EMERGENCY SIMULTANEOUS TRANSTHORACIC AND EPICARDIAL DEFIBRILLATION FOR REFRACTORY VENTRICULAR-FIBRILLATION DURING ROUTINE IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR TESTING IN THE OPERATING-ROOM

被引:3
作者
COHEN, TJ [1 ]
SCHEINMAN, MM [1 ]
PULLEN, BT [1 ]
COGGINS, DI [1 ]
GONZALEZ, RP [1 ]
EPSTEIN, LM [1 ]
GROGIN, HR [1 ]
GRIFFIN, JC [1 ]
机构
[1] UNIV CALIF SAN FRANCISCO,SAN FRANCISCO,CA 94143
关键词
D O I
10.1016/0002-9149(93)90527-J
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Ventricular fibrillation (VF) induced during routine implantable cardioverter-defibrillator placement in the operating room almost always responds to the prompt application of direct-current epicardial shocks (≤40 J), and in some cases, high-energy transthoracic shocks or internal paddle defibrillation is needed to terminate VF. In rare cases, VF that is unresponsive to the standard methods occurs. Recently, a method of emergency intracardiac defibrillation was described for treatment of refractory VF during routine electrophysiologic study.1 This method uses a standard right ventricular pacing catheter and a posterior skin patch. Defibrillation is performed from the distal pole of the right ventricular catheter to the posterior patch. This method has been successful in 9 of 9 patients at our institution in the electrophysiology laboratory. However, no such rescue procedure has been described for refractory VF induced in the operating room. In this report, we describe 2 patients who received emergency simultaneous transthoracic and epicardial defibrillation for the management of refractory VF during implantable cardioverter-defibrillator placement and testing. © 1993.
引用
收藏
页码:619 / 622
页数:4
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