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Rehfeldt KH, Smith BB, Gillespie SM. An Unusual Indication for Precordial Thump: Acute Prosthetic Valve Obstruction. J Cardiothorac Vasc Anesth 2023; 37:561-564. [PMID: 36707377 DOI: 10.1053/j.jvca.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/12/2022] [Accepted: 01/02/2023] [Indexed: 01/09/2023]
Affiliation(s)
- Kent H Rehfeldt
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
| | - Bradford B Smith
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, AZ
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2
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Whiteley JP. An evaluation of some assumptions underpinning the bidomain equations of electrophysiology. MATHEMATICAL MEDICINE AND BIOLOGY-A JOURNAL OF THE IMA 2020; 37:262-302. [PMID: 31680135 DOI: 10.1093/imammb/dqz014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 04/11/2019] [Accepted: 08/02/2019] [Indexed: 11/13/2022]
Abstract
Tissue level cardiac electrophysiology is usually modelled by the bidomain equations, or the monodomain simplification of the bidomain equations. One assumption made when deriving the bidomain equations is that both the intracellular and extracellular spaces are in electrical equilibrium. This assumption neglects the disturbance of this equilibrium in thin regions close to the cell membrane known as Debye layers. We first demonstrate that the governing equations at the cell, or microscale, level may be adapted to take account of these Debye layers with little additional complexity, provided the permittivity within the Debye layers satisfies certain conditions that are believed to be satisfied for biological cells. We then homogenize the microscale equations using a technique developed for an almost periodic microstructure. Cardiac tissue is usually modelled as sheets of cardiac fibres stacked on top of one another. A common assumption is that an orthogonal coordinate system can be defined at each point of cardiac tissue, where the first axis is in the fibre direction, the second axis is orthogonal to the first axis but lies in the sheet of cardiac fibres and the third axis is orthogonal to the cardiac sheet. It is assumed further that both the intracellular and extracellular conductivity tensors are diagonal with respect to these axes and that the diagonal entries of these tensors are constant across the whole tissue. Using the homogenization technique we find that this assumption is usually valid for cardiac tissue, but highlight situations where the assumption may not be valid.
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Affiliation(s)
- Jonathan P Whiteley
- Department of Computer Science, University of Oxford, Wolfson Building, Parks Road, Oxford OX1 3QD, UK
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3
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Quinn TA, Kohl P. Cardiac Mechano-Electric Coupling: Acute Effects of Mechanical Stimulation on Heart Rate and Rhythm. Physiol Rev 2020; 101:37-92. [PMID: 32380895 DOI: 10.1152/physrev.00036.2019] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The heart is vital for biological function in almost all chordates, including humans. It beats continually throughout our life, supplying the body with oxygen and nutrients while removing waste products. If it stops, so does life. The heartbeat involves precise coordination of the activity of billions of individual cells, as well as their swift and well-coordinated adaption to changes in physiological demand. Much of the vital control of cardiac function occurs at the level of individual cardiac muscle cells, including acute beat-by-beat feedback from the local mechanical environment to electrical activity (as opposed to longer term changes in gene expression and functional or structural remodeling). This process is known as mechano-electric coupling (MEC). In the current review, we present evidence for, and implications of, MEC in health and disease in human; summarize our understanding of MEC effects gained from whole animal, organ, tissue, and cell studies; identify potential molecular mediators of MEC responses; and demonstrate the power of computational modeling in developing a more comprehensive understanding of ‟what makes the heart tick.ˮ.
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Affiliation(s)
- T Alexander Quinn
- Department of Physiology and Biophysics and School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada; Institute for Experimental Cardiovascular Medicine, University Heart Centre Freiburg/Bad Krozingen, Medical Faculty of the University of Freiburg, Freiburg, Germany; and CIBSS-Centre for Integrative Biological Signalling Studies, University of Freiburg, Freiburg, Germany
| | - Peter Kohl
- Department of Physiology and Biophysics and School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada; Institute for Experimental Cardiovascular Medicine, University Heart Centre Freiburg/Bad Krozingen, Medical Faculty of the University of Freiburg, Freiburg, Germany; and CIBSS-Centre for Integrative Biological Signalling Studies, University of Freiburg, Freiburg, Germany
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4
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Chou PY, Chiang WY, Chan CK, Lai PY. Dynamics of beating cardiac tissue under slow periodic drives. Phys Rev E 2020; 101:012201. [PMID: 32069621 DOI: 10.1103/physreve.101.012201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Indexed: 11/06/2022]
Abstract
Effects of mechanical coupling on cardiac dynamics are studied by monitoring the beating dynamics of a cardiac tissue which is being pulled periodically at a pace slower than its intrinsic beating rate. The tissue is taken from the heart of a bullfrog that includes pacemaker cells. The cardiac tissue beats spontaneously with an almost constant interbeat interval (IBI) when there is no external forcing. On the other hand, the IBI is observed to vary significantly under an external periodic drive. Interestingly, when the period of the external drive is about two times the intrinsic IBI of the tissue without pulling, the IBI as a function of time exhibits a wave packet structure. Our experimental results can be understood theoretically by a phase-coupled model under external driving. In particular, the theoretical prediction of the wave-packet period as a function of the normalized driving period agrees excellently with the observations. Furthermore, the cardiac mechanical coupling constant can be extracted from the experimental data from our model and is found to be insensitive to the external driving period. Implications of our results on cardiac physiology are also discussed.
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Affiliation(s)
- Po-Yu Chou
- Department of Physics, and Center for Complex Systems, National Central University, Chungli District, TaoYuan City 320, Taiwan, Republic of China
| | - Wei-Yin Chiang
- Department of Physics, and Center for Complex Systems, National Central University, Chungli District, TaoYuan City 320, Taiwan, Republic of China
| | - C K Chan
- Institute of Physics, Academia Sinica, Nankang, Taipei 115, Taiwan, Republic of China
| | - Pik-Yin Lai
- Department of Physics, and Center for Complex Systems, National Central University, Chungli District, TaoYuan City 320, Taiwan, Republic of China
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5
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Meira C, Glaus T, Ringer SK. Reversal of ventricular fibrillation with esmolol in an anaesthetized cat. Vet Anaesth Analg 2018; 45:713-714. [PMID: 30082182 DOI: 10.1016/j.vaa.2018.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 03/15/2018] [Accepted: 03/27/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Carolina Meira
- Department of Clinical Diagnostics and Services, Section Anesthesiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
| | - Tony Glaus
- Small Animal Department, Clinic for Small Animal Medicine, Section Cardiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Simone K Ringer
- Department of Clinical Diagnostics and Services, Section Anesthesiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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6
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Jin H, Iribe G, Naruse K. Effects of bepridil on stretch-activated BKca channels and stretch-induced extrasystoles in isolated chick hearts. Physiol Res 2017; 66:459-465. [PMID: 28248537 DOI: 10.33549/physiolres.933315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Various types of mechanosensitive ion channels, including cationic stretch-activated channels (SAC(NS)) and stretch-activated BKca (SAKca) channels, modulate heart rhythm. Bepridil has been used as an antiarrhythmic drug with multiple pharmacological effects; however, whether it is effective for mechanically induced arrhythmia has not been well investigated. To test the effects of Bepridil on SAKca channels activity, cultured chick embryonic ventricular myocytes were used for single-channel recordings. Bepridil significantly reduced the open probability of the SAKca channel (P(O)). Next, to test the effects of bepridil on stretch-induced extrasystoles (SIE), we used an isolated 2-week-old Langendorff-perfused chick heart. The left ventricle (LV) volume was rapidly changed, and the probability of SIE was calculated in the presence and absence of bepridil, and the effect of the drug was compared with that of Gadolinium (Gd(3+)). Bepridil decreased the probability of SIE despite its suppressive effects on SAKca channel activity. The effects of Gd(3+), which blocks both SAKca and SAC(NS), on the probability of SIE were the same as those of bepridil. Our results suggest that bepridil blocks not only SAKca channels but possible also blocks SAC(NS), and thus decreases the stretch-induced cation influx (stabilizing membrane potential) to compensate and override the effects of the decrease in outward SAKca current (destabilizing membrane potential).
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Affiliation(s)
- H Jin
- Department of Pharmacy, The Affiliated Hospital of YanBian University, YanJi City, JiLin Province, China. ; Cardiovascular Physiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kita-ku, Okayama, Japan.
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7
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Kohut AR, Vecchio C, Adam D, Lewin PA. The potential of ultrasound in cardiac pacing and rhythm modulation. Expert Rev Med Devices 2016; 13:815-22. [DOI: 10.1080/17434440.2016.1217772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Abstract
Mechanical forces will have been omnipresent since the origin of life, and living organisms have evolved mechanisms to sense, interpret, and respond to mechanical stimuli. The cardiovascular system in general, and the heart in particular, is exposed to constantly changing mechanical signals, including stretch, compression, bending, and shear. The heart adjusts its performance to the mechanical environment, modifying electrical, mechanical, metabolic, and structural properties over a range of time scales. Many of the underlying regulatory processes are encoded intracardially and are, thus, maintained even in heart transplant recipients. Although mechanosensitivity of heart rhythm has been described in the medical literature for over a century, its molecular mechanisms are incompletely understood. Thanks to modern biophysical and molecular technologies, the roles of mechanical forces in cardiac biology are being explored in more detail, and detailed mechanisms of mechanotransduction have started to emerge. Mechano-gated ion channels are cardiac mechanoreceptors. They give rise to mechano-electric feedback, thought to contribute to normal function, disease development, and, potentially, therapeutic interventions. In this review, we focus on acute mechanical effects on cardiac electrophysiology, explore molecular candidates underlying observed responses, and discuss their pharmaceutical regulation. From this, we identify open research questions and highlight emerging technologies that may help in addressing them.
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Affiliation(s)
- Rémi Peyronnet
- From the National Heart and Lung Institute, Imperial College London, United Kingdom (R.P., P.K.); Departments of Developmental Biology and Internal Medicine, Center for Cardiovascular Research, Washington University School of Medicine, St. Louis, MO (J.M.N.); Institute for Experimental Cardiovascular Medicine, University Heart Centre Freiburg/Bad Krozingen, Freiburg, Germany (R.P., P.K.)
| | - Jeanne M Nerbonne
- From the National Heart and Lung Institute, Imperial College London, United Kingdom (R.P., P.K.); Departments of Developmental Biology and Internal Medicine, Center for Cardiovascular Research, Washington University School of Medicine, St. Louis, MO (J.M.N.); Institute for Experimental Cardiovascular Medicine, University Heart Centre Freiburg/Bad Krozingen, Freiburg, Germany (R.P., P.K.)
| | - Peter Kohl
- From the National Heart and Lung Institute, Imperial College London, United Kingdom (R.P., P.K.); Departments of Developmental Biology and Internal Medicine, Center for Cardiovascular Research, Washington University School of Medicine, St. Louis, MO (J.M.N.); Institute for Experimental Cardiovascular Medicine, University Heart Centre Freiburg/Bad Krozingen, Freiburg, Germany (R.P., P.K.).
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9
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Rotenberg MY, Gabay H, Etzion Y, Cohen S. Feasibility of Leadless Cardiac Pacing Using Injectable Magnetic Microparticles. Sci Rep 2016; 6:24635. [PMID: 27091192 PMCID: PMC4876985 DOI: 10.1038/srep24635] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 04/01/2016] [Indexed: 12/11/2022] Open
Abstract
A noninvasive, effective approach for immediate and painless heart pacing would have invaluable implications in several clinical scenarios. Here we present a novel strategy that utilizes the well-known mechano-electric feedback of the heart to evoke cardiac pacing, while relying on magnetic microparticles as leadless mechanical stimulators. We demonstrate that after localizing intravenously-injected magnetic microparticles in the right ventricular cavity using an external electromagnet, the application of magnetic pulses generates mechanical stimulation that provokes ventricular overdrive pacing in the rat heart. This temporary pacing consistently managed to revert drug-induced bradycardia, but could only last up to several seconds in the rat model, most likely due to escape of the particles between the applied pulses using our current experimental setting. In a pig model with open chest, MEF-based pacing was induced by banging magnetic particles and has lasted for a longer time. Due to overheating of the electromagnet, we intentionally terminated the experiments after 2 min. Our results demonstrate for the first time the feasibility of external leadless temporary pacing, using injectable magnetic microparticles that are manipulated by an external electromagnet. This new approach can have important utilities in clinical settings in which immediate and painless control of cardiac rhythm is required.
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Affiliation(s)
- Menahem Y. Rotenberg
- The Avram and Stella Goldstein-Goren Department of Biotechnology
Engineering, Ben-Gurion University of the Negev, Beer-Sheva,
Israel
| | - Hovav Gabay
- Cardiac Arrhythmia Research Laboratory, Department of Physiology
and Cell Biology, Ben-Gurion University of the Negev,
Beer-Sheva, Israel
| | - Yoram Etzion
- Cardiac Arrhythmia Research Laboratory, Department of Physiology
and Cell Biology, Ben-Gurion University of the Negev,
Beer-Sheva, Israel
- Regenerative Medicine & Stem Cell Research Center,
Ben-Gurion University of the Negev, Beer-Sheva,
Israel
| | - Smadar Cohen
- The Avram and Stella Goldstein-Goren Department of Biotechnology
Engineering, Ben-Gurion University of the Negev, Beer-Sheva,
Israel
- Regenerative Medicine & Stem Cell Research Center,
Ben-Gurion University of the Negev, Beer-Sheva,
Israel
- Ilse Katz Institute for Nanoscale Science and Technology,
Ben-Gurion University of the Negev, Beer-Sheva,
Israel
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Pfeiffer ER, Tangney JR, Omens JH, McCulloch AD. Biomechanics of cardiac electromechanical coupling and mechanoelectric feedback. J Biomech Eng 2014; 136:021007. [PMID: 24337452 DOI: 10.1115/1.4026221] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 12/12/2013] [Indexed: 11/08/2022]
Abstract
Cardiac mechanical contraction is triggered by electrical activation via an intracellular calcium-dependent process known as excitation-contraction coupling. Dysregulation of cardiac myocyte intracellular calcium handling is a common feature of heart failure. At the organ scale, electrical dyssynchrony leads to mechanical alterations and exacerbates pump dysfunction in heart failure. A reverse coupling between cardiac mechanics and electrophysiology is also well established. It is commonly referred as cardiac mechanoelectric feedback and thought to be an important contributor to the increased risk of arrhythmia during pathological conditions that alter regional cardiac wall mechanics, including heart failure. At the cellular scale, most investigations of myocyte mechanoelectric feedback have focused on the roles of stretch-activated ion channels, though mechanisms that are independent of ionic currents have also been described. Here we review excitation-contraction coupling and mechanoelectric feedback at the cellular and organ scales, and we identify the need for new multicellular tissue-scale model systems and experiments that can help us to obtain a better understanding of how interactions between electrophysiological and mechanical processes at the cell scale affect ventricular electromechanical interactions at the organ scale in the normal and diseased heart.
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Takahashi K, Kakimoto Y, Toda K, Naruse K. Mechanobiology in cardiac physiology and diseases. J Cell Mol Med 2013; 17:225-32. [PMID: 23441631 PMCID: PMC3822585 DOI: 10.1111/jcmm.12027] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Accepted: 01/11/2013] [Indexed: 11/28/2022] Open
Abstract
Mechanosensitivity is essential for heart function just as for all other cells and organs in the body, and it is involved in both normal physiology and diseases processes of the cardiovascular system. In this review, we have outlined the relationship between mechanosensitivity and heart physiology, including the Frank-Starling law of the heart and mechanoelectric feedback. We then focused on molecules involved in mechanotransduction, particularly mechanosensitive ion channels. We have also discussed the involvement of mechanosensitivity in heart diseases, such as arrhythmias, hypertrophy and ischaemic heart disease. Finally, mechanobiology in cardiogenesis is described with regard to regenerative medicine.
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Affiliation(s)
- Ken Takahashi
- Department of Cardiovascular Physiology, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
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12
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Pellis T, Pausler D, Gaiarin M, Franceschino E, Epstein A, Boulin C, Kohl P. Off-patient assessment of pre-cordial impact mechanics among medical professionals in North-East Italy involved in emergency cardiac resuscitation. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2012; 110:390-6. [DOI: 10.1016/j.pbiomolbio.2012.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 08/03/2012] [Indexed: 11/25/2022]
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13
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Iribe G, Jin H, Naruse K. Role of sarcolemmal BK(Ca) channels in stretch-induced extrasystoles in isolated chick hearts. Circ J 2011; 75:2552-8. [PMID: 21914957 DOI: 10.1253/circj.cj-11-0486] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND It remains unclear whether sarcolemmal BK(Ca) channels in post-hatch chick ventricular myocytes contribute to stretch-induced extrasystoles (SIE), and whether they are stretch-activated BK(Ca) (SAK(Ca)) channels or a non-stretch-sensitive BK(Ca) variant. METHODS AND RESULTS To determine the role of sarcolemmal BK(Ca) channels in SIE and their stretch sensitivity, an isolated 2-week-old Langendorff-perfused chick heart and mathematical simulation were used. The ventricular wall was rapidly stretched by application of a volume change pulse. As the speed of the stretch increased, the probability of SIE also significantly increased, significantly shortening the delay between SIE and the initiation of the stretch. Application of 100 nmol/L of Grammostola spatulata mechanotoxin 4, a cation-selective stretch-activated channel (SAC) blocker, significantly decreased the probability of SIE. The application of Iberiotoxin, however, a BK(Ca) channel blocker, significantly increased the probability of SIE, suggesting that a K(+) efflux via a sarcolemmal BK(Ca) channel reduces SIE by balancing out stretch-induced cation influx via SACs. The simulation using a cardiomyocyte model combined with a new stretch sensitivity model that considers viscoelastic intracellular force transmission showed that stretch sensitivity in BK(Ca) channels is required to reproduce the present wet experimental results. CONCLUSIONS Sarcolemmal BK(Ca) channels in post-hatch chick ventricular myocytes are SAK(Ca) channels, and they have a suppressive effect on SIE.
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Affiliation(s)
- Gentaro Iribe
- Cardiovascular Physiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
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Küstermann J, Tannert A, Roewer N, Muellenbach RM. [Successful resuscitation after cardiac arrest using a precordial thump.]. Anaesthesist 2010; 59:714-6. [PMID: 20549174 DOI: 10.1007/s00101-010-1738-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The case of 16-year-old, ASA I classified patient who suffered cardiac arrest during orthopedic surgery is reported. Return of spontaneous circulation was achieved with a precordial thump. The patient was discharged from hospital without any neurological deficits 10 days after the event.
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Affiliation(s)
- J Küstermann
- Klinik und Poliklinik für Anästhesiologie, Universität Würzburg, Deutschland.
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