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Cardiac arrhythmias in acute coronary syndromes
Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Circulation 2010;122(suppl 2): S325– 37. 140. Altamura G, Bianconi L, Lo Bianco F, Toscano L, Ammirati F, Pandozi C et al. Transthoracic DC shock may represent a serious hazard in pacemaker dependent patients. Pacing Clin Electrophysiol 1995;18:194 – 8. 141. Kirchhof P, Eckhardt L, Loh P, Weber K, Fischer RJ, Seidl KH et al. Anterior – posterior versus anterior –lateral electrode positions for external cardioversion of atrial fibrillation: a randomised trial. Lancet 2002;360:1275 –9.
142. Page RL, Kerber RE, Russell JK, Trouton T, Waktare J, Gallik D et al. Biphasic versus monophasic shock waveform for conversion of atrial fibrillation: the results of an international randomized, double-blind multicenter trial. J Am Coll Cardiol 2002; 39:1956 – 63. 143. Manegold JC, Israel CW, Ehrlich JR, Duray G, Pajitnev D, Wegener FT et al. External cardioversion of atrial fibrillation in patients with implanted pacemaker or cardioverter-defibrillator systems: a randomized comparison of monophasic and biphasic shock energy application. Eur Heart J 2007;28: 1731 – 8.
IMAGES IN ELECTROPHYSIOLOGY
doi:10.1093/europace/euu142 Online publish-ahead-of-print 7 June 2014
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Iatrogenic extra-pleural haematoma following cardiac device implantation Charles Nadeau-Routhier, Andres Enriquez, and Adrian Baranchuk* * Corresponding author. Tel: +1 613 549 6666 ext 3801; fax: +1 613 548 1387. E-mail address: [email protected]
A 67-year-old gentleman with dilated cardiomyopathy, decreased ejection fraction (18%), and left bundle branch block underwent an uneventful cardiac resynchronization therapy-defibrillator (CRT-D) implantation. He was treated with clopidogrel 75 mg/day. Post-operatively (Panel A), a chest radiograph revealed an opacity over the left hemithorax. A computed tomography scan further characterized a large (25.4 cm diameter) fluid collection in the extrapleural space, extending superiorly and anteriorly. The suspected mechanism was an inadvertent arterial puncture of a subclavian artery branch (probably ,0.3 mm diameter). Interventional radiology performed an angiogram targeting the left subclavian artery (Panel B). A small blush of contrast was identified, and a 10 cm long Gore Viabahn stent was deployed. Arterial extra-pleural haematoma can be a complication of CRT-D implantation warranting prompt recognition and resolution. Conflict of interest: none declared.
The article has been co-published with permission in EP-Europace, European Heart Journal - Acute Cardiovascular and Eurointervention. All rights reserved in respect of European Heart Journal - Acute Cardiovascular and Eurointervention. & The Authors 2014. For EP-Europace, & The Author 2014.
Downloaded from by guest on November 4, 2014
Department of Cardiology (Arrhythmia Service), Kingston General Hospital, Queen’s University, Kingston, ON, Canada K7L 2V7
Cardiac arrhythmias in acute coronary syndromes
Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Circulation 2010;122(suppl 2): S325– 37. 140. Altamura G, Bianconi L, Lo Bianco F, Toscano L, Ammirati F, Pandozi C et al. Transthoracic DC shock may represent a serious hazard in pacemaker dependent patients. Pacing Clin Electrophysiol 1995;18:194 – 8. 141. Kirchhof P, Eckhardt L, Loh P, Weber K, Fischer RJ, Seidl KH et al. Anterior – posterior versus anterior –lateral electrode positions for external cardioversion of atrial fibrillation: a randomised trial. Lancet 2002;360:1275 –9.
142. Page RL, Kerber RE, Russell JK, Trouton T, Waktare J, Gallik D et al. Biphasic versus monophasic shock waveform for conversion of atrial fibrillation: the results of an international randomized, double-blind multicenter trial. J Am Coll Cardiol 2002; 39:1956 – 63. 143. Manegold JC, Israel CW, Ehrlich JR, Duray G, Pajitnev D, Wegener FT et al. External cardioversion of atrial fibrillation in patients with implanted pacemaker or cardioverter-defibrillator systems: a randomized comparison of monophasic and biphasic shock energy application. Eur Heart J 2007;28: 1731 – 8.
IMAGES IN ELECTROPHYSIOLOGY
doi:10.1093/europace/euu142 Online publish-ahead-of-print 7 June 2014
.............................................................................................................................................................................
Iatrogenic extra-pleural haematoma following cardiac device implantation Charles Nadeau-Routhier, Andres Enriquez, and Adrian Baranchuk* * Corresponding author. Tel: +1 613 549 6666 ext 3801; fax: +1 613 548 1387. E-mail address: [email protected]
A 67-year-old gentleman with dilated cardiomyopathy, decreased ejection fraction (18%), and left bundle branch block underwent an uneventful cardiac resynchronization therapy-defibrillator (CRT-D) implantation. He was treated with clopidogrel 75 mg/day. Post-operatively (Panel A), a chest radiograph revealed an opacity over the left hemithorax. A computed tomography scan further characterized a large (25.4 cm diameter) fluid collection in the extrapleural space, extending superiorly and anteriorly. The suspected mechanism was an inadvertent arterial puncture of a subclavian artery branch (probably ,0.3 mm diameter). Interventional radiology performed an angiogram targeting the left subclavian artery (Panel B). A small blush of contrast was identified, and a 10 cm long Gore Viabahn stent was deployed. Arterial extra-pleural haematoma can be a complication of CRT-D implantation warranting prompt recognition and resolution. Conflict of interest: none declared.
The article has been co-published with permission in EP-Europace, European Heart Journal - Acute Cardiovascular and Eurointervention. All rights reserved in respect of European Heart Journal - Acute Cardiovascular and Eurointervention. & The Authors 2014. For EP-Europace, & The Author 2014.
Downloaded from by guest on November 4, 2014
Department of Cardiology (Arrhythmia Service), Kingston General Hospital, Queen’s University, Kingston, ON, Canada K7L 2V7
