Critical Care Transthoracic Echocardiography: Atrial Sinus Rhythm During Ventricular Fibrillation. (19th February 2014)

• Record Type: Journal Article
• Authors: Schulman, Peter Mark; Gelow, Jill M.; Merkel, Matthias J.; Mudd, James O.; Wei, Kevin; Hutchens, Michael P.
• Is Part Of: Journal of investigative medicine high impact case reports. Volume 2:Number 1(2014)
• Publication Date: 2014-02-19
• Subjects: LVAD -- TTE -- intensivist -- ventricular fibrillation -- sinus rhythm; Internal medicine -- Periodicals; Medical care -- Periodicals; 616.005
• DOI: 10.1177/2324709614524945
• Languages: English
• ISSNs: 2324-7096

Abstract

A 70-year-old man with end-stage heart failure and a continuous-flow left ventricular assist device received repeated electrical discharges from his biventricular implantable cardiac defibrillator. Although the electrocardiogram demonstrated ventricular fibrillation, the patient was awake and in no distress. A focused transthoracic echocardiogram was performed to assess ventricular function revealing simultaneous atrial sinus rhythm and ventricular fibrillation. This clinical scenario highlights a unique clinical finding, the complexity of the care of continuous-flow left ventricular assist device patients, and the challenges of intensivist-performed bedside focused transthoracic echocardiogram.