0000000000800500
AUTHOR
K. Von Olshausen
“Three-level shock” in ablation-refractory paroxysmal atrial fibrillation
His-bundle ablation is a very effective method to control drug-refractory supraventricular arrhythmias. We present a 69-year-old woman with paroxysmal atrial fibrillation, in whom several attempts of unipolar and bipolar His-bundle ablation were ineffective. Ultimately a stable 2/1 atrioventricular block was induced when three successive shocks of 400 W were applied. The first shock was given in that position with the largest His-potential deflection. The other two shocks were applied at catheter positions more distal and more proximal from the first one, respectively. We suppose that the initial lack of success was due to an atypical atrioventricular junction anatomy.
Manifestation und Therapie von Reperfusionsarrhythmien bei der Thrombolyse des akuten Myokardinfarktes
Schon seit 1943 ist bekannt, das die Wiederherstellung der Durchlassigkeit eines verschlossenen Kranzgefases zu Rhythmusstorungen fuhren kann (9). Diese Art von Rhythmusstorungen werden Reperfusionsarrhythmien genannt. Seitdem die intrakoronare und intravenose Streptokinaseapplikation bei Patienten mit frischem Herzinfarkt immer haufiger verabreicht werden, ist auch das Interesse fur die Reperfusionsarrhythmien gestiegen.