Contrast-Induced Ventricular Fibrillation

Report:

Sinus rhythm

Sinus tachycardia

VEBs

Ventricular fibrillation

Comment:

It is surprising that this complication does not happen more often. The incidence was 0.75% in Gensini’s large series125, but may be larger in less experienced hands.

The hand injection is marked by the rise in the coronary artery pressure trace, which then falls to rejoin the aortic root pressure as the first VEBs appear. The pressure falls during sinus tachycardia and further VEBs, with complete collapse during the VF. At the end of the recording, modest rise is induced by closed chest compressions. Had the patient been trained to do so, cough would have been more effective interim measure126, 127.

168. 84 year old man with pre-syncope.

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