Heart failure clinics
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Heart failure clinics · Apr 2011
ReviewThe role of ventricular tachycardia ablation in the reduction of implantable defibrillator shocks.
Frequent shocks from an implantable defibrillator (ICD) can have adverse cardiac affects and lead to increased pain, anxiety, and a decreased quality of life. Pharmacologic attempts and ICD reprogramming strategies aimed at reducing ICD shocks have modest results, with frequent discontinuation of medicines because of side effects. Ventricular tachycardia (VT) ablation is recommended in the treatment of patients with frequent ICD shocks caused by VT. VT ablation may also be considered in patients with an initial ICD shock and as prophylactic treatment in patients with a history of sustained VT who are undergoing ICD implant.
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In the United States, 250,000 people die from a cardiac arrest every year. Despite a well established emergency medical response system, survival from out-of-hospital cardiac arrest remains poor in United States cities. Paramount to achieving successful resuscitation of a cardiac arrest victim is provision of early defibrillation. ⋯ In 1995, the American Heart Association challenged the medical industry to develop a defibrillator that could be placed in public settings, used safely by lay responders, and provide earlier defibrillation to cardiac arrest victims. Over the last decade, there have been significant technological advancements in automated external defibrillators (AEDs), and clinical studies have demonstrated their benefits and limitations in various public locations. This article discusses the technologic features of the modern AED and the current data available on the use of AEDs in public settings.
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This article focuses on important advances in the science of cardiopulmonary resuscitation in the last decade that have led to a significant improvement in understanding the complex physiology of cardiac arrest and critical interventions for the initial management of cardiac arrest and postresuscitation treatment. Special emphasis is given to the basic simple ways to improve circulation, vital organ perfusion pressures, and the grave prognosis of sudden cardiac death.