Implantable cardioverter-defibrillators: implications for the nonelectrophysiologist
Article Abstract:
Doctors should know how to manage patients with implanted heart defibrillators. Most diagnostic tests and surgeries may be carried out if the defibrillator is deactivated before the procedure and reactivated afterwards. This requires personnel familiar with the defibrillator and heart monitoring of the patient. Radiation therapy may affect circuitry. Short wave diathermy near the defibrillator and magnetic resonance scanning are contraindicated. Standard resuscitation techniques may be used, although external defibrillation shocks may damage the unit. Infection of the defibrillator system is potentially life-threatening and should not be treated with oral antibiotics. Multiple defibrillator discharges over a short time must be evaluated in conjunction with heart monitoring and where resuscitation is available. Antidepressant and antipsychotic medications may affect heart rhythms.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1995
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Cost-Effectiveness of Cardioversion and Antiarrhythmic Therapy in Nonvalvular Atrial Fibrillation
Article Abstract:
Restoration of a normal heart rhythm, plus treatment with antiarrhythmic drugs or aspirin, most effectively reduce the risk of stroke in patients with nonvalvular atrial fibrillation. Atrial fibrillation is a disordered rhythm of the upper chambers of the heart. Researchers compared treatments for a hypothetical group of 70-year-old patients with the arrhythmia. Cardioversion, or the restoration of a normal sinus rhythm with an electric shock, was the most cost-effective treatment for all patients. Depending on the risk of stroke, patients may then benefit from drug therapy with amiodarone or aspirin to control the arrhythmia and reduce the formation of blood clots.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1999
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Interference with an implantable defibrillator by an electronic antitheft-surveillance device
Article Abstract:
Metal detectors used as antitheft devices in stores may affect implantable cardiac defibrillators. These devices detect arrhythmias and deliver a mild shock to restore a regular heart beat. A 72-year-old man received several shocks from his cardiac defibrillator as he stood next to a bookstore's metal detector. He was approximately one foot from the metal detector at the time. A nurse at the scene pulled him away from the metal detector and he recovered. Tests using a different metal detector confirmed that a properly functioning detector can affect defibrillators.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1998
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