Harefuah
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Sudden death is a major public hazard and is usually caused by ventricular fibrillation (VF). Although in the majority of cases witnesses are to be found, resuscitation efforts are begun only in a minority of victims. The only treatment for VF is electrical shock and the time from collapse to resuscitation and defibrillation determine prognosis. ⋯ Recent evidence of the survival benefit of AED utility is emerging. During the coming years, AEDs will be introduced to a growing number of hospitals and public places. This review summarizes the rationale for use, advantages, and disadvantages as well as the current status of AEDs and recommendations for placement of AEDs in Israel.
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Clinical Trial
[Intravenous flecainide administration for conversion of paroxysmal atrial fibrillation in the emergency room].
Since the removal of intravenous propafenone from the Israeli market, flecainide is the only intravenous antiarrhythmic class 1C drug available nowadays in Israel. ⋯ Intravenous flecainide has effective and rapid action in the conversion of PAF and its administration is safe in the treatment of this arrhythmia in the ER.
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Recent studies have shown that percutaneous carotid artery angioplasty and stenting can be safely performed in patients with carotid artery stenosis, especially those considered to be at high-risk for surgery. ⋯ These results support the use of carotid artery angioplasty and stenting in high-risk patients with significant primary or secondary carotid artery stenosis. In both types of lesions, acceptable results justify its use as a valid revascularization method. While clinical embolic events occur in a minority of patients in both lesion types, they are not entirely prevented by distal protection devices.