaca/prevenção & controle , Taquicardia Ventricular/fisiopatologia , Taquicardia Ventricular/terapia , Antiarrítmicos/uso terapêutico , Gerenciamento Clínico , Eletrocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ablação por Radiofrequência/métodos , Taquicardia Ventricular/complicações , Taquicardia Ventricular/diagnóstico
3.
Prog Cardiovasc Dis ; 62(3): 227-234, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31078562

RESUMO

Sudden cardiac death (SCD) accounts for 230,000 to 350,000 deaths per year in the United States. While many who suffer SCD possess underlying structural heart disease, inherited arrhythmia syndromes are also important contributors to SCD. In patients without structural heart disease, inherited arrhythmia syndromes are identified in >50% of the remaining patients. In this review, we will focus on the presentation and management of three major inherited syndromes that lead to SCD in patients without structural heart disease: long QT syndrome (LQTS), Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia (CPVT). All these syndromes can present in patients who are asymptomatic or, at the other extreme, with syncope and even SCD. LQTS syndrome and Brugada are the most common inherited arrhythmogenic syndromes, while CPVT is much rarer. Determining which patients need pharmacologic treatment and those who would benefit from more aggressive treatment such as sympathectomies and implantable defibrillators is not always clear.


Assuntos
Síndrome de Brugada , Morte Súbita Cardíaca/etiologia , Síndrome do QT Longo , Taquicardia Ventricular , Síndrome de Brugada/complicações , Síndrome de Brugada/diagnóstico , Síndrome de Brugada/terapia , Desfibriladores Implantáveis , Eletrocardiografia , Humanos , Síndrome do QT Longo/complicações , Síndrome do QT Longo/diagnóstico , Síndrome do QT Longo/terapia , Medição de Risco , Taquicardia Ventricular/complicações , Taquicardia Ventricular/diagnóstico , Taquicardia Ventricular/terapia
6.
Am J Ther ; 26(4): e469-e480, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30946044

RESUMO

BACKGROUND: The optimal management for the prevention of recurrent ventricular tachycardia in patients with implantable cardioverter-defibrillators (ICDs) offers a challenge with no set guidelines regarding which therapy offers a best safety and efficacy profile. STUDY QUESTION: Which therapeutic strategy, among antiarrhythmic drugs and catheter ablation (CA), offers the most effective and safe approach in patients with ICDs? DATA SOURCES: Randomized controlled trials (RCTs) comparing the efficacy and safety of antiarrhythmic drugs or CA against a placebo group. RCTs were identified from a comprehensive search in PubMed, Embase, and Cochrane library. STUDY DESIGN: Our outcomes of interest were reductions in appropriate ICD shocks, inappropriate ICD shocks, and overall mortality. We used the event rates in both groups, and then using a frequentist approach employing a graph theory methodology, we constructed a network meta-analysis model. RESULTS: Fourteen RCTs with 3815 participants and 6 different interventions treatments were included in our network meta-analysis. The most effective treatment for the prevention of recurrent ventricular tachycardia after ICD is amiodarone followed by CA. Amiodarone is most effective in the reduction of appropriate and inappropriate ICD shocks with an odds ratio (OR) of 0.29 [95% confidence interval (CI), 0.11-0.74] and 0.15 (95% CI, 0.04-0.60), respectively. CA was effective in the reduction of appropriate ICD shocks (OR, 0.41; 95% CI, 0.20-0.87), whereas sotalol was effective in the reduction of inappropriate ICD shocks (OR, 0.46; 95% CI, 0.22-0.95). There was no significant reduction in the overall mortality from any therapy. There was a trend of increased mortality associated with amiodarone therapy (OR, 2.40; 95% CI, 0.92-6.26). CONCLUSIONS: Amiodarone remains the most efficacious therapy for the reduction of appropriate and inappropriate shocks in patients with ICD. No therapy resulted in mortality reduction, but amiodarone showed a trend toward increased mortality.


Assuntos
Desfibriladores Implantáveis , Insuficiência Cardíaca/prevenção & controle , Prevenção Secundária/métodos , Taquicardia Ventricular/prevenção & controle , Antiarrítmicos/administração & dosagem , Antiarrítmicos/efeitos adversos , Ablação por Cateter/efeitos adversos , Ablação por Cateter/métodos , Cardioversão Elétrica/efeitos adversos , Cardioversão Elétrica/métodos , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/mortalidade , Humanos , Meta-Análise em Rede , Recidiva , Taquicardia Ventricular/complicações , Taquicardia Ventricular/mortalidade , Resultado do Tratamento
7.
Circulation ; 139(12): e530-e552, 2019 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-30760026

RESUMO

Coronary artery disease is prevalent in different causes of out-of-hospital cardiac arrest (OHCA), especially in individuals presenting with shockable rhythms of ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT). The purpose of this report is to review the known prevalence and potential importance of coronary artery disease in patients with OHCA and to describe the emerging paradigm of treatment with advanced perfusion/reperfusion techniques and their potential benefits on the basis of available evidence. Although randomized clinical trials are planned or ongoing, current scientific evidence rests principally on observational case series with their potential confounding selection bias. Among patients resuscitated from VF/pVT OHCA with ST-segment elevation on their postresuscitation ECG, the prevalence of coronary artery disease has been shown to be 70% to 85%. More than 90% of these patients have had successful percutaneous coronary intervention. Conversely, among patients resuscitated from VF/pVT OHCA without ST-segment elevation on their postresuscitation ECG, the prevalence of coronary artery disease has been shown to be 25% to 50%. For these patients, early access to the cardiac catheterization laboratory is associated with a 10% to 15% absolute higher functionally favorable survival rate compared with more conservative approaches of late or no access to the cardiac catheterization laboratory. In patients with VF/pVT OHCA refractory to standard treatment, a new treatment paradigm is also emerging that uses venoarterial extracorporeal membrane oxygenation to facilitate return of normal perfusion and to support further resuscitation efforts, including coronary angiography and percutaneous coronary intervention. The burden of coronary artery disease is high in this patient population, presumably causative in most patients. The strategy of venoarterial extracorporeal membrane oxygenation, coronary angiography, and percutaneous coronary intervention has resulted in functionally favorable survival rates ranging from 9% to 45% in observational studies in this patient population. Patients with VF/pVT should be considered at the highest severity in the continuum of acute coronary syndromes. These patients have a significant burden of coronary artery disease and acute coronary thrombotic events. Evidence from randomized trials will further define optimal clinical practice.


Assuntos
Doença da Artéria Coronariana/diagnóstico , Parada Cardíaca Extra-Hospitalar/terapia , Cateterismo Cardíaco , Reanimação Cardiopulmonar , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/mortalidade , Guias como Assunto , Humanos , Parada Cardíaca Extra-Hospitalar/complicações , Intervenção Coronária Percutânea , Taxa de Sobrevida , Taquicardia Ventricular/complicações , Fibrilação Ventricular/complicações
8.
Kyobu Geka ; 72(2): 144-147, 2019 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-30772882

RESUMO

A 74-year-old man was transferred to our hospital for heart failure and ventricular tachycardia. Left ventricular aneurysm of a huge size( 6×9 cm) was found on the imaging test, and was suspected to be a pseudo-false aneurysm because of its thick wall with small orifice. Occulusion of the right coronary artery (#1) was revealed by coronary arteriography and the diskinetic aneurysm in the inferior wall was revealed by left ventriculography. The surgical treatment was needed, because of the high risk of rupture. He successfully underwent Dor operation with endocardial cryoablation and left ventricular ejection fraction (LVEF) was found to be improved by postoperative left ventriculography. He discharged on 56 days after operation. Ventricular pseudo-false aneurysm is rare and the treatment is controversial.


Assuntos
Falso Aneurisma/cirurgia , Aneurisma Cardíaco/cirurgia , Idoso , Falso Aneurisma/complicações , Falso Aneurisma/diagnóstico por imagem , Angiografia Coronária , Endocárdio , Aneurisma Cardíaco/complicações , Aneurisma Cardíaco/diagnóstico por imagem , Insuficiência Cardíaca/complicações , Ventrículos do Coração , Humanos , Masculino , Volume Sistólico , Taquicardia Ventricular/complicações
9.
Pacing Clin Electrophysiol ; 42(4): 447-452, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30680747

RESUMO

BACKGROUND: While there is an association between isolated mitral valve prolapse (MVP) and sudden cardiac arrest (SCA), the baseline characteristics and outcomes of patients with isolated MVP who experience ventricular arrhythmias (VAs) and then subsequently undergo catheter ablation and/or implantable cardioverter defibrillator (ICD) implantation are unknown. METHODS: We performed a retrospective review of all patients at the Cleveland Clinic with isolated MVP between 1997 and 2016 who underwent VA catheter ablation or secondary prevention ICD implantation. RESULTS: Of 617 screened patients, we identified 43 patients with isolated MVP and significant VA who underwent ICD placement (n = 13, 30%) or catheter ablation (n = 30, 70%). Both leaflets were most commonly involved (n = 22, 52%) with posterior MVP being next most common (n = 15, 36%). The most common foci of VA origin was the left ventricular papillary muscle (n = 9, 27%). Ablation was successful in the majority of cases (n = 20, 65%). At a mean follow-up of 2.5 years, 11 patients (26%) had recurrent VT. CONCLUSIONS: Patients with isolated MVP and VA were more likely to have bileaflet prolapse and at least moderate mitral regurgitation. VA originated more commonly from left-sided foci. While ablation was acutely successful in the majority of cases, there was still a moderate rate of VA recurrence. There is still more study needed on factors that will predict malignant VAs and management of these VAs in the MVP population.


Assuntos
Ablação por Cateter , Desfibriladores Implantáveis , Prolapso da Valva Mitral/terapia , Taquicardia Ventricular/terapia , Complexos Ventriculares Prematuros/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prolapso da Valva Mitral/complicações , Prolapso da Valva Mitral/cirurgia , Estudos Retrospectivos , Prevenção Secundária , Taquicardia Ventricular/complicações , Taquicardia Ventricular/cirurgia , Complexos Ventriculares Prematuros/complicações , Complexos Ventriculares Prematuros/cirurgia
11.
Echocardiography ; 36(1): 182-183, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30426550

RESUMO

A rare and unusual form of myocardial rupture that can complicate acute myocardial infarction is intra-myocardial dissecting hematoma (IDH). Reports in the literature describing this entity are limited to case reports or series. The diagnosis prior to the advent of noninvasive imaging was at autopsy. We present a case of IDH occurring after acute anterior wall myocardial infarction that terminated fatally preceded by a hemodynamically unstable incessant ventricular tachycardia.


Assuntos
Infarto Miocárdico de Parede Anterior/complicações , Ecocardiografia/métodos , Hematoma/diagnóstico por imagem , Hematoma/etiologia , Taquicardia Ventricular/complicações , Infarto Miocárdico de Parede Anterior/diagnóstico por imagem , Diagnóstico Diferencial , Evolução Fatal , Feminino , Coração/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade
12.
Am Heart J ; 208: 1-10, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30471486

RESUMO

BACKGROUND: Long-term trends in the incidence rates (IRs) and hospital case-fatality rates (CFRs) of ventricular tachycardia (VT) and ventricular fibrillation (VF) among patients hospitalized with acute myocardial infarction (AMI) have not been recently examined. METHODS: We used data from 11,825 patients hospitalized with AMI at all 11 medical centers in central Massachusetts on a biennial basis between 1986 and 2011. Multivariable adjusted logistic regression modeling was used to examine trends in hospital IRs and CFRs of VT and VF complicating AMI. RESULTS: The median age of the study population was 71 years, 57.9% were men, and 94.7% were white. The hospital IRs declined from 14.3% in 1986/1988 to 10.5% in 2009/2011 for VT and from 8.2% to 1.7% for VF. The in-hospital CFRs declined from 27.7% to 6.9% for VT and from 49.6% to 36.0% for VF between 1986/1988 and 2009/2011, respectively. The IRs of both early (<48 hours) and late VT and VF declined over time, with greater declines in those of late VT and VF. The incidence rates of VT declined similarly for patients with either an ST-segment elevation myocardial infarction (STEMI) or non-STEMI, whereas they only declined in those with VF and a STEMI. CONCLUSIONS: The hospital IRs and CHRs of VT and VF complicating AMI have declined over time, likely because of changes in acute monitoring and treatment practices. Despite these encouraging trends, efforts remain needed to identify patients at risk for these serious ventricular arrhythmias so that preventive and treatment strategies might be implemented as necessary.


Assuntos
Mortalidade Hospitalar/tendências , Infarto do Miocárdio/complicações , Taquicardia Ventricular/epidemiologia , Fibrilação Ventricular/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Incidência , Modelos Logísticos , Masculino , Massachusetts/epidemiologia , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio sem Supradesnível do Segmento ST/complicações , Infarto do Miocárdio sem Supradesnível do Segmento ST/epidemiologia , Infarto do Miocárdio com Supradesnível do Segmento ST/complicações , Infarto do Miocárdio com Supradesnível do Segmento ST/epidemiologia , Taquicardia Ventricular/complicações , Taquicardia Ventricular/mortalidade , Fatores de Tempo , Fibrilação Ventricular/complicações , Fibrilação Ventricular/mortalidade
13.
Heart Lung Circ ; 28(1): 146-154, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30392982

RESUMO

Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac condition, with an associated increased risk of ventricular arrhythmias and sudden cardiac death. Young and asymptomatic patients, including professional athletes, are not spared this risk. Implantable cardiac defibrillators (ICDs) are highly effective in terminating malignant ventricular arrhythmias in this group, but they are associated with significant morbidity, such as inappropriate shocks and device complications. Accurate prognostication to guide ICD implantation is therefore essential. The interplay of traditional risk factors, risk modifiers and predictive models creates a complex decision-making environment for the HCM clinician. Risk stratifying tools are expanding with improved understanding of advanced imaging modalities, such as late gadolinium enhancement on cardiac magnetic resonance imaging (cMRI). Once the decision to implant a defibrillator is reached, the choice of device and programming in HCM is unique and should take into account disease substrate and younger age of patients.


Assuntos
Cardiomiopatia Hipertrófica/complicações , Morte Súbita Cardíaca/etiologia , Taquicardia Ventricular/complicações , Cardiomiopatia Hipertrófica/mortalidade , Morte Súbita Cardíaca/epidemiologia , Saúde Global , Humanos , Incidência , Taxa de Sobrevida/tendências , Taquicardia Ventricular/mortalidade
16.
Clin Res Cardiol ; 108(1): 16-21, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29948287

RESUMO

BACKGROUND: The subcutaneous ICD is a promising treatment option in patients at risk for sudden cardiac death. Approved in 2009, the first S-ICD® in Germany was implanted in June 2010. Although large prospective registry studies have shown safety and efficacy of the system, there is a lack of long-term data with regard to battery longevity of the S-ICD®. Therefore, we report follow-up of our first initial S-ICD® cases from implantation till battery depletion. MATERIALS AND METHODS: All S-ICD® patients with device replacement for battery depletion in our large single-center S-ICD® registry were included in this study. Baseline characteristics, appropriate and inappropriate shocks, and complications were documented in a median follow-up of 75.9 ± 6.8 months. RESULTS: Twenty-eight patients with S-ICD® systems were included in this study. Of these patients, 21 were male and 7 were female, with an overall mean age of 41.9 ± 12.6 years. Primary prevention of sudden cardiac death was the indication in 19 patients (67.9%). Ventricular tachycardia was adequately terminated in two patients (7.1%). In 7 patients, non-sustained ventricular arrhythmias were not treated. A total of three inappropriate shocks occurred in three patients (10.7%). Mean time from implantation till battery depletion was 65.8 ± 8.1 months. Only one patient presented premature elective replacement criteria because of rapid battery depletion. No lead-related complication occurred during follow-up and no complications were seen regarding device replacement. In one patient (3.6%), the system was explanted without replacement due to patient's preference. CONCLUSION: The estimated battery longevity of S-ICD® of about 5 years was reached in all but one patient. Compared to larger S-ICD® registry studies, frequency of inappropriate shocks was relatively high in the initial S-ICD® cases. Both technological improvement as well as programming and operators' experience have led to a reduction of complications. Replacement of the S-ICD® seems to be a safe and effective procedure.


Assuntos
Morte Súbita Cardíaca/prevenção & controle , Desfibriladores Implantáveis , Prevenção Primária/métodos , Sistema de Registros , Taquicardia Ventricular/terapia , Adulto , Morte Súbita Cardíaca/epidemiologia , Morte Súbita Cardíaca/etiologia , Feminino , Seguimentos , Humanos , Masculino , Estudos Prospectivos , Taquicardia Ventricular/complicações , Fatores de Tempo , Resultado do Tratamento
17.
Int J Cardiol ; 274: 132-137, 2019 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-30122502

RESUMO

BACKGROUND: Inflammatory heart disease is known to be associated with ventricular arrhythmias (VA) and impaired ventricular function at presentation or during follow-up. We aimed to investigate the need for implanted cardioverter defibrillator (ICD) due to ventricular dysfunction and occurrence of VA during long-term follow-up in patients admitted with suspected myocarditis. METHODS: Between 2000 and 2016, 191 patients (age 43 ±â€¯13 years, 71% male, mean left ventricular ejection fraction (LVEF) 33 ±â€¯15%) with clinically suspected myocarditis, who underwent endomyocardial biopsies (EMB), were prospectively enrolled and followed up in 6-months-intervals (median follow-up was 83 (49-156) months). The primary endpoint was deterioration of cardiac function (LVEF ≤ 35%) or occurrence of VA leading to ICD implantation. RESULTS: According to EMB results, patients were stratified in three diagnostic groups: acute myocarditis (5%), chronic myocarditis (50%) and dilated cardiomyopathy (DCM) (45%). An ICD implantation was performed in 58 patients (30%, n = 38 for primary prevention). Besides LVEF at baseline, chronic myocardial inflammation was the only independent predictor of ICD implantation for primary prevention (hazard ratio 2.48 (95% confidence interval 1.02-5.5); p = 0.045). VA requiring ICD therapy occurred in 29 of 58 patients (50%) after a median of 14 (2-37) months without a significant difference between presence and absence of myocardial inflammation. CONCLUSIONS: Nearly one third of patients with suspected myocarditis require an ICD due to impaired LVEF or occurrence of VA. Half of these patients experienced VA with adequate ICD therapy.


Assuntos
Desfibriladores Implantáveis , Miocardite/etiologia , Miocárdio/patologia , Prevenção Primária/métodos , Volume Sistólico/fisiologia , Taquicardia Ventricular/complicações , Função Ventricular Esquerda/fisiologia , Adulto , Biópsia , Feminino , Seguimentos , Humanos , Masculino , Miocardite/diagnóstico , Estudos Retrospectivos , Taquicardia Ventricular/fisiopatologia , Taquicardia Ventricular/prevenção & controle , Fatores de Tempo , Resultado do Tratamento
19.
Heart Lung Circ ; 28(1): 155-163, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30554599

RESUMO

Athletes enjoy excellent health outcomes including greater longevity relative to non-athletic counterparts. Paradoxically, however, endurance athletic conditioning is associated with an increase in some arrhythmias. This review discusses the potential mechanisms for this paradox and strategies enabling early identification of potentially serious pathologies. Screening remains contentious due to the challenges of identifying relatively rare entities amongst a healthy cohort. The imperfect diagnostic accuracy of all current tests means that screening strategies have potential for harm through incorrect diagnoses as well as the potential for identification of important sub-clinical pathologies. Management of athletes at risk of ventricular arrhythmias and sudden cardiac death is similarly complex. There is much yet to learn about the specific patterns of ventricular arrhythmias in athletes, and the separation of benign from potentially life-threatening remains imperfect. There are some promising advances, however, such as specialised imaging modalities combined with improved electrophysiological diagnostics and therapeutics. Some unique clinical patterns are emerging to advance our understanding and management of athletes with ventricular arrhythmias, requiring specialised skillsets for evaluation and management.


Assuntos
Atletas , Ablação por Cateter/métodos , Morte Súbita Cardíaca/prevenção & controle , Programas de Rastreamento/métodos , Taquicardia Ventricular , Morte Súbita Cardíaca/epidemiologia , Eletrocardiografia , Saúde Global , Humanos , Incidência , Taxa de Sobrevida/tendências , Taquicardia Ventricular/complicações , Taquicardia Ventricular/diagnóstico , Taquicardia Ventricular/cirurgia
20.
Circulation ; 138(23): e740-e749, 2018 12 04.
Artigo em Inglês | MEDLINE | ID: mdl-30571262

RESUMO

Antiarrhythmic medications are commonly administered during and immediately after a ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest. However, it is unclear whether these medications improve patient outcomes. This 2018 American Heart Association focused update on advanced cardiovascular life support guidelines summarizes the most recent published evidence for and recommendations on the use of antiarrhythmic drugs during and immediately after shock-refractory ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest. This article includes the revised recommendation that providers may consider either amiodarone or lidocaine to treat shock-refractory ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest.


Assuntos
Antiarrítmicos/uso terapêutico , Reanimação Cardiopulmonar/métodos , Parada Cardíaca/tratamento farmacológico , American Heart Association , Amiodarona/uso terapêutico , Serviços Médicos de Emergência , Parada Cardíaca/etiologia , Humanos , Lidocaína/uso terapêutico , Magnésio/uso terapêutico , Taquicardia Ventricular/complicações , Taquicardia Ventricular/patologia , Estados Unidos , Fibrilação Ventricular/complicações , Fibrilação Ventricular/patologia
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