scholarly journals Esmolol for the treatment of recurrent ventricular tachycardia

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Simone Savastano ◽  
Alessandra Greco ◽  
Benedetta Matrone
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Ventricular Tachycardia ◽  
Beta Blockers ◽  
Left Ventricle Ejection Fraction ◽  
Idiopathic Dilated Cardiomyopathy ◽  
Electrical Storm ◽  
Low Output Syndrome ◽  
Major Emergencies ◽  
Clinical Conditions

Cardiac arrest and electrical storm are two major emergencies. The use of beta blockers in these clinical conditions has been proposed however, definite data about the emergency use of beta blockers in recurrent ventricular tachycardia with pulse have never been published. We report two cases of recurrent ventricular tachycardia which were unresponsive to the standard pharmacological treatment but successfully responsive to esmolol infusion. Both cases showed a reduced left ventricle ejection fraction due to an acute myocardial infarction and to an idiopathic dilated cardiomyopathy respectively. Nevertheless, the use of esmolol was shown to be both safe and effective without inducing low output syndrome.

scholarly journals Electrical storm 11 days after acute myocardial infarction: a case report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Sayaka Ohsawa ◽  
Hiroki Isono ◽  
Eiji Ojima ◽  
Masahiro Toyama ◽  
Yasuhisa Kuroda ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Ventricular Tachycardia ◽  
Ventricular Fibrillation ◽  
Rare Condition ◽  
Coronary Intervention ◽  
University Hospital ◽  
Electrical Storm ◽  
Old Japanese ◽  
Overdrive Pacing

Abstract Background The definition of electrical storm is still debated. For example, an electrical storm is defined as a clustering of three or more separate episodes of ventricular tachycardia/ventricular fibrillation within 24 hours or one or more episodes occurring within 5 minutes of termination of the previous episode of ventricular tachycardia/ventricular fibrillation. When it is refractory to medications, prompt assessments by coronary angiography, sedation, and overdrive pacing should be performed. An electrical storm may occur anytime, including at night or after the patient leaves an intensive care unit. Case presentation A 70-year-old Japanese man with type 2 diabetes mellitus was diagnosed as having ST-elevation myocardial infarction. His clinical course after an urgent percutaneous coronary intervention was uneventful, but he developed electrical storm that was refractory to antiarrhythmic medications on day 11 of hospitalization. We used sedative medications and performed ventricular overdrive pacing and transferred him to a university hospital for further treatment, which included electrical ablation and cardioverter-defibrillator implantation. Conclusion An electrical storm is a relatively rare and fatal complication of acute myocardial infarction. It is important that the treatment choices for this condition are known by non-cardiologist physicians who might encounter this rare condition.

scholarly journals Successful Refractory of Acute Myocardial Infarction-induced Electrical Storm by Defibrillations and Amiodarone: A Case Report

2020 ◽  
Author(s):  
Huanhuan Guo ◽  
Quan Gan
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Ventricular Tachycardia ◽  
Case Report ◽  
Ventricular Arrhythmias ◽  
Electrical Storm ◽  
Case Presentation ◽  
Cardioverter Defibrillator ◽  
Progressive Heart Failure

Abstract Background: Acute myocardial infarction (AMI) often complicated with multiple arrhythmias, especially ventricular arrhythmias, including sustained ventricular tachycardia (SVT) and ventricular fibrillation (VF) are often presages progressive heart failure in 48 hours. The present study reports a case of electrical storm (ES) occurring in an 84-year-old woman with acute myocardial infarction (AMI).Case presentation: With the defibrillations or amiodarone, the recurrence of ventricular tachycardia inhibited and the electrocardiographic pattern normalized.Conclusions: The results suggest that defibrillations and amiodarone may be able to improve the survival rate of patients with ES with AMI and would be considered as an alternative treatment for implantable cardioverter defibrillator (ICD) and invasive catheter ablation in the management of cardiac ES.

Abstract 3522: Transfer Patients With Acute Myocardial Infarction Do Not Impact Hospital Quality Measurements, Despite Being Sicker Than Directly Admitted Patients

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Creighton Don ◽  
Douglas Stewart ◽  
Susan Heckbert ◽  
Charles Maynard ◽  
Richard Goss
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Beta Blockers ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Hospital Quality ◽  
Lipid Lowering ◽  
Hospital Death ◽  
Hospital Level ◽  
Risk Of Death

BACKGROUND Studies of hospital quality and national performance measures for acute myocardial infarction (AMI) frequently exclude transfer patients. Little is known about the clinical characteristics and outcomes of patients with AMI transferred for revascularization. HYPOTHESIS Transfer patients have greater clinical comorbidity and worse hospital survival than non-transfer patients, and negatively impact hospital quality measures. METHODS A retrospective-cohort study was performed using all patients with ST-elevation myocardial infarction who underwent coronary intervention or coronary artery bypass grafting (CABG) in Washington State from 2002 – 2005. Data on clinical and procedural characteristics, medications, and complications were obtained from the Clinical Outcomes Assessment Program. Hospitals were compared by rates of death and discharge with aspirin, beta-blockers, lipid lowering agents, and ACE inhibitors. Logistic regression was used for adjusted analysis. RESULTS Of patients undergoing revascularization for AMI, 7080 were directly admitted and 2910 were transferred. Diabetes (23.4 v. 19.7%, p<0.01), hypertension (61.3 v. 55.7%, p<0.01), and thrombolysis (32.3 v. 3.4%, p <0.01) were greater among transfers. Transfers presented with a higher rate of left main and three-vessel disease, intra-aortic balloon pump use (6.4 v. 3.6%, p<0.01) and underwent CABG more frequently (15.4 v. 5.5%, p <0.01). Transfer patients had a lower risk of death (3.9 v. 4.9%, p=0.03), but no difference in discharge medication prescription. Adjusting for major risk factors, procedure, and hospital type, transfers had a similar risk for in-hospital death compared to non-transfers (OR 0.9, CI 0.5 – 1.6). Hospitals with a high percentage of transfers treated higher-risk patients, but had similar outcomes to those with few transfers. Excluding transfers from the hospital-level analysis did not appreciably change these results. CONCLUSION Transfers were higher-risk, but had similar in-hospital mortality and were equally likely to receive appropriate medication at discharge compared to directly admitted patients. Inclusion of transfers did not affect hospital-level inpatient mortality or measurements of adherence to quality guidelines.

Abstract 12691: Long-term Optimal Medical Therapy for Patients With Mid-range Left Ventricular Ejection Fraction After Acute Myocardial Infarction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
YeeKyoung KO ◽  
Seungjae JOO ◽  
Jong Wook Beom ◽  
Jae-Geun Lee ◽  
Joon-Hyouk CHOI ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Left Ventricular Ejection Fraction ◽  
Medical Therapy ◽  
Beta Blockers ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Ras Inhibitors

Introduction: In the era of the initial optimal interventional and medical therapy for acute myocardial infarction (AMI), a number of patients with mid-range left ventricular ejection fraction (40% <EF<50%) becomes increasing. However, the long-term optimal medical therapy for these patients has been rarely studied. Aims: This observational study aimed to investigate the association between the medical therapy with beta-blockers or inhibitors of renin-angiotensin system (RAS) and clinical outcomes in patients with mid-range EF after AMI. Methods: Among 13,624 patients enrolled in the Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH), propensity-score matched patients who survived the initial attack and had mid-range EF were selected according to beta-blocker or RAS inhibitor therapy at discharge. Results: Patients with beta-blockers showed significantly lower 1-year cardiac death (2.4 vs. 5.2/100 patient-year; hazard ratio [HR] 0.46; 95% confidence interval [CI] 0.22-0.98; P =0.045) and MI (1.7 vs. 4.0/100 patient-year; HR 0.41; 95% CI 0.18-0.95; P =0.037). On the other hand, RAS inhibitors were associated with lower 1-year re-hospitalization due to heart failure (2.8 vs. 5.5/100 patient-year; HR 0.54; 95% CI 0.31-0.92; P =0.024), and no significant interaction with classes of RAS inhibitors (angiotensin-converting enzyme inhibitors or angiotensin receptor blockers) was observed ( P for interaction=0.332). Conclusions: Beta-blockers or RAS inhibitors at discharge were associated with better 1-year clinical outcomes in patients with mid-range EF after AMI.

scholarly journals In-Hospital Electrical Storm in Acute Myocardial Infarction　― Clinical Background and Mechanism of the Electrical Instability ―

2018 ◽  
Vol 83 (1) ◽  
pp. 91-100 ◽  
Author(s):  
Yoshinori Kobayashi ◽  
Kaoru Tanno ◽  
Akira Ueno ◽  
Seiji Fukamizu ◽  
Hiroshige Murata ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Electrical Storm ◽  
Electrical Instability ◽  
Clinical Background

P6424The association between long-term beta-blocker use and outcome in a contemporary large-scale cohort of patients with acute myocardial infarction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C X Song ◽  
R Fu ◽  
J G Yang ◽  
K F Dou ◽  
Y J Yang
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Beta Blocker ◽  
Cardiovascular Events ◽  
Beta Blockers ◽  
Left Ventricular Ejection ◽  
Major Adverse Cardiovascular Events ◽  
Baseline Characteristics

Abstract Background Controversy exists regarding the use of beta-blockers (BBs) among patients with acute myocardial infarction (AMI) in contemporary reperfusion era. Previous studies predominantly focused on beta-blockers prescribed at discharge, and the effect of long-term adherence to beta-blocker on major adverse cardiovascular events (MACE) remains unclear. Objective To explore the association between long-term beta-blocker use patterns and MACE among contemporary AMI patients. Methods We enrolled 7860 patients with AMI, who were discharged alive and prescribed with BBs based on CAMI registry from January 2013 to September 2014. Patients were divided into two groups according to BBs use pattern: Always users group (n=4476) were defined as patients reporting BBs use at both 6- and 12-month follow-up; Inconsistent users group were defined as patients reporting at least once not using BBs at 6- or 12-month follow-up. Primary outcome was defined as MACE at 24-month follow-up, including all-cause death, non-fatal MI and repeat-revascularization. Multivariable cox proportional hazards regression model was used to assess the association between BBs and MACE. Results Baseline characteristics are shown in table 1. At 2-year follow-up, 518 patients in inconsistent users group (15.6%) and 548 patients in always users group (12.3%) had MACE. After multivariable adjustment, inconsistent use of BBs was associated with higher risk of MACE (HR: 1.323, 95% CI: 1.171–1.493, p<0.001). Table 1 Baseline characteristics Variable Always user (N=4476) Inconsistent user (N=3384) P value Age (years) 60.6±12.0 61.2±12.2 <0.001 Male 3381 (75.7%) 2461 (74.3%) 0.084 Diabetes 892 (20.0%) 610 (18.4%) 0.003 Hypertension 2372 (53.2%) 1543 (46.6%) <0.001 Dyslipidemia 244 (5.5%) 126 (3.8%) <0.001 Prior myocardial infarction 351 (7.9%) 232 (7.0%) <0.001 Heart failure 88 (2.0%) 63 (1.9%) <0.001 Chronic obstructive pulmonary disease 66 (1.5%) 60 (1.8%) <0.001 Current smoker 2054 (46.1%) 1579 (47.8%) 0.179 Left ventricular ejection fraction (%) 53.7±11.48 54.0±10.9 <0.001 Major Adverse Cardiovascular Events 548 (12.3%) 518 (15.6%) <0.001 Conclusions Our results showed consistent BBs use was associated with reduced risk of MACE among patients with AMI managed by contemporary treatment. Acknowledgement/Funding CAMS Innovation Fund for Medical Sciences (CIFMS) (2016-I2M-1-009)

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