Cardiophile MD Archive

Multiple spikes within the QRS is known as fragmented QRS (f-QRS). Morita et al, from Okayama, Japan has found an association between f-QRS and ventricular fibrillation in Brugada Syndrome (Circulation. 2008;118:1697-1704). 115 patients were evaluated – 13 resuscitated from ventricular fibrillation, 28 with syncope and 74 asymptomatic. 43% of them had f-QRS. The highest occurrence [...]

QRS prolongation, QT prolongation and elevated BNP are good markers of SCD in persons with reduced left ventricular function. These markers can be considered while planning devices for those with left ventricular dysfunction.

  Goals: Assess system integrity Proper programming for better battery life   Basic steps: Assess patient’s clinical status Drug history has to checked Inspection of the site of implantation Chest radiography to document lead and device positions ICD interrogation Interrogation at the earliest after every device therapy (shock) Whether a particular position of the body [...]

  Beta blocker use was more in the ICD arm than conventional therapy arm, which could have contributed to the better results in the ICD. This criticism was taken care of by MADIT II trial which showed that just the presence of a low ejection fraction following myocardial infarction was enough to implant a defibrillator. [...]

  Amiodarone can raise the defibrillation threshold though it may not raise the pacing threshold Amiodarone may slow the rate of spontaneous ventricular tachycardia below the detection threshold rate of the ICD   Role of amiodarone in ICD patients is to reduce the frequency of tachycardias requiring ICD discharge