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"Cardioversion" AND "Emergency"

Jun Yasuhara, Takashi Kumamoto, Takuro Kojima, Hiroyuki Shimizu, Shigeki Yoshiba, Toshiki Kobayashi, Takayuki Oyanagi, Hiroyuki Yamagishi, Naokata Sumitomo
A 1-year-old infant with asplenia syndrome and congenital heart disease consisting of common atrium, common inlet left ventricle with a common atrio-ventricular (AV) valve, pulmonary atresia, and total anomalous pulmonary venous connection was admitted to our hospital for radiofrequency catheter ablation (RFCA) of supraventricular tachycardia (SVT) before total cavo-pulmonary connection. After antiarrhythmic medications were discontinued for RFCA, she suffered from SVT that resulted in the rapid deterioration of hemodynamic status...
January 2019: Journal of Cardiology Cases
Eric Dryver, David Larsson, Ulrika Pahlm
Emergency Medicine became a full-fledged speciality in Sweden in 2015. This prospective study analyzed the safety and implementation of Emergency Physician-administered propofol to sedate patients with hemodynamically stable atrial fibrillation prior to cardioversion. During the first 1.5 years, 321 sedations were carried out at Lund's Emergency Department by Emergency Physicians or senior residents. In two cases, the oxygen saturation dipped below 90% before responding to simple measures. In 12 cases, the systolic blood pressure dipped below 90 mmHg, and in two cases patients were administered a push-dose pressor...
January 8, 2019: Läkartidningen
Tatsuya Norii, Yosuke Homma, Hiroyasu Shimizu, Hiroshi Takase, Sung-Ho Kim, Shimpei Nagata, Akihikari Shimosato, Cameron Crandall
PURPOSE: Procedural sedation and analgesia (PSA) is widely performed outside of the operating theater, often in emergency departments (EDs). The practice and safety of PSA in the ED in an aging society such as in Japan have not been well described. We aimed to characterize the practice pattern of PSA including indications, pharmacology and incidence of adverse events (AEs) in Japan. METHODS: We formed the Japanese Procedural Sedation and Analgesia Registry, a multicenter prospective observation registry of ED patients undergoing PSA...
January 7, 2019: Journal of Anesthesia
Alexander Carpenter, Sabrina Sargent
Background: Direct current cardioversion (DCCV) is a safe and effective treatment for recent-onset atrial fibrillation (AF) or flutter and when performed in the emergency department (ED), it can provide an excellent treatment option for patients as well as reducing unnecessary hospital admissions and healthcare costs. However, appropriate periprocedural anticoagulation is absolutely essential to reduce the risk of adverse outcomes, chiefly thromboembolic stroke. Our intention was for 100% of patients undergoing DCCV in the ED to receive appropriate periprocedural anticoagulation...
2018: BMJ open quality
Gareth Squire, Mohammed Eltayeb, Kai Hogrefe
We describe the case of a 3-week postpartum 27-year-old woman who presented with chest pain to the emergency department shortly before developing cardiac arrest with refractory ventricular fibrillation. She was initially misdiagnosed and treated for presumed pulmonary embolism (PE) with thrombolysis. A total of 14 direct current cardioversion shocks were given and return of spontaneous circulation (ROSC) was achieved post thrombolysis. Subsequent CT pulmonary angiography excluded PE. A post-ROSC ECG demonstrated anterolateral ST elevation and she was transferred to the local cardiac unit for angiography...
November 28, 2018: BMJ Case Reports
Peter R Kowey, Saba Ahmad
As eager medical residents at a busy heart hospital, the opportunity to participate in the drama of cardiac resuscitation was abundant. Our population's demographic translated into a high percentage of morbidly obese among the unfortunate souls who needed our emergent ministration. So it was fairly early in my (PRK) career that I began to reflect on the adequacy of the methods we have traditionally used to cardiovert and defibrillate patients in whom the heart was distant from our paddles, functionally insulated from the electrical energy meant to reverse their arrhythmias and, in some cases, to save their lives...
December 16, 2018: Journal of Cardiovascular Electrophysiology
Reka Dulandas, Petra Brysiewicz
Introduction: Emergency nurses are usually the first to interact with critically ill patients and victims of violence and injuries, and require advanced skills and knowledge to manage such patients. Inadequate training prevents nurses from providing optimal emergency care, and it is important to investigate if there are any skills and competencies lacking in these emergency nurses. We sought to describe the self-perceived educational needs of emergency nurses in Durban, South Africa. Methods: A descriptive quantitative survey was conducted with nurses working in four emergency centres (two state, and two privately funded hospitals) in Durban, South Africa...
September 2018: African Journal of Emergency Medicine Revue Africaine de la Médecine D'urgence
Justin L Vandermolen, Murrium I Sadaf, Anil K Gehi
Introduction: Management of atrial fibrillation (AF) and atrial flutter (AFL) in the emergency department (ED) varies greatly, and there are currently no United States guidelines to guide management with regard to patient disposition after ED treatment. The aim of this systematic review was to evaluate the literature for decision aids to guide disposition of patients with AF/AFLin the ED, and assess potential outcomes associated with different management strategies in the ED. Methods and Results: A systematic review was done using PubMed (MEDLINE), Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE, combining the search terms "Atrial Fibrillation", "Atrial Flutter", "Emergency Medicine", "Emergency Service", and "Emergency Treatment"...
June 2018: Journal of Atrial Fibrillation
Ikuto Takeuchi, Hiroki Nagasawa, Kei Jitsuiki, Akihiko Kondo, Hiromichi Ohsaka, Youichi Yanagawa
Context/Aims: We retrospectively analyzed the characteristics of prehospital care for cardiopulmonary arrest (CPA) to identify the predictors of a good recovery (GR) among the recent changes in the management of Japanese prehospital care. Settings and Design: This study was a retrospective medical chart review. Subjects and Methods: We reviewed the transportation records written by emergency medical technicians and the characteristics of prehospital management of out-of-hospital (oh) CPA described by the Sunto-Izu Fire Department from April 2016 to March 2017...
July 2018: Journal of Emergencies, Trauma, and Shock
Douglas Robinson, Gregory Hand, Jason Ausman, Anthony Hackett
BACKGROUND: Brugada pattern is a well-known pathological finding on electrocardiogram (ECG) which increases the likelihood of cardiac arrest due to ventricular arrhythmia. These cases generally present in younger patients without evidence of an electrolyte abnormality, structural heart disease, or cardiac ischemia. In many instances, this pattern is either hidden on initial presentation or presents as an incidental finding on an EKG. Often times the Brugada syndrome leads to sudden cardiac death or more rarely can be unmasked with a class 1A or 1C anti-arrhythmic agent...
February 2019: American Journal of Emergency Medicine
Julian W E Jarman, Wajid Hussain, Tom Wong, Vias Markides, Jamie March, Laura Goldstein, Ray Liao, Iftekhar Kalsekar, Abhishek Chitnis, Rahul Khanna
BACKGROUND: The objective of our study was to compare resource use and clinical outcomes among atrial fibrillation (AF) patients who underwent catheter ablation versus antiarrhythmic drug (AAD) treatment. METHODS: A retrospective cohort design using the Clinical Practice Research Data-Hospital Episode Statistics linkage data from England (2008-2013) was used. Patients undergoing catheter ablation treatment for AF were indexed to the date of first procedure. AAD patients with at least two different AAD drugs were indexed to the first fill of the second AAD...
November 7, 2018: BMC Cardiovascular Disorders
Abdulelah Nuqali, Qaiser Shafiq, Mubbasher M Syed, Mujeeb Sheikh
BACKGROUND Non-atherosclerotic causes of ST-segment elevation myocardial infarction (STEMI) are uncommon, and there are few case reports of acute myocardial infarction secondary to coronary artery embolism. CASE REPORT A 66-year-old man presented with shortness of breath and leg swelling. Diagnoses of congestive heart failure and atrial fibrillation were made. He was electrically cardioverted to normal sinus rhythm. Coronary angiogram was performed to rule out ischemic etiology of new-onset systolic heart failure, and anticoagulation therapy was interrupted for cardiac catheterization...
November 2, 2018: American Journal of Case Reports
Maciej T Wybraniec, Wojciech Wróbel, Katarzyna Wilkosz, Karolina Wrona, Karolina Bula, Katarzyna Mizia-Stec
Background Antazoline mesylate represents an antihistamine capable of rapid and safe cardioversion of atrial fibrillation, yet evidence concerning its efficacy in comparison to other medications is insufficient. The study aimed to evaluate the success rate and safety of pharmacological cardioversion of atrial fibrillation with intravenous antazoline ( CANT [Cardioversion With Antazoline Mesylate] study) in the setting of the emergency department. Methods and Results After reviewing 1984 medical records, 450 eligible patients (22...
October 16, 2018: Journal of the American Heart Association
Simon S Craig, Marc Auerbach, John Alexander Cheek, Franz E Babl, Ed Oakley, Lucia Nguyen, Arjun Rao, Sarah Dalton, Mark D Lyttle, Santiago Mintegi, Joshua Nagler, Rakesh D Mistry, Andrew Dixon, Pedro Rino, Guillermo Kohn-Loncarica, Stuart R Dalziel
OBJECTIVE: To describe senior paediatric emergency clinician perspectives on the optimal frequency of and preferred modalities for practising critical paediatric procedures. METHODS: Multicentre multicountry cross-sectional survey of senior paediatric emergency clinicians working in 96 EDs affiliated with the Pediatric Emergency Research Network. RESULTS: 1332/2446 (54%) clinicians provided information on suggested frequency of practice and preferred learning modalities for 18 critical procedures...
October 16, 2018: Emergency Medicine Journal: EMJ
Michal M Farkowski, Aleksander Maciag, Malgorzata Zurawska, Ilona Kowalik, Hanna Szwed, Mariusz Pytkowski
INTRODUCTION: Options for a pharmacological cardioversion (CV) of short-duration atrial fibrillation (AF) in patients with a stable coronary artery disease (CAD) are limited to amiodarone or vernakalant. Antazoline has been reported to achieve high rates of AF conversion to sinus rhythm, but data on its effectiveness and, more importantly, safety in stable CAD patients, have been sparse. AIMS: To assess the effectiveness and safety of antazoline-based therapy in patients with a stable CAD undergoing pharmacological CV of short-duration AF in the emergency department (ED)...
October 3, 2018: Cardiovascular Therapeutics
Ilia Davarashvili, Moshe Rav Acha, Michael Glikson, Rivka Farkash, Benjamin Mazouz, Adi Butnaru, Tal Hasin
Acute pulmonary congestion (APC) may occur within hours after electrical cardioversion of atrial fibrillation (AF). There is scarce data about its incidence, risk factors, and the outcome. In the present study, data of consecutive patients admitted for first electrical cardioversion for AF between 2007 and 2016 were retrospectively reviewed. APC within the 48hours following cardioversion was defined as dyspnea and at least one of the following: drop in saturation to <90%, administration of intravenous diuretic or an emergent chest X-ray with new pulmonary congestion...
August 21, 2018: American Journal of Cardiology
Edward Koźluk, Dorota Zyśko, Agnieszka Piątkowska, Marek Kiliszek, Piotr Lodziński, Sylwia Małkowska, Paweł Balsam, Dariusz Rodkiewicz, Małgorzata Żukowska, Grzegorz Opolski
BACKGROUND: Atrial fibrillation (AF) is a common clinical problem. The left atrium anatomy makes up a factor that may significantly affect the effectiveness of the AF ablation. OBJECTIVES: The aim of the study was to evaluate a long-term effectiveness ablation in patients with common pulmonary vein trunk (CPVT) and AF. MATERIAL AND METHODS: The outcomes of 129 procedures in 95 patients with CPVT out of 1,475 procedures carried out in 1,150 patients with AF treated with ablation, were analyzed...
August 8, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Michele Massimo Gulizia, Roberto Cemin, Furio Colivicchi, Leonardo De Luca, Andrea Di Lenarda, Giuseppe Boriani, Giuseppe Di Pasquale, Federico Nardi, Marino Scherillo, Donata Lucci, Gianna Fabbri, Aldo Pietro Maggioni
Aims: To assess the number of admissions to the emergency room (ER) of patients with atrial fibrillation (AF) or atrial flutter (af) and their subsequent management. To evaluate the clinical profile and the use of antithrombotics and antiarrhythmic therapy in patients with AF admitted to cardiology wards. Methods and results: BLITZ-AF is a multicentre, observational study conducted in 154 centres on patients with AF/af. In each centre, data were collected, retrospectively for 4 weeks in ER and prospectively for 12 weeks in cardiology wards...
July 27, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Julie Rice, Rodney Omron, Hugh Calkins
Background: Deliberate practice (DP) is a method of mastery learning widely used in healthcare education. Investigations into improved mastery learning environments are important as we move to competency-based educational models. The objective of this pilot project is to create and test the feasibility of a simulation-based learning methodology based on close adherence to the tenants of DP for the acquisition of mastery knowledge. Methods: We created a new methodology for simulation-based mastery learning modules after review of the tenants of DP...
April 2018: AEM education and training
Krishnan Ganapathy, Dhavapalani Alagappan, Hubert Rajakumar, Baskar Dhanapal, Ganesh Rama Subbu, Lovakanth Nukala, Satgunam Premanand, Krishna Murthy Veerla, Saroj Kumar, Vikram Thaploo
INTRODUCTION: Nonavailability of emergency healthcare services in mountainous, isolated, and sparsely populated regions is a universal problem. In a first of its kind initiative, Tele-emergency Services (TES) was provided in Keylong and Kaza in Himachal Pradesh in Northern India, at an altitude of 3,353 meters with temperatures of -30°C during winter months. METHODS: Existing rooms in regional hospital (Keylong) and community health center (Kaza) were converted into tele-emergency centers by connecting them, to a state-of-the-art emergency department at the Joint Commission International-accredited Apollo Main Hospital at Chennai, 2,925 km away...
July 23, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
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