RESUMO
In this case report, we describe a 73 year old female with structuraly normal heart that developed shortcoupled torsades de pointes (TdP) resulting in an electrical storm unresponsible to several antiarrhythmic drugs, but fully controlled with verapamil. The critical timing of the ventricular premature beats that initiated TdP corresponded to those that occurred at the peak of the previous T wave. This behavior differentiates this entity from other forms of malignant ventricular arrhythmias in patients with structurally normal heart. It is imperative that the clinical set-up and unique electrocardiographic fingerprint of this unusual malignant entity be assiduously recognized since verapamil can be life-saving in this condition.
Assuntos
Torsades de Pointes , Complexos Ventriculares Prematuros , Idoso , Antiarrítmicos/uso terapêutico , Eletrocardiografia , Feminino , Humanos , Torsades de Pointes/diagnóstico , Complexos Ventriculares Prematuros/complicações , Complexos Ventriculares Prematuros/diagnóstico , Verapamil/uso terapêuticoAssuntos
Desfibriladores Implantáveis , Marca-Passo Artificial , Consenso , Eletrônica , Coração , HumanosRESUMO
Objetivos: Comparar el cambio del nivel de riesgo ergonómico en posturas forzadas y movimiento repetitivo por rediseño de puesto de máquina sopladora de botellas de plástico en una fábrica en la ciudad de Lima. Material y Métodos: Las metodologías empleadas para posturas de trabajo y de movimiento repetitivo fueron las normas ISO 11226:2000 y OCRA Checklist respectivamente.Resultados:Los niveles de riesgo de los trabajadores en la primera evaluación de OCRA Checklist para movimientos repetitivos dieron niveles de riesgo medio y riesgo elevado y para posturas forzadas evaluado mediante ISO 11226:2000 se encontraba en nivel no recomendado. Luego del rediseño ergonómico se obtuvo el nivel riesgo aceptable.Conclusión: En el proceso de abastecimiento de botellas de máquinas sopladoras, inicialmente no presentaban criterios ergonómicos aceptables para los peligros de movimiento repetitivo y posturas de trabajo. No obstante, al realizar el rediseño del puesto de trabajo se obtuvo niveles de riesgos aceptables. (AU)
Objective: To compare the change in the level of ergonomic risk in forced postures and repetitive movement due to the redesign of the job of a plastic bottle blowing machine in a factory in the city of Lima. Material and Methods: The methodologies used for work postures and repetitive movement were the ISO 11226:2000 and OCRA Checklist standards, respectively.Results:The risk levels of the workers in the first evaluation of OCRA Checklist for repetitive movements gave levels of medium risk and high risk and for forced postures evaluated by ISO 11226:2000 it was at the not recommended level. After the ergonomic redesign, the acceptable risk level was obtained. Conclusion: In the bottle supply process for blow molding machines, initially they did not present acceptable ergonomic criteria for the dangers of repetitive movement and work postures. However, when carrying out the redesign of the workplace, acceptable risk levels were obtained. (AU)