Heart rhythm : the official journal of the Heart Rhythm Society
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While the mechanism underlying the development of post-cardiothoracic surgery atrial fibrillation has not been fully elucidated, it has been suggested that inflammation may play a causative role. Corticosteroids have been traditionally used to reduce inflammation, and when administered perioperatively, they may decrease the incidence of atrial fibrillation. ⋯ Corticosteroids appear to reduce the incidence of post-cardiothoracic surgery atrial fibrillation and shorten hospital length of stay in randomized controlled trials.
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Review Practice Guideline
Inter-association task force recommendations on emergency preparedness and management of sudden cardiac arrest in high school and college athletic programs: a consensus statement.
To assist high school and college athletic programs prepare for and respond to a sudden cardiac arrest (SCA). This consensus statement summarizes our current understanding of SCA in young athletes, defines the necessary elements for emergency preparedness, and establishes uniform treatment protocols for the management of SCA. ⋯ Comprehensive emergency planning is needed for high school and college athletic programs to ensure an efficient and structured response to SCA. Essential elements of an emergency action plan include establishing an effective communication system, training of anticipated responders in cardiopulmonary resuscitation and AED use, access to an AED for early defibrillation, acquisition of necessary emergency equipment, coordination and integration of onsite responder and AED programs with the local emergency medical services system, and practice and review of the response plan. Prompt recognition of SCA, early activation of the emergency medical services system, the presence of a trained rescuer to initiate cardiopulmonary resuscitation, and access to early defibrillation are critical in the management of SCA. In any collapsed and unresponsive athlete, SCA should be suspected and an AED applied as soon as possible for rhythm analysis and defibrillation if indicated.
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Comparative Study
Increased incidence of subacute lead perforation noted with one implantable cardioverter-defibrillator.
The rapid evolution of implantable cardioverter-defibrillator (ICD) leads has resulted in thinner active fixation leads. While these advances have made the leads more versatile, new configurations may be associated with unforeseen complications. ⋯ In 2005, at one institution, there were significantly more cardiac perforations and lead revisions with the Riata lead as compared with the Sprint Fidelis right ventricular defibrillator lead. Further data are required to determine whether certain lead characteristics are responsible for this observation.
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The precise electrophysiological characteristics and essential effects of left-sided ablation in atrioventricular nodal reentrant tachycardia (AVNRT) with eccentric coronary sinus (CS) activation (ECSA) have not been described. ⋯ Atypical AVNRT with ECSA involved the left-sided SP as a retrograde limb, and the reentrant circuit was more frequently associated with evidence that suggested a UCP and LCP. Ablation exclusively targeting the earliest retrograde atrial activation inside the CS was highly effective in this entity.