Acute and Critical Care

Original Article

Nursing
Quality of life among patients with supraventricular tachycardia post radiofrequency cardiac ablation in Jordan: Mohammad Tayseer Al- Betar, Rami Masa'deh, Shaher H. Hamaideh, Fatma Refaat Ahmed, Hajar Bakkali, Mohannad Eid AbuRuz; Acute Crit Care. 2023;38(3):333-342. Published online August 30, 2023; DOI: https://doi.org/10.4266/acc.2023.00052

1,475 View
48 Download

Abstract PDF: Background
Supraventricular tachycardia (SVT) is a common arrhythmia with associated symptoms such as palpitation, dizziness, and fatigue. It significantly affects patients’ quality of life (QoL). Radiofrequency cardiac ablation (RFCA) is a highly effective treatment to eliminate arrhythmia and improve patients’ QoL. The purpose of this study was to assess the level of QoL among patients with SVT and examine the difference in QoL before and after RFCA.
Methods
One group pre-posttest design with a convenience sample of 112 patients was used. QoL was assessed by 36-Item Short Form (SF-36). Data were collected at admission through face-to-face interviews and 1-month post-discharge through phone interviews.
Results
There was a significant difference between QoL before (33.7±17.0) and 1 month after (62.5±18.5) the RFCA. Post-RFCA patients diagnosed with atrioventricular nodal reentrant tachycardia had higher QoL than other types of SVT. Moreover, there were significant negative relationships between QoL and the number and duration of episodes pre- and post-RFCA. There were no significant differences in QoL based on: age, sex, working status, marital status, smoking, coronary artery disease, diabetes mellitus, and hypertension.
Conclusions
After RFCA, the QoL of patients with ST improved for both physical and mental component subscales.

Case Report

Cardiology
Successful neural modulation of bedside modified thoracic epidural anesthesia for ventricular tachycardia electrical storm: Ki-Woon Kang; Received November 17, 2021 Accepted March 7, 2022 Published online May 31, 2022; DOI: https://doi.org/10.4266/acc.2021.01683 [Epub ahead of print]

1,523 View
32 Download
1 Crossref

Ventricular tachycardia (VT)/ventricular fibrillation (VF) storm can be hemodynamically compromising and life-threatening. Management of medically refractory VT/VF storm is challenging in the intensive care unit. A 38-year-old male patient was diagnosed with non-ischemic heart failure and acute kidney injury with documented frequent premature ventricular contraction with QT prolongation after recurrent VT/VF. Even though the patient was intubated with sedatives and had taken more than two anti-arrhythmic drugs with external recurrent defibrillation at bedside, the electrical storm persisted for several hours. However, medically refractory VT/VF storm can be successfully and rapidly terminated with a modified thoracic epidural anesthesia at bedside. This case demonstrates that a bedside thoracic epidural anesthesia can be an effective non-pharmacological option to treat medically refractory VT/VF storm in the intensive care unit.

Citations

Citations to this article as recorded by

Continuous stellate ganglion block for ventricular arrhythmias: case series, systematic review, and differences from thoracic epidural anaesthesia
Veronica Dusi, Filippo Angelini, Enrico Baldi, Antonio Toscano, Carol Gravinese, Simone Frea, Sara Compagnoni, Arianna Morena, Andrea Saglietto, Eleonora Balzani, Matteo Giunta, Andrea Costamagna, Mauro Rinaldi, Anna Chiara Trompeo, Roberto Rordorf, Matte
Europace.2024;[Epub] CrossRef

Original Article

Pediatrics
Early postoperative arrhythmias after pediatric congenital heart disease surgery: a 5-year audit from a lower- to middle-income country: Sidra Ishaque, Saleem Akhtar, Asma Akbar Ladak, Russell Seth Martins, Muhammad Kamran Younis Memon, Alisha Raza Kazmi, Fatima Mahmood, Anwar ul Haque; Acute Crit Care. 2022;37(2):217-223. Published online February 3, 2022; DOI: https://doi.org/10.4266/acc.2020.00990

3,974 View
194 Download
2 Web of Science
2 Crossref

Abstract PDF

Background
Arrhythmias are known complication after surgery for congenital heart disease (CHD). This study aimed to identify and discuss their immediate prevalence, diagnosis and management at a tertiary care hospital in Pakistan. Methods: A retrospective study was conducted at a tertiary care hospital in Pakistan between January 2014 and December 2018. All pediatric (<18 years old) patients admitted to the intensive care unit and undergoing continuous electrocardiographic monitoring after surgery for CHD were included in this study. Data pertaining to the incidence, diagnosis, and management of postoperative arrhythmias were collected. Results: Amongst 812 children who underwent surgery for CHD, 185 (22.8%) developed arrhythmias. Junctional ectopic tachycardia (JET) was the most common arrhythmia, observed in 120 patients (64.9%), followed by complete heart block (CHB) in 33 patients (17.8%). The highest incidence of early postoperative arrhythmia was seen in patients with atrioventricular septal defects (64.3%) and transposition of the great arteries (36.4%). Patients were managed according to the Pediatric Advanced Life Support guidelines. JET resolved successfully within 24 hours in 92% of patients, while 16 (48%) patients with CHB required a permanent pacemaker. Conclusions: More than one in five pediatric patients suffered from early postoperative arrhythmias in our setting. Further research exploring predictive factors and the development of better management protocols of patients with CHB are essential for reducing the morbidity and mortality associated with postoperative arrhythmia.

Citations

Citations to this article as recorded by

Prevalence and risk factors analysis of early postoperative arrhythmia after congenital heart surgery in pediatric patients
Ketut Putu Yasa, Arinda Agung Katritama, I. Komang Adhi Parama Harta, I. Wayan Sudarma
Journal of Arrhythmia.2024; 40(2): 356. CrossRef
Improvements in Accuracy and Confidence in Rhythm Identification After Cardiac Surgery Using the AtriAmp Signals
Diane H. Brown, Xiao Zhang, Awni M. Al-Subu, Nicholas H. Von Bergen
Journal of Intensive Care Medicine.2023; 38(9): 809. CrossRef

Case Reports

Cardiology
Implantable cardioverter defibrillator as a treatment for massive left ventricular fibroma-induced ventricular arrhythmia in a child: In Su Choi, Hyung Ki Jeong, Hyung Wook Park, Yi-Seul Kim; Acute Crit Care. 2021;36(2):164-168. Published online May 28, 2021; DOI: https://doi.org/10.4266/acc.2020.00269

3,941 View
107 Download
1 Web of Science
1 Crossref

Abstract PDF

Pediatric cardiac tumors are rare. Among these, cardiac fibroma is the second most common. Its clinical manifestations depend on size and location of the tumor and include arrhythmia or obstruction to blood flow. Symptomatic cardiac fibroma is generally treated with surgical resection or cardiac transplantation. We present the case of a 12-year-old boy with a lethal ventricular arrhythmia induced by a remnant tumor that was previously partially resected. An implantable cardioverter defibrillator was inserted as the arrhythmia was resistant to medical treatment. He was discharged in stable condition with an implantable cardioverter defibrillator generator and followed up in the outpatient clinic.

Citations

Citations to this article as recorded by

Lipid emulsion attenuates propranolol-induced early apoptosis in rat cardiomyoblasts
Seong-Ho Ok, Seung Hyun Ahn, Soo Hee Lee, Hyun-Jin Kim, Gyujin Sim, Jin Kyeong Park, Ju-Tae Sohn
Human & Experimental Toxicology.2022; 41: 096032712211108. CrossRef

Pulmonary
Termination of Idiopathic Sustained Monomorphic Ventricular Tachycardia by Synchronized Electrical Cardioversion during Pregnancy: Sungmin Lee; Acute Crit Care. 2018;33(1):46-50. Published online February 20, 2017; DOI: https://doi.org/10.4266/acc.2016.00115

7,692 View
157 Download

Abstract PDF: The most common cardiac complications detected during pregnancy are an arrhythmia. However, idiopathic continuous monomorphic ventricular tachycardia (VT) during pregnancy is unusual. A 31-year-old pregnant woman presented at 20 weeks of gestation with progressive palpitation and episodes of agitation. An initial 12-lead electrocardiogram (ECG) showed normal sinus rhythm. However, 30 minutes after presenting at the emergency room, she complained of chest pain. A subsequent ECG showed wide complex monomorphic VT. We attempted to administer an antiarrhythmic drug, but the patient refused any medication because of concerns regarding possible adverse effects on the fetus. Therefore, we performed synchronized electrical cardioversion eight times. After the eighth synchronized cardioversion at 200 J, the ECG showed successful restoration of sinus rhythm. The condition of the fetus was monitored via ultrasonography and cardiotocography, and no adverse events were observed. We present the case of a successful synchronized electrical cardioversion performed in a woman at 20 weeks of gestation because of sustained symptomatic VT.

Cardiology
Recurrent Pulseless Ventricular Tachycardia Induced by Commotio Cordis Treated with Therapeutic Hypothermia: Sanghyun Lee, Hyunggoo Kang, Taeho Lim, Jaehoon Oh, Chiwon Ahn, Juncheal Lee, Changsun Kim; Korean J Crit Care Med. 2015;30(4):349-353. Published online November 30, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.4.349

7,135 View
75 Download

Abstract PDF: The survival rate of commotio cordis is low, and there is often associated neurological disability if return of spontaneous circulation (ROSC) can be achieved. We report a case of commotio cordis treated with therapeutic hypothermia (TH) that demonstrated a favorable outcome. A 16-year-old female was transferred to our emergency department (ED) for collapse after being struck in the chest with a dodgeball. She has no history of heart problems. She was brought to our ED with pulseless ventricular tachycardia (VT), and ROSC was achieved with defibrillation. She was comatose at our ED and was treated with TH at a target temperature of 33°C for 24 hours. After transfer to the intensive care unit, pulseless VT occurred, and defibrillation was performed twice. She recovered to baseline neurologic status with the exception of some memory difficulties.

Cardiology
Torsades de Pointes during Treatment of Tachycardia-Induced Cardiomyopathy: Dong Kyu Lee, Il Hwan Ryu, Ji Hyung Yoo, Su A Yun, Sang Hyun Park, Ki Woon Kang, Won Ho Kim, Yu Jeong Choi, Kyung Tae Jung, Jung Yeon Chin; Korean J Crit Care Med. 2014;29(1):19-22. Published online February 28, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.1.19

5,423 View
71 Download

Abstract PDF: Tachycardia-induced cardiomyopathy is caused by persistent tarchyarrhythmias and is characterized by ventricular systolic dysfunction and congestive heart failure. Tachycardia-induced cardiomyopathy is usually reversible via treatment. The cornerstone in the management of disease in these patients is to achieve a normal heart rate. We report a torsades de pointes during treatment of tachycardia-induced cardiomyopathy. Intravenous magnesium sulfate and potassium were administrated, but torsades de pointes was repeated. After overdrive right ventricular pacing, torsades de pointes was terminated. Careful monitoring of the QT interval and serum electrolyte and drug levels in such patients is warranted during treatment of tachycardia-induced cardiomyopathy.

Hyperthermia Plus Tachycardia Is Predictive of Fatal Outcome in Pontine Hemorrhage: A Case Report: Dong Woong Eom, Kyoung Dong Jeon, Jung Soo Kim; Korean J Crit Care Med. 2010;25(4):263-265.; DOI: https://doi.org/10.4266/kjccm.2010.25.4.263

3,076 View
16 Download
1 Crossref

Abstract PDF

Pontine hemorrhage is characterized by high mortality and morbidity. We report a case of pontine hemorrhage treated by extraventricular drainage (EVD) of cerebrospinal fluid (CSF) and control of intracranial pressure (ICP) at the neuro-intensive care unit (NICU). The patient's ICP was well controlled, but hyperthermia with tachycardia developed 8 hours after admission, and the patient expired with sudden cardiac arrest. A literature review revealed that high fever (>39degrees C) developing within 24 hours after onset of hemorrhage with tachycardia (>110 beat/min) is a clinical indicator for high probability of death. Therefore, it is important that not only ICP and neurological changes but also vital signs, especially body temperature and heart rate, be monitored in pontine hemorrhage patients.

Citations

Citations to this article as recorded by

Korean Medical Treatment for Prolonged Central Hyperthermia Following Pontine Hemorrhage: A Case Report
Chan-sol Yi, Song-won Park, Seungcheol Hong, Youngji Kim, Juyeon Song, Jeong-yun Lee, Gil-cho Shin, Dong-jun Choi
The Journal of Internal Korean Medicine.2018; 39(5): 1061. CrossRef

Pharmacological Cardioversion with Phenylephrine for Paroxysmal Supraventricular Tachycardia during Lung Resection Surgery: A Case Report: Hyun Jung Kim, Soo Kyung Lee, Young Mi Kim, Hyun Soo Moon; Korean J Crit Care Med. 2006;21(1):57-62.

2,151 View
38 Download

Abstract PDF: Supraventricular arrhythmias during and after thoracotomy for pulmonary resections are well documented, and risk factors of post-pulmonary resection arrhythmias are old age, magnitude of surgery, and coexisting cardiopulmonary disease etc. Among of supraventricular arrhythmias, atrial fibrillation is the most common rhythm disturbance that may be associated with increased morbidity and mortality. We experienced a case of paroxysmal supraventricular tachycardia with severe hypotension which was escalated from atrial fibrillation during pulmonary bilobectomy for tuberculosis in a 44-year old male patient. Instead of usual electrical cardioversion or common antiarrhythmic agents, we selected phenylephrine bolus injection which induced normal sinus rhythm successfully from paroxysmal supraventricular tachycardia of the patient.

Randomized Controlled Trial

Effects of Alfentanil on Hemodynamic and Catecholamine Responses to Laryngoscopy and Endobronchial Intubation in the Elderly: Kyung Yeon Yoo, Sung Su Chung, Myung Ha Yoon, Seong Wook Jeong, Jeong Il Choi, Chang Young Jeong; Korean J Crit Care Med. 2005;20(2):114-120.

1,441 View
14 Download

Abstract PDF: BACKGROUND
Endobronchial intubation should elicit significant circulatory responses. We examined the effects of alfentanil on hemodynamic and catecholamine responses to endobronchial intubation in elderly patients. METHODS: A total of 60 patients aged over 60 years requiring endobronchial intubation were randomized into three groups of 20 patients each. Anesthesia was induced with thiopental 4~6 mg/kg followed by saline (placebo) or alfentanil 10 or 30microgram/kg given as a bolus over 30 s. Succinylcholine 1 mg/kg was given for neuromuscular block. Laryngoscopy and intubation were performed 1 min later. RESULTS: The intubation significantly increased systolic arterial pressure and heart rate. The maximum pressure changes from pre-intubation values in both alfentanil groups (58+/-27 and 33+/-30 mm Hg in 10 and 30microgram/kg, respectively) were significantly lower compared with that of 83+/-35 mm Hg in the control group. The tachycardiac response was not significantly affected by alfentanil 10microgram/kg, but attenuated by alfentanil 30microgram/kg. The plasma norepinephrine concentrations were increased, which was not affected by alfentanil 10microgram/kg, but was significantly attenuated by alfentanil 30microgram/kg. Both doses of alfentanil abolished the increase of plasma epinephrine concentrations. Three patients in the 30microgram/kg group received ephedrine for hypotension. CONCLUSIONS: This study showed that endobronchial intubation elicited significant pressor response, and that alfentanil 30microgram/kg is more efficacious in attenuating the hemodynamic and catecholamine responses, although potential hypotension warrants a caution of its use, in elderly patients.

Case Report

Pulmonary Embolism Detected in the General Ward after Operation: A Case Report: Se Hyun Lew, Jong Hun Jun, Hee Koo Yoo, Yong Ho Kim; Korean J Crit Care Med. 2004;19(1):38-41.

1,658 View
41 Download

Abstract PDF: Pulmonary embolism is a common medical complication following major orthopedic procedures of the lower extremities and a leading cause of morbidity and mortality. However, the clinical manifestations of pulmonary embolism are nonspecific and it may be difficult to diagnose. An 82 years old female with severe restrictive pulmonary disease received the elective operation for the fracture of left femur neck under combined spinal-epidural anesthesia. During the operation, we sometimes gave her oxygen via face mask and maintained oxygen saturation of more than 80% which was measured by a pulse oxymeter. The operation and anesthesia was performed uneventfully. On the seventh postoperative day, she showed tachycardia suddenly and cardiac arrest later on the electrocardiogram. After cardiopulmonary resuscitation, she was transferred to intensive care unit and checked by a computed tomography and echocardiography. She was diagnosed with pulmonary embolism and deep vein thrombosis and treated with heparin and urokinase. But she did not improve and died.

First
Prev
Page of 1
Next
Last

Search