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Belharty N, El Ghali T, Siagh S, Choho Z, Benmessaoud FA, Fellat I, Oukerraj L, Cherti M. Post-Myocardial Revascularization: As a Nidus for an Electrical Storm! Cureus 2023; 15:e43450. [PMID: 37711947 PMCID: PMC10498482 DOI: 10.7759/cureus.43450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 09/16/2023] Open
Abstract
Electrical storm (ES) is a critical and potentially life-threatening cardiac rhythm disorder. It is characterized by the presence of three or more distinct episodes of sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) that necessitate appropriate termination. ES may occur in the setting of acute myocardial infarction or following myocardial reperfusion. An urgent treatment approach is necessary for better outcomes. We represent a case of a 64-year-old patient who presented with sudden chest pain and an episode of palpitations related to non-ST elevation myocardial infarction (NSTEMI), who has undergone percutaneous coronary intervention of the stenotic epicardial artery, but subsequently experienced an ES in the absence of stent thrombosis. ES presented in the form of sustained monomorphic VT that required synchronous direct current cardioversion, anti-arrhythmic drugs, deep sedation, and endotracheal intubation with a favorable course, with the patient being discharged after 14 days hospital stay. The practitioner should be mindful of the potential occurrence of ES following myocardial revascularization and should tailor the management approach.
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Affiliation(s)
- Najlaa Belharty
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Tanae El Ghali
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Selma Siagh
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Zakaria Choho
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | | | - Ibtissam Fellat
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Latifa Oukerraj
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Mohamed Cherti
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
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Li B, Feng Q, Yu C, Yang J, Qin X, Li X, Cao J, Xu X, Yang C, Jin Y. Predictive value of serum HIF-1α and VEGF for arrhythmia in acute coronary syndrome patients. Exp Biol Med (Maywood) 2023; 248:685-690. [PMID: 37350444 PMCID: PMC10291207 DOI: 10.1177/15353702231171902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 02/22/2023] [Indexed: 06/24/2023] Open
Abstract
Percutaneous coronary intervention (PCI) has been widely used in the alleviation of myocardial ischemia in patients with acute coronary syndrome (ACS). However, the incidence of reperfusion arrhythmia (RA) after PCI is high, which seriously affects the prognosis of ACS patients. Therefore, this study aimed to study the predictive value of serum HIF-1α and VEGF levels before PCI for RA in ACS patients post PCI. A total of 200 ACS patients who underwent PCI were selected and divided into those with RA after PCI (RA, n = 93) and those without RA after PCI (non-RA, n = 107) according to Lown grade. Spearman correlation analysis was applied for the relationship between serum hypoxia inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) levels and Lown grade. Patients with RA after PCI tended to have higher levels of creatine kinase muscle and brain isoenzyme (CK-MB), serum HIF-1α and VEGF before surgery. Low left ventricular ejection fraction (LVEF), high CK-MB, high serum VEGF and HIF-1α were risk factors for RA in ACS patients within 24 h after PCI. Receiver operating characteristic (ROC) analysis revealed that serum HIF-1α and VEGF levels could predict RA in ACS patients after PCI, and the combined detection could increase the sensitivity of single HIF-1α detection and the specificity of single VEGF detection. Lown grade was positively correlated with the serum HIF-1α and VEGF concentrations. In conclusion, serum HIF-1α and VEGF levels before PCI are risk factors for the occurrence of RA in ACS patients after PCI, and have certain predictive values for the occurrence of RA in ACS patients after PCI.
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Affiliation(s)
- Bin Li
- Wuxi No.2 People’s Hospital, The Affiliated Wuxi Clinical College of Nantong University, Wuxi 214002, China
| | - Qiuting Feng
- Department of Cardiology, Jiangnan University Medical Center (JUMC), Wuxi 214002, China
| | - Cheng Yu
- Department of Cardiology, Jiangnan University Medical Center (JUMC), Wuxi 214002, China
| | - Jun Yang
- Department of Cardiology, Jiangnan University Medical Center (JUMC), Wuxi 214002, China
| | - Xian Qin
- Department of Cardiology, Jiangnan University Medical Center (JUMC), Wuxi 214002, China
| | - Xing Li
- Department of Cardiology, Jiangnan University Medical Center (JUMC), Wuxi 214002, China
| | - Jianing Cao
- Department of Cardiology, Jiangnan University Medical Center (JUMC), Wuxi 214002, China
| | - Xin Xu
- Department of Cardiology, Jiangnan University Medical Center (JUMC), Wuxi 214002, China
| | - Chenjian Yang
- Department of Cardiology, Jiangnan University Medical Center (JUMC), Wuxi 214002, China
| | - Yan Jin
- Wuxi No.2 People’s Hospital, The Affiliated Wuxi Clinical College of Nantong University, Wuxi 214002, China
- Department of Cardiology, Jiangnan University Medical Center (JUMC), Wuxi 214002, China
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Protective Role of Amiodarone on Reperfusion Arrhythmia in Patients of Acute Myocardial Infarction with Percutaneous Coronary Intervention Treatment. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:2597173. [PMID: 36065272 PMCID: PMC9440625 DOI: 10.1155/2022/2597173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/29/2022] [Indexed: 11/18/2022]
Abstract
With the development and popularity of percutaneous coronary intervention (PCI), ischemia-reperfusion injury (IRI) has attracted more and more clinical attention. Reperfusion arrhythmia (RA), one of the common manifestations during and after PCI, can affect the postoperative cardiac function of patients with acute myocardial infarction (AMI). Therefore, effective intervention on RA has important clinical significance. This study observed the effect of amiodarone on reperfusion arrhythmia (RA) after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) and explored its possible mechanism. The results showed that amiodarone had good clinical efficacy in the prevention of RA in patients with AMI after PCI, and it could reduce the levels of serum IL-6, hs-CRP, CK-MB, and cTnI in patients and reduce the damage caused by reperfusion, thereby reducing the occurrence of RA.
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