Permanent cardiac pacing.
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Arrhythmia, Sinus↗
Biomedical subjects
L W Larson
Publications and source records attributed to L W Larson.
Are RNFAs a threat to PAs?
PAs are dependent practitioners, but that means we are an integral part of a team, and our value extends far beyond the operating room. Reimbursement for surgical services includes all services provided within a 60-day period of the operation. All care provided by a PA, therefore--care that an RNFA is neither trained nor allowed by law to perform--represents added value. Our presence and contribution save time, reduce the workload of the surgeon in and out of the operating room, and enhance care. Our mission, then, is to communicate our value not only to our employers but also to the hospitals in which we work and the communities that we serve. Are RNFAs a threat to PAs? As long as we remain multifaceted and promptly address misinformation disseminated about the PA profession, our value will speak for itself.
Humans↗
Sustained ventricular arrhythmias: differences between survivors of cardiac arrest and patients with recurrent sustained ventricular tachycardia.
Clinical, angiographic, echocardiographic and electrophysiologic data were examined in 101 patients with a history of sustained ventricular arrhythmia not associated with acute myocardial infarction. These patients included 66 survivors of out of hospital cardiac arrest and 35 patients presenting with hemodynamically well tolerated sustained ventricular tachycardia. On univariate analysis, patients in the cardiac arrest group had a lower incidence of previous myocardial infarction and left ventricular aneurysm and a higher ejection fraction compared with the ventricular tachycardia group. During electrophysiologic testing, the arrhythmia induced in the patients in the cardiac arrest group was fast and polymorphic and frequently degenerated into ventricular fibrillation. In contrast, in the ventricular tachycardia group, a slower, monomorphic and hemodynamically well tolerated ventricular tachycardia was commonly induced. On multivariate analysis, a polymorphic pattern of the induced ventricular arrhythmia was the only independent variable that distinguished the survivors of cardiac arrest from those presenting with sustained ventricular tachycardia. These results suggest that 1) the survivors of cardiac arrest and patients presenting with sustained well tolerated ventricular tachycardia are clinically distinct groups; and 2) the polymorphic tachycardia induced during programmed electrical stimulation in the survivors of cardiac arrest may indicate an unstable tachycardia mechanism. This may explain why these patients present with ventricular fibrillation and cardiac arrest, whereas others present with hemodynamically stable ventricular tachycardia.
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