Research Paper On Atrial Fibrillation

Research Paper On Atrial Fibrillation
Atrial fibrillation (AF) is the most common sustained cardiac rhythm disorder with evidence
suggesting an increasing prevalence and incidence worldwide [1]. It is the most common arrhythmia
seen in clinical practice and is associated with plenty of morbidities and mortalities, e.g. stroke and
heart failure. The clinical subtypes of AF are paroxysmal, persistent, longstanding persistent and
permanent AF. Paroxysmal atrial fibrillation is defined as atrial fibrillation that is self–terminating,
usually within 48 h. Persistent atrial fibrillation is present when an episode of atrial fibrillation either
lasts longer than 7 days or needs cardioversion. Longstanding persistent atrial fibrillation has lasted
for 1 year or more and is when arrhythmia
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Atrial Fibrillation Essay
Introduction
Atrial fibrillation (AF) is a cardiac arrhythmia. It is the most common arrhythmia and it has
implications for patients and anaesthetists alike. The anaesthetist must take into consideration the
physiological and pharmacological implications of this common arrhythmia.
In a healthy individual receiving a general anaesthetic, the anaesthetist must be aware of the causes
and treatment of acute onset AF, both intra–operatively and peri–operatively. Patients with AF often
develop a decline in left ventricular performance and other hemodynamic instabilities including
reduced diastolic filling and tachycardia mediated cardiomyopathy1, all of which can reduce cardiac
output and pose difficulties for the anaesthetist.
One of the ... Show more content on Helpwriting.net ...
Atrial remodeling, both structural and electrical, can facilitate reentrant circuits for electrical
current, which can then lead to permanent fibrillations. The main mechanism proposed for electrical
remodeling leading to permanent AF is shortening of the refractory period7.
Postoperative atrial fibrillation (POAF) is a common problem seen by anaesthetists and patients who
develop POAF have a worse outcome8. Developing POAF puts patients at risk of hemodynamic
derangements, postoperative stroke, perioperative myocardial infarction, ventricular arrhythmias,
and heart failure8.
In cardiothoracic surgical patients, an incidence of as high as 16–46% has been reported8. This is
related to a number of factors that can be encountered during surgery. Mechanical factors like
manipulating the heart, pain and sympathetic stimulation can all induce POAF. It can also be related
to systemic inflammatory processes, hypotension, hypoxia, anemia and metabolic alterations. These
situations can all be expected during anaesthesia. Volatile agents used during anaesthesia may also
have antifibrillatory action8.
Another interesting cause of AF is a familial cause. Olson et al (2006) investigated a hereditary
predisposition to AF involved a nonsense mutation in the KCNA5 gene. This gene encodes kv1.5.
kv1.5 is an atrial specific potassium channel. The group reported a novel genetic basis for idiopathic
AF seen in patients lacking traditional risk

The Medical Intensive Care Unit
The Medical Intensive Care Unit provides acute provides care for adult and critically ill medical
patients. It has various different staff members that work together to achieve the best patient
outcome. The care is directed by those who specialize in critical care medicine. They take care of
patients with life threatening diseases, sickness and injuries. They do this by having a highly
prepared, equipped and knowledgeable staff with sophisticated organ support and invasive
monitoring. (Medical Intensive Care Unit – University Hospitals. n.d). The patients usually have a
good chance of surviving when they are in the intensive care unit, they just need to be closely
monitored and given proper treatment in order to fully recover. A common medical procedure in the
medical intensive care unit is cardioversion.
The ... Show more content on Helpwriting.net ...
Synchronized electrical cardioversion uses a therapeutic dose of electric current to the heart at a
specific moment in the cardiac cycle. This is used when patients have a tachycardia, when it is so
severe and critical, the physicians in the medical intensive care unit perform these procedures. The
procedure is performed by using two electrode pads. Each pad has metallic plate which has saline
gel on it, the pads are usually placed on the patient's chest, although one could be on the patient's
back, the other on their chest. The pads and cables are connected to the electrocardiography display
screen. The cardioverter, is used to deliver a reversion shock, and depending the patient's' needs, the
amount of electric current and time in between shocks will differ. The R wave on the
electrocardiography is an indicator of when to deliver the shocks to the patient because timing the
shock to the R wave is crucial, because it prevents the shock during the vulnerable period (Intensive
care medicine.

Atrial Contraction Case Study
NEW ONSET ATRIAL FIBRILLATION IN A NON–CARDIAC SURGICAL PATIENT
Atrial fibrillation (AF) is the commonest arrhythmia. It is characterised by disorganised random
electrical activity in the atria that results in a lack of effective atrial contraction. It is associate with a
five–fold risk of stroke and a three–fold incidence of congestive heart failure, and overall higher
mortality. There are many known risk factors for the development of acute AF including coronary
artery disease (CAD), hypertension and valvular heart disease but AF may occur in the absence of
any underlying cardiac or non–cardiac disease . As its incidence increases with age and with the
ageing of western populations it is becoming ever more common in surgical patients.
CASE ... Show more content on Helpwriting.net ...
These tools use known stroke risk factors to predict the patient's annual risk of stroke and artificially
divide patients into low, intermediate and high risk categories3. High risk groups should be started
on long–term oral anticoagulant therapy. Traditionally this was with a Vitamin K antagonist (VKA)
such as Wafarin but new oral anticoagulants such as Dabigatran have been shown to be non–inferior
to VKA for the prevention of stroke and systemic embolization with similar rates of major
haemorrhage in randomised controlled trials3. Bleeding risk also needs to be taken into account
before starting

Brady Arrhythmia Research Paper
Brady Arrhythmias is any disruption of cardiac rhythm resulting in 60 heartbeats per minute or less.
However, it should be noted that 60 BPM is normal heart rate for young adults and athletes. There
are multiple possible causes including heart tissue damage, hypothyroidism and inflammatory
diseases: Risk for Brady Arrhythmia increases due to age, smoking and high blood pressure. Effects
include fainting or feeling faint, fatigue and chest pains. Treatment depends on the severity of
symptoms ranging from medications to implanting a pacemaker to monitor heart rate and generate
electrical impulses to stimulate a proper heartrate.
Atrial Fibrillation is the most common type of arrhythmia. In A Fib, the right and left atrium do not
produce a normal

Write An Essay On Atrial Fibrillation
Atrial fibrillation (AF) is a type of irregular heartbeat or dysrhythmia. Atrial fibrillation can be
something that happens every now and sometimes you may develop atrial fibrillation that doesn't go
away and needs to be treated. Symptoms of atrial fibrillation usually include heart palpations,
dizziness or light–headedness, and a feeling of fluttering or "butterflies" in the chest. Although AF
may be asymptomatic, up to two thirds of patients report that the arrhythmia is disruptive to their
lives (Markides, 2003). Atrial fibrillation can a lot of the time lead to more serious complications
such as stroke, and other heart diseases.
In a healthy heart, the sinoatrial node sends an electrical impulse through the atria to contract and
pump blood into the ventricles. During atrial fibrillation the normal function of the heart is
disrupted. It starts with a chaotic electrical discharge in the atria of the heart, which then causes an
irregular, rapid atrial contraction – which leads to rapid ventricular conduction in the AV node.
Diseases that damage the heart or abnormalities of the heart's structure are the most common cause
of atrial fibrillation. Certain factors increase the risk of developing atrial fibrillation, such as age,
heart disease, high blood pressure, obesity or family history.
Depending on ... Show more content on Helpwriting.net ...
It is important to educate the patient about the side effects of each medication. Because most
patients with atrial fibrillation are sent home on anticoagulants it is important to teach the signs and
symptoms of bleeding, and to make sure they understand how vital it is to have lab work drawn
because the dosage of the medication may need to be adjusted depending on the results. It is very
important the patient understands not to use any aspirin products. Patients should understand the
importance of follow up visits, so that the physician can continuously monitor their heart

Ventricular Tachycardia Lab
Ventricular Tachycardia
An dysrhythmia of the heart is an irregular heartbeat rhythm. Ventricular tachycardia is an
dysrhythmia in which the lower chambers of the heart, the ventricles, beat unusually fast.
The heart rate is measured with an electrocardiogram, or ECG. This is a machine that measures the
electrical impulses from the patient's heart. This is displayed on a monitor or ECG graph paper. The
boxes on the graph paper measure time. Five small boxes are equal to one large box. The large box
represents two–tenths of a second.
The atrial contraction is represented by the P wave. This is an upward, or positive wave of the line
on the graph. The ventricular contraction is displayed by the QRS complex. The QRS ... Show more
content on Helpwriting.net ...
The SA node is the primary pacemaker of the heart. It starts the heartbeat by spontaneously
contracting, causing the rest of the heart to contract in a wave.
The wave spreads through the atria before reaching the atrioventricular node, or AV node, located
just above the right ventricle. The AV node focuses the wave into the ventricles, contracting the
ventricles. Should the SA node fail, the AV node can take over as the primary pacemaker at a rate of
forty to sixty beats per minute.
Should both the SA node and the AV node fail, there is a tertiary pacemaker, the perkinje fibers.
Perkinje fibers are located near the bottom of the ventricles and can stimulate contraction at a rate of
twenty to forty beats per minute.
If the perkinje fibers or the AV node becomes irritated, they can begin contraction of the ventricles
at speeds well above normal. Other causes of ventricular tachycardia include heart disease and
medications.
When the ventricles are contracting at a rate greater than one hundred beats per minute, the heart
becomes inefficient. Blood cannot properly fill the ventricular chambers before it is forced out. This
decreases the amount of oxygenated blood circulating through the body.
The lack of oxygen in the body causes the heart to attempt to pump more blood, forcing the
ventricles to work even harder. Should the

Symptoms and Causes of Heart Attacks Essay
Symptoms and Causes of Heart Attacks
A heart attack (myocardial infarction) is the death of heart muscle due to the loss of blood supply.
Usually, the loss of blood supply is caused by a complete blockage of a coronary artery by a blood
clot. A coronary artery is an artery that supplies blood to the heart muscle. Death of the heart muscle
causes chest pain and electrical instability of the heart muscle tissue. Electrical instability of the
heart causes ventricular fibrillation (chaotic electrical disturbance). Orderly transmission of
electrical signals in the heart is important for the regular beating (pumping) of the heart. A heart
undergoing ventricular fibrillation quivers, and can not pump or deliver oxygenated blood to the ...
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Therefore, prompt CPR and rapid paramedic response can improve the survival chances from a
heart attack.
A heart attack is caused by the formation of a blood clot on a cholesterol plaque located on the inner
wall of an artery to the heart (coronary artery). Cholesterol is a fatty chemical that is part of the
outer lining of cells in the body. Cholesterol plaque is the formation of a hard, thick substance on the
artery walls which is caused by deposits of cholesterol on the artery walls; a process that begins in
the late teens. Over time, the accumulation of cholesterol plaque causes thickening of the artery
walls and narrowing of the arteries; a process called atherosclerosis. Plaque accumulation can be
accelerated by smoking, high blood pressure, elevated cholesterol, and diabetes. Ultimately,
atherosclerosis causes significant narrowing of the coronary arteries. During exercise or excitement,
the narrowed coronary arteries cannot increase the blood supply to meet the increased oxygen
demand of the heart muscle.
Heart muscle that is starved of blood oxygen, a condition called ischemia causes chest pain (angina).
Chest pain that occurs with exercise is called exertional angina. Exertional angina is reversible, and
subsides with rest. Occasionally, for unknown reasons, the surface of the cholesterol plaque can
become sticky, causing blood clotting. When a blood clot forms on top of this plaque, the artery
becomes completely blocked, causing death of the heart

Supraventricular Tachycardia
Supraventricular tachycardia:
Supraventricular Tachycardia is a cardio–vascular disease which occasionally results in abnormally
fast heartbeat which is not related to exercise, stress or illness.
Early doctors were researching arrhythmia in heart beat as a result of unknown abnormal neuro–
cardio mechanisms of the heart, one of theories was that SA and AV nodes were interfering with
each other's bio–electrical impulses another theory was that the right side of the septum was
hypersensitive to electrical impulse, all were more else on the right track because we know now that
SVT is a result of a faulty electrical connections of the heart.
The abnormally fast heartbeat caused by SVT, lasts in episodes lasting for several hours. During an
episode

Atrial Flutter Research Paper
Atrial Flutter
Atrial flutter is when the heartbeat is fast but regular. There are two types of atrial flutter:
Paroxysmal atrial flutter. This type starts suddenly. It usually stops on its own soon after it starts.
Permanent atrial flutter. This type does not go away.
CAUSES
This condition may be caused by:
A heart condition or problem, such as:
A heart attack.
Heart failure.
A heart valve problems.
A lung problem, such as:
A blood clot in the lungs (pulmonary embolism).
Chronic obstructive pulmonary disease (COPD). Medications used to treat COPD can attribute to
atrial flutter.
Poorly controlled high blood pressure (hypertension).
Hyperthyroidism.
Caffeine.
Some decongestant ... Show more content on Helpwriting.net ...
Medicine to make your heart beat more slowly.

Medicine to keep the condition from coming back.
A procedure to keep the condition under control. Some procedures to do this include:
Cardioversion. During this procedure medicines or an electrical shock are given to make the heart
beat normally.
Ablation. During this procedure the heart tissue causing the problem is destroyed. This procedure
may be done if atrial flutter lasts a long time or happens often.
HOME CARE INSTRUCTIONS
Take over–the–counter and prescription medicines only as told by your health care provider.
Do not take any new medicines without talking to your health care provider.
Do not use tobacco products, including cigarettes, chewing tobacco, or e–cigarettes. If you need
help quitting, ask your health care provider.
Limit alcohol intake to no more than 1 drink per day for nonpregnant women and 2 drinks per day
for men. One drink equals 12 oz of beer, 5 oz of wine, or 1½ oz of hard liquor.
Try to reduce any stress. Stress can make your symptoms worse.
SEEK MEDICAL CARE IF:
You have new symptoms.
Your symptoms get

High Depenncy Experience
Introduction
Working on the high dependency unit for 2 years and this has been an enjoyable experience. I had
learned a lot and like the team I worked with. The first time I was in the role of charge nurse it was
because none of the usual respondents were working that day! One of the regulars made the
comment "Well, looks like you can be in charge," Was she being real or what? Me –– a charge
person? I had not been in the role of a charge RN since will never. I had consistently worked in this
role as a staff RN and that is what I liked. My manager's parting words were, "Looks like you're
getting baptized with fire. Good luck."
In charge
Friday and a full house with 14 patients' already and this was before the weekend. Friday night and
the ... Show more content on Helpwriting.net ...
This was obviously to deal with the task at hand i.e. the high dependence unit in bedlam. As I have
known the rest of the staff for some time I was able to communicate with them with ease, and there
were no barriers to communication. The team had worked will with each other for some time, and I
knew the strength and weakness of each member of my team. I encouraged open communication
and for staff participation in decisions. As my outcome for that day was satisfactory and the unit was
put back in short order I regard it as a success. But on reflecting I would have approach this tasked
slightly differently using the Knowledge Management theory (KMS). The KMS Nursing process
involves a number of convoluted and knowledge–intensive practices that hi depend on nursing
knowledge and experience. This would have been ideal in my scenario, the nurse can utilize and
manage their knowledge in providing care in an efficient and optimum manner. Technologies
currently available allow for the development of e–health systems that can affect the entire
professional experience for nurses. For instance, nurses can now electronically link to several or all
information systems that influence their practice. These systems have been in ICU and HDU for
some time, giving faster access to blood work results, electronic health records, medical knowledge
bases, prescription ordering, and clinical decision support systems. With the use of knowledge
management theory, I don't believe the end result would have change, but it may have been a little
smoother

Bridging: Subtherapeutic Anticoagulation Therapy
Bridging refers to the process where thromboembolic risk is reduced by decreasing the time of
subtherapeutic anticoagulation. The most popularly known method is the use of short–term blood
thinners, such as enoxaparin, when anticoagulation therapy (warfarin) is interrupted for surgeries or
other procedures. The desired results of this process is to reduce blood clot development risk but
carries the possible consequence of increasing serious bleeding. According to the ACC/AHA 2014
guidelines, in perioperative management, bridging is recommended for patients with atrial
fibrillation and a mechanical heart valve when the procedure requires interruption of the warfarin
therapy. However, if a patient has atrial fibrillation but no mechanical heart ... Show more content
on Helpwriting.net ...
Since the BRIDGE trial, there has been a decrease in the number of bridging procedures in the low–
to–moderate risk patients with atrial fibrillation. To reiterate, patients with non–mechanical heart
valve atrial fibrillation with low bleed risk procedures and have a lower CHADS2/CHA2DS2–Vasc
score are less likely to need bridging, than those with high risk procedures and
CHADS2/CHA2DS2–Vasc scores. However, risk vs. benefit in using bridging in atrial fibrillation
should always be

Fibrillation Patient Case Study
Nursing Management of an Atrial Fibrillation Patient With Peptic Ulcer Mr. C.J. is a married 68–
year–old African American man who presents to the emergency department with a chief complaint
(CC) of emesis of bright red blood. The patient reported that he was shopping when he began
throwing up blood at the store. He denied any associated shortness of breath, melena, hematochezia,
liver disease, or prior episodes. The patient appears pale, diaphoretic, and he reported some
lightheadedness with standing and epigastric pain. On further questioning, he stated that he was
admitted in the hospital approximately one month ago with heart palpitation and dizziness and was
diagnosed with Atrial fibrillation. Subsequently, he was discharged home with a prescription of 5
mg of Coumadin daily and Tikosyn following a successful cardioversion. Mr. C.J. was also advised
to monitor his INR ... Show more content on Helpwriting.net ...
Some patients can be asymptomatic, many experience a wide variety of symptoms as a consequence
of the hemodynamic dysfunction (Grossman & Porth, 2014). The people with AF who exhibits no
symptoms often diagnose their condition with a physical examination and an EKG. The common
symptoms that the patient's with AF experience include; palpitations (sensation of chest racing or a
flip–flopping in the chest), weakness, decreased ability to exercise, fatigue, lightheadedness, and
dizziness, while symptoms related to congestive heart failure including dyspnea and angina can
develop in more severe cases (CDC, 2015). Finally, a few will experience the thromboembolic
phenomenon as a consequence of blood flow stasis within the atrium, endothelial dysfunction, and
hypercoagulability (Virchow's triad). The dislodgement of a clot from the atrium resulting in an
embolus to the brain (transient ischemic attach or stroke) or to the mesenteric circulation (bowel
ischemia) can have severe consequences and require immediate

Characteristics Of A Female Patient At The Mature Age Of...
Introduction
A female patient at the mature age of 78 was presented to A&E with symptoms in accordance with
new onset Atrial Fibrillation(AF). The patients' medical history was notable only for controlled
hypertension, which recurrently coexists with AF and is acknowledged for being one of the principal
risk factors of AF. With Hypertension being '... the most common cardiovascular disorder' and AF
equally being '... the most common clinically significant sustained cardiac arrhythmia', the
management routes must be cautiously considered so the appropriate treatment care can be
administered for the patient (Manolis et al, 2012). ECG characteristics of Atrial Fibrillation
AF is characteristically exhibited on a 12–lead electrocardiogram (ECG) with an irregular and rapid
ventricular rate except when the patient is on any sort of AV node blocking drug such as beta–
blockers, which the patient may be possibly on due to her hypertension. AF is initiated due the rapid
and chaotic firing of action potentials within the pulmonary veins or atrium, generating fast atrial
rates with minimal amplitudes. P waves are therefore no existent on an ECG. All this chaotic action
potential is however incapable of passing through the intermittently refractory AV node, meaning
the QRS complexes created are also irregularly irregular. This fabricates varying R–R intervals due
to there being no pattern to their frequency. (Lome, no date). There is also a deficiency of the
isoelectric baseline, and

Heart Failure ( Hf )
Considered a major health problem in the United States, heart failure (HF) is a syndrome involving
insufficient pumping and/or filling of the heart (Lewis, Heitkemper, Dirkson, & Bucher, 2014). As
HF progresses, the heart cannot continue to meet the oxygen demands of the body's tissues due to a
decreased cardiac output. Acute HF and chronic HF have replaced the term congestive heart failure
(CHF) since not all HF patients experience pulmonary congestion, but CHF is still commonly used
in the clinical setting (Lewis et al., 2014). Regardless of the terminology, HF typically results in
poor outcomes and a high incidence of hospital readmissions.
Patient Profile
Reason for Hospital Admission The patient is a fifty–seven year old Caucasian male who presented
to the University Medical Center triage center on September 6, 2015 with shortness of breath (SOB)
and labored breathing. The patient's SOB was of moderate severity with a three–week duration of
gradual onset, recurrent, worsening, constant, worse with exertion, and relived by sitting up. The
patient reported an inability to climb one flight of stairs without experiencing SOB. The patient
presented with bilateral lower extremity edema, abdominal swelling and distention, anasarca,
jugular vein distention (JVD), wheezing, and productive cough with phlegm. The patient reported a
fifty–pound weight gain over the past few weeks because prescription diuretics were ineffective
when he stated "fluid pills haven't

Delta Waves Case Study
A 45–year–old male comes into the emergency department with symptoms of acute dizziness,
dyspnea, chest pressure, and palpitations. He states that he feels that his heart is "racing.". He has a
history of hypertension (HTN) and coronary heart disease (CAD) status post one bare metal stent.
He is currently on clopidogrel, aspirin, metoprolol, and Llisinopril. His BP blood pressure is 87/60
mmHg, pulse heart rate 160––170 beats/min, respirations rate 26 breaths/min, oxygen saturation
90% on room air, and afebrile. His physical exam has pertinent positive findings of diminished
global breath sounds and rapid sinus heart sounds. He has no jugular venous distention (JVD),
abdominal tenderness, nuchal rigidity, lower extremity swelling, or focal ... Show more content on
Helpwriting.net ...
Atrial fibrillation would not be in sinus rhythm and it would not have discernable P waves present
on ECG tracing.
Choice "C" is not the best answer. Sinus vs. supraventricular tachycardia (SVT) is based on how
high the heart rate is. If the heart rate is greater than 120 bpm with narrow QRS waves, it is
considered SVT.
Choice "D" is not the best answer. The vignette states that the QRS length is less than 120
milliseconds. Ventricular tachycardia consists of wide QRS waves that are greater than 200

Notes On The Rhythm Control
2.5.3. Rhythm Control
2.5.1.1. Cardioversion
Usually performed electively, cardioversions are procedures that are performed to convert an
arrhythmia back to sinus rhythm.. There are two types of cardioversions; pharmacological and
electrical.
Pharmacological cardioversions are performed via administering arrhythmia–medication to patients
to restore the heart's rhythm to normal sinus rhythm. Pharmacological cardioversions were the
standard cardioversion procedures performed before electrical cardioversion became more
commonly used. Advantages of pharmacological cardioversions are such that the procedure does not
require sedation, (whereas electrical cardioversion does), and the development of new drugs has
made it more of a popular ... Show more content on Helpwriting.net ...
The main risk associated with DC cardioversion is the occurrence of embolic events and cardiac
arrhythmias (Fuster V et al; 2001).
2.5.1.2. Surgical Ablation – Cox Maze Procedure
James Cox, along with his colleagues, developed the Cox Maze procedure, (also known as the Maze
procedure) which is an open–heart surgical procedure designed to eliminate AF. The procedure
consists of creating conduction barriers within the RA and LA, thus limiting the number of wavelets
able to propagate themselves within the atrial myocardium, thus eliminating AF.
A five–year follow up study was conducted to assess whether the Cox Maze procedure was a viable
treatment option for AF patients. The sample size consisted of 75 patients who had undergone the
maze procedure for the treatment of AF. At the end of the five years, 65 patients had been followed
up for three months post–procedure. The end result was that the Maze procedure was successful in
treating AF in 98% (n = 64) of the 65 patients followed up. It was also successful in treating AF
without the need for medication in 89% (n = 58), and with the need for medication in 9% (n = 6) of
the total cohort respectively. This therefore proves that the Cox maze procedure is an effective
treatment method for AF patients (Cox JL et al; 1993).
2.5.1.3. Catheter Ablation

As a result of the success of the Cox Maze procedure, catheter ablation strategies were developed in
an attempt to replicate the

Hypertrophic Cardiomyopathy Essay
"Atrial Fibrillation in Hypertrophic Cardiomyopathy:Diagnosis and Considerations for
Management," discusses the significance of early recognition and treatment of Atrial Fibrillation
(AF). In addition, the journal provides information about the role rhythm plays in hypertrophic
cardiomyopathy and ventricular arrhythmias.
Hypertrophic cardiomyopathy (HCM) is the leading monogenetic cardiomyopathy. HCM has a
prevalence of 1:500 (Ali, 2018). Localization and severity of hypertrophy dictate whether HCM
patients may suffer from ventricular outflow tract obstruction, mitral regurgitation, diastolic
dysfunction, myocardial ischemia and fibrosis (Ali, 2018). AF is the most common arrhythmia in
HCM. The prevalence is mostly dependent on the severity, ... Show more content on Helpwriting.net
...
Stroke, edema, hypotension, and chest pain are also indicators of possible AF.
Treatment strategies include a timely given oral anticoagulant, rhythm or rate control using medical
and interventional option (Ali, 2018). It is advised that symptomatic patients get a rapid electrical
cardioversion to restore sinus rhythm (Ali, 2018). There are drugs that maintain sinus rhythm. They
include: amiodarone, sotalol, and disopyramide (Ali, 2018). A Beta blocker helps reduce the
gradient of LVOT improving diastolic dysfunction. Catheter ablation is also a safe and effective
option for patients with HCM (Ali, 2018). It's shown to have fewer complications and a better
recovery than surgical ablation (Ali, 2018).
This journal clearly described how to diagnose and treat AF. With heart disease being the leading
killer in the U.S., I appreciate all the symptoms the article listed as well the additional updated
diagnosage measures. I wish the journal would've explained what is it the beta blockers do and how
the anticoagulants work at the cellular level. A description or picture of the catheter and surgical
ablation would've helped readers get an idea of what's taking place in treating AF.

Atrial Fibrillation: A Case Study
It's known that atrial fibrillation (AF) is the most common sustained cardiac arrhythmia representing
abnormal rapid and irregular ventricular rates with deterioration of atrial mechanical function
resulted by disorganized atrial electrical activity classified as acute, chronic, paroxysmal,
intermittent, constant, persistent, or permanent and when a patient has 2 or more episodes, AF is
considered recurrent(1). During the last decade, it accounted for approximately one third of hospital
admissions for cardiac arrhythmias with progressive increases in the worldwide prevalence and
incidence(1,2). It is more common in patients with cardiovascular problems such as hypertension,
valvular heart disease, congestive heart failure (CHF) or coronary ... Show more content on
Helpwriting.net ...
Rate control is the older therapeutic strategy but it is still a primary therapy for AF. Beta–blockers
and calcium channel blockers are both effective and well resistant therapies which can be used in a
wide range of acute and long–term clinical conditions, as well as both contribute in controlling
hypertension. It's investigated that oral beta–blockers are more favorable than calcium channel
blockers for patients with ischemic heart disease, CHF and depressed left ventricular function.
Digoxin is effective for controlling heart rate especially in sedentary elderly and concomitant CHF
patients due to its effectiveness in improving ventricular function. Other potential advantages of rate
control include less adverse drug effects and less hospitalization. However, it has some
disadvantages including risk of toxicity, chronotropic incompetence and difficulties in achieving
dose adjustments in patients with compromised renal function adding that it is not preferred in
younger patients and those with a history of

The Similarities And Differences Between Rcis And Rces
The Similarities and Differences of RCIS and RCES Seeking cardiovascular technician who are able
to monitoring patients and assisting doctors with performing angiograms, PCIs, Interventional
Radiology procedures, and Electrophysiology procedures. Minimum requirement: Registered
Cardiovascular Invasive Specialist (RCIS) or Registered Cardiovascular Electrophysiology
Specialist (RCES). This is an example of the many job posting for cardiovascular technician. What
do these individuals have in common that cardiac laboratory can accept either credentials? What set
them apart to have different credential title? It is easier to discuss the similarities of both RCIS and
RCES registrant since they are so similar. Similarity It is easier to discuss the similarities of both
RCIS and RCES individuals since they are so alike. The first similarities of RCIS and RCES
individuals is the amount of extensive cardiovascular education they receive through a 2 years
program which include didactic and skills labs. Both are credentials through Cardiovascular
Credentialing International (CCI) with upon passing the RCIS or RCES exam. Since the field of
invasive and electrophysiology is still expanding, new techniques and equipment are continually
being research, released and revised. As a results, RCIS and RCES individuals pursue continue
education (CEUs) in order to be informed and proficient with innovative techniques and equipment.
Furthermore, CCI required both RCES and RCIS registrants

Arrhythmias
An arrhythmia is an irregular heartbeat. The muscle either beats too quickly (called a tachycardia) or
too slowly (bradycardia). When the disorder is mild, it usually poses few problems. When it is
severe, it can be fatal.
Arrhythmias are categorized based on whether they affect the atria (two top chambers) or ventricles
(two bottom chambers), and whether they quicken or slow the patient's heartbeat. These
circumstances occur due to a disruption in the heart's electrical system. Normally, electrical
impulses spread across the chambers in a uniform pattern, causing them to contract. Each impulse
generates a single heartbeat. An arrhythmia interrupts these impulses, causing a change in the heart's
rhythm.
In this article, we'll provide an overview of the main types of cardiac arrhythmias. ... Show more
This form of arrhythmia is known simply as a premature beat. They are referred to as premature
atrial contractions (PACs) when they affect the atria, and premature ventricular contractions when
they affect the ventricles. In most cases, they cause no problems. Few patients even realize they
have them.
Methods Used To Treat Arrhythmias
A mild arrhythmia may require no treatment, though your doctor will want to monitor the condition
periodically to make sure it doesn't worsen. When treatment is given, it is usually in the form of
drugs, surgery, or one of many nonsurgical procedures. Medications include blood thinners
(warfarin or heparin) to prevent clotting, along with beta blockers and calcium channel blockers.
These latter two classes of medications are given to slow the patient's heart rhythm; they are often
used to treat a–fib or v–fib.
When an arrhythmia has been caused by an obstruction in the coronary arteries, a coronary artery
bypass graft may be done to restore blood flow. With a–fib, surgeons may also recommend an
operation called the maze procedure, which reroutes the heart's electrical impulses along a defined

Cold War Environmental Changes
Medical and Environment Advancements from the Cold War The Cold War had a major impact on
people's lives then, and now. Most people are using technology generated from the cold war today
without even knowing it. Even though the U.S. and the U.S.S.R. were allies during WWI, their
relationship became uneasy after WWII. The fear of communism spreading made it tense for the
American people. There were many advancements during this time because each country was trying
to determine which country was superior to one another. The medical and environmental
achievements were some of the most significant improvements in technology and they helped
America prosper then, as well as today.
Medical Improvements The Cold War had a vital impact on medicine ... Show more content on
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After the war, the health of the children improved tremendously. Vaccines against polio, measles,
and rubella were developed. Polio is a crippling and potentially deadly disease that killed many
people and children. The first polio vaccine was developed by Jonas Stalk and came into use in
1955. The oral polio vaccine was developed by Albert Sabin and people started using it in 1961.
Measles is an infectious disease causing fever and a red rash on the skin. The introduction to the
vaccine occured in 1963. The vaccine helped eliminate hundreds and thousands of cases of measles
every year. Rubella is a contagious viral disease with symptoms like measles. It can cause fetal
malformation if it is contracted early in pregnancy. The rubella vaccine became available in 1963
and an improved one came out in 1968. Measles, rubella, and mumps were all combined into one
vaccine in 1971 called MMR. By 1930, the life expectancy had risen to sixty years old, and heart
disease had become the number one cause of death. There is a range of conditions that affect your
heart. Heart disease usually refers to conditions that involve narrowed or blocked blood vessels that
can lead to heart attacks. Children obtained heart disease mostly by illnesses or genetic syndromes.
There is a multitude of treatments for heart disease: heart bypass surgery, cardioversion,
pacemakers, heart transplant,

S. D Case Study
S.D. is a 45–year–old woman who comes to the ED complaining of sudden onset of palpitations and
shortness of breath. Standard protocol requires you to obtain a 12–lead ECG and attach S.D. to the
cardiac monitor for continuous monitoring. A 12–lead ECG recording for S.D is ordered while you
print out a rhythm strip from the cardiac monitor.
1. Describe the appropriate location to apply the leads for both the 5–lead cardiac monitor as well as
the 12– lead ECG.
– For the 5–lead cardiac monitor, there are five electrode pads placed. The RA electrode (white) is
placed below the right clavicle (2nd interspace, right midclavicular line), the LA (black) is placed
below the left clavicle (2nd interspace, left midclavicular line), the RL ( green) is ... Show more
What specific ECG change will you be looking for to determine if S.D.'s chest pain is related to
cardiac ischemia? Injury? Infarction?
– To determine if the patient's chest pain is related to cardiac ischemia, you would look for ST–
segment depression and/or T wave inversion. If the ST–segment depression is at least 1mm (one
small box) below the isoelectric line, it is significant and occurs in response to inadequate supply of
blood and oxygen, which leads to an electrical disturbance. Once this is treated, adequate blood flow
is restored, the ECG changes will resolve, and the ECG will return back to patient's baseline.
To determine if the patient's chest pain is related to injury, you would look for ST–segment
elevation. Myocardial injury represents a worsening stage of ischemia. If ST–segment elevation is
greater than or equal to 1mm above the isoelectric line, it is significant and treatment needs to be
prompt and effective to try to restore oxygen to the myocardium, and to avoid or limit infarction.
The absence of serum cardiac markers confirms that infarction has not

Bioradio Mobile And Wireless System Essay
"BioRadio Mobile & Wireless System" Introduction A health care technology, which changed health
care communication is the "The BioRadio Mobile and Wireless System." The BioRadio is a wireless
monitor that records physiological signals, such as the electrical activity of the heart, brain, and
muscles. This biomedical device is innovative, simple to set up and operate, it is equipped with
multi–programmable channels which captures and transmits human physiological data via Wi–Fi to
computers, laptops, tablets or Smartphones. Additionally, the information can be stored in the
onboard memory of the BioRadio itself. This system comes with a range of applications software
kits such as ECG, EEG, EKG and more all in one unit. By installing these kits, users can stream
real–time data onto their own custom application The BioRadio mobile and wireless systems are
utilized in various hospitals, nursing homes and health care facilities to effectively serve their
patients, staff, and communities. Automated wireless EEG analysis The mobile and wireless
ambulatory ECG monitoring system is cost–effective and functions to capture reliable, accurate data
for uses in a variety of applications including human physiology labs, exercise physiology
monitoring or clinical trials." Since 2014, the mobile ECG has been used in medical diagnostic
application, and by researchers from a broad range of neuroscience research. Yet still, it is used to
record and provide sleep and daytime assessment for

A Patient With A Suspected Dvt
What is an appropriate focused assessment and care to provide a patient with a suspected DVT? A
focused assessment is an assessment that centers directly on the chief complaint that a patient
presents with when they arrive to seek out care. In this case, our assessment is focused on a potential
deep vein thrombosis (DVT). A DVT is a essentially a ball of blood cells that are clumped together
impeding blood flow which can cause irritation to the vein and potentially more dangerous
problems. If the thrombus moves, it can travel through the body and into the lungs and impeded
breathing which is not good. Therefore, it is essential to catch DVT's right away and treat them to
prevent them from moving. The first thing that needs to be assessed when a patient presents with a
suspected DVT is their level of consciousness and their vital signs including the heart rate, blood
pressure, respirations, temperature and oxygen saturation. Next, assess the site of the expected DVT,
and perform a neurovascular assessment which comparing to the same site on the opposite side of
the patients body. Check for adequate circulation by assessing for pink color distal to the site. While
performing this assessment, you want the area distal to the site to be pink to ensure there is adequate
blood flow. If it is whitish in color, this is a sign of a DVT and needs to be documented. While
assessing color, also assess the site directly for any color deviation from the clients natural skin
color. If the

The Possibly Detrimental Effects of Cardiac Arrhythmia
Cardiac arrhythmia is defined as, "a condition in which the heart's normal rhythm is disrupted"
(Scholarpedia). A heart usually beats anywhere from 60 to 100 times a minute. If there is a palpation
or a fluttering rarely, the person should usually be fine. If these occur more often or on a frequent
manner, this cardiac arrhythmia could be very severe (Hopkinsmedicine). The hearts electrical
system is what controls the speed and pace of the heartbeat (NHLBI,NIH). Sinoatrial node or SA
node is located in the right atrium and controls the rhythm of the heart. The SA node is cardiac
muscle cells, and it acts as a pacemaker. Sinus rhythm is the regular heart rhythm (Scholarpedia).
Atrial tachycardia is when the heart beats too fast. On the other hand, bradycardia is when the heart
beats too slowly. The heart can also beat irregularly (Hopkinsmedicine). The electrical signal goes
from the SA node to the left and right atria. This allows the atria to pump and contract blood to the
ventricles. Then, the signal goes to the atrioventricular or AV node. The electrical signal slows down
here, so the ventricles have time to fill themselves with blood. After the AV node, the electrical
signal goes to the bundle of His, where the signal is eventually transported to the ventricles. In this
phase, the signal causes the ventricles to contract and pump blood to the lungs and the other parts of
the body (NHLBI, NIH). The reason I described this whole process was for the reader to

Running Head : Cardiac Arrest
Running head: Cardiac Arrest
Cardiac Arrest
Dylan Noble
Utah Valley University
Captain Steve Allred
Paramedic 3110 Intro
"Each year, 326,200 people in the U.S. experience EMS–assessed out–of–hospital non–traumatic
sudden cardiac arrest, and nine out of ten victims die." (www.sca–aware.org 1) This number may
seem quite low, but in the end one out of ten lives saved is still better than none.
This paper will be going over a scenario involving a real patient and what things could have been
different with EMS care. It will also be covering what exactly cardiac arrest is and what rhythms
produce it. And for every cardiac rhythm in cardiac arrest, there is a specific treatment plan
paramedics can follow.
Scenario
The day started off normally. I got to the station early at 0645 and started to talk to some of the guys
working. There were a couple guys I just met that day. Then I started to get all my stuff ready for the
day. I put all my gear on the ambulance and started on the daily checks for our rig. The daily checks
consist of checking the lights and sirens, fluids, and making sure all our supplies are in the
compartments and in the bags. As I started going through the monitor bag with the
electrocardiogram (EKG), we get a call to a male in his 40's unresponsive and not breathing.
Everyone jumped into the rigs and we rushed off to the scene code three. We were en route to a
residence to the south. When we arrived we looked for the address but it did not

Cardiopulmonary Mentorship
From that moment during the internship, I was never the same person again. A Disoriented patient,
aged 25 years, suspected with cerebral malaria was admitted to the emergency department of my
medical college, 4 Years back. Upon administration of a loading dose of quinine with dextrose, The
general practitioner in charge of the emergency department shifted him to the intensive care unit. On
the 2nd day of ICU, a catastrophic event occurred; the patient suffered from fatal ventricular
tachycardia with hemodynamic instability. Following this, The Resident Doctors urgently proceeded
with the Synchronized cardioversion, while assigning me to deliver Cardiopulmonary Resuscitation
in between the events. Fortunately, by God's grace, our efforts to ... Show more content on
Helpwriting.net ...
Furthermore, my passion for Soccer strongly matches with that of Internal Medicine; Team Work,
Patience and Constant improvement are essential in both to win the glory. Besides, I feel I am
endowed with capable observing and listening skills. My experience as a Government Medical
Officer for 2 years in a district hospital located in a remote hilly region of Midwestern Nepal, where
I had to work with underprivileged and people of low socioeconomic status served as a bedrock for
my transformation in interpersonal skills and contemplation. Having to follow the patient over and
over again and listening to their problems develops a special bond with the patient which is
fundamental to learning in Internal

Echocardiography And Cardioversion Procedure: A Case Study
Last Thursday was an exciting and enthusiastic day getting to observed a patient who is having a
transesophageal echocardiography (TEE) and cardioversion procedure done due to atrial fibrillation
which is a quivering or irregular heartbeat. The TEE was performed before the cardioversion to look
for clot in the heart, which could make it dangerous to proceed with the shock. The Tee is an
ultrasound test done from the esophagus to allow a close inspection of the heart to make sure there is
no clot. Before the procedure, all the equipment's were set–up by the nurse techs. After everything
was set–up, the anesthesiologists and medical doctors entered the room and proceeded with the
procedure. The anesthesiologist and doctors explained to the patient

Atrial Fibrillation Case Studies
Atrial fibrillation (AF) is the most common type of heart dysrhythmia which causes the irregular
beating of the two atria in the heart. The cause of AF is multiple atrial ectopic foci firing randomly
and chaotically. Atria rhythm can be completely disorganized at a rate of 350 to 600 times per
minute by the multiple rapid impulses from numerous atrial foci, so the atria are in a quiver status;
the ventricles beat with a rapid rate due to the rapid atrial impulses (Ignatavicius and Workman,
2013). The ventricular contraction rhythm can be 120 to 200 beats per minute. The ECG result
shows a chaotic rhythm, no P waves, no atrial contractions, no atrial kick and irregular ventricular
contractions. The rapid, irregular ventricular rate decreases ... Show more content on
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Amiodarone is a potent antiarrhythmic agent which inhibits α– and β)–adrenergic neurons, increases
PR and QT intervals, reduces sinus rhythm and peripheral vascular resistance. The rationale for
using amiodarone is to decrease the ventricular rate and improve cardiac output. Heparin is an
anticoagulant which prevents the activation of fibrin and thrombin by inhibiting thrombin III. The
rationale is that anticoagulant agents prevent the formation of emboli that could result in a stroke or
pulmonary embolus. Aspirin is an antiplatelet aggregation agent which is used for prophylaxis of
thromboembolism. TEE is a test to identify the anatomical changes and whether a clot exists in the
heart; it is a pretest for electrical

Atrial Septal Disease
Atrial septal defects (ASDs) are a deficiency in the wall between the right and left atrium of the
heart (5). ASDs account for 10% of all congenital heart defects(19) and 30% of those diagnosed in
adulthood (20). Definitive diagnosis is by transthoracic echocardiography, though signs of an ASD
can be found on physical examination, electrocardiography and chest radiography (21).
There are four types of ASD, classified according to their position in the interatrial septum (Figure
2):
Ostium secundum defects which represent 80% of all ASDs and are located in the region of the
fossa ovalis
Ostium primum defects which are located in the lower portion of the septum, adjacent to the
atrioventricular (AV) valve
Sinus venosus defects which are located at the junction of the superior/inferior caval veins
Coronary sinus defects. While coronary sinuses are not true defects in the atrial ... Show more
Exertional dyspnoea and fatigue are the most common symptoms. These are caused by a left–to–
right shunt, when the connection between the two atria allows blood to pass from the left side of the
heart to the right. This occurs because the pressure in the left side of the heart is naturally higher
than the right. The extra blood from the left atrium overloads the right atrium and the right ventricle,
causing right heart dilation, and subsequent heart failure (5). If left untreated, patients can develop
reversal of the ASD, resulting in a right to left shunt; this is known as Eisenmenger's syndrome.
Other complications include atrial tachyarrhythmias or stroke (21, 22).
A patient is indicated for closure if they experience symptoms, irrespective of age, to reduce
subsequent morbidity and mortality (21). To reduce this risk, closure should be considered in
patients at risk of a paradoxical embolism, such as patients undergoing pacemaker implantation or
professional divers (5,

Atrial Fibrillation Essay
Cardiac dysrhythmias come in different degrees of severity. There are heart conditions that you are
able to live with and manage on a daily basis and those that require immediate attention. Atrial
Fibrillation is one of the more frequently seen types of dysrhythmias (NIH, 2011). The best way to
diagnosis a heart condition is by reading a cardiac strip (Ignatavicius &Workman, 2013). Cardiac
strips play an chief part in the nursing world allowing the nurse and other trained medical
professionals to interpret what the heart is doing. In a normal strip, one can clearly identify a P wave
before every QRS complex, which is then followed by a T wave; in Atrial Fibrillation, the Sinoatrial
node fires irregularly causing there to be no clear P ... Show more content on Helpwriting.net ...
If this were to happen over a long period of time it can lead to an overall decreased cardiac output.
Aside from the decreased cardiac output, a potential for blood clots is now present since there is
pooling in the atria chambers (Ignatavicius & Workman, 2013). Stress, surgery, lung disease, and
hypertension, are just a few concerns that can lead to atrial fibrillation (Cleveland Clinic, 2014)
Atrial Fibrillation is divided into three categories: Paroxysmal, which is where heart beat becomes
irregular all of a sudden and then corrects itself quickly; Persistent, where the irregular heart rate
occurs for more than a week, and either clears up on its own or with treatment; and Permanent,
which is where a normal heart rhythm cannot be reestablished with treatment (Cleveland Clinic,
2014). Symptoms of atrial fibrillation can vary depending on the person, and the severity of the
dysrhythmia. Because decreased cardiac output over a period of time is something to worry about, it
is important to assess the patient for fatigue, weakness, shortness of breath, dizziness, anxiety,
syncope, palpitations, chest pain, and hypotension. Some patients are even asymptomatic
(Ignatavicius & Workman, 2013).
Nursing Management
Atrial Fibrillation is a dysrhythmia that can be treated. First

A Disoriented Patient, Aged 25 Years
A disoriented patient, aged 25 years, suspected with cerebral malaria was admitted to the emergency
department of my medical school. Upon administrating quinine with dextrose, the general
practitioner shifted him to the intensive care unit. Within a short span of time while monitoring the
patient in the ICU, a catastrophic event occurred; he sustained ventricular tachycardia with
hemodynamic instability. Following this, the resident on call proceeded with the cardioversion
immediately. In the meantime, the doctor assigned me to deliver cardiopulmonary resuscitation in
between the events. Fortunately, our efforts to restore him back to sinus rhythm proved effective and
the patient responded. Before the incident, the patient had multiple episodes of vomiting. Vomiting
depleted his potassium levels in the blood and hypokalemia contributed to quinine toxicity which
was the primary cause of this debacle. Being able to bring back patient's life was an exhilarating
moment; collective team effort was the key reason behind this unique feat. From that moment
during the internship, I was never the same person again. I realized if I had to handle the patients
without supervision I would not have been able to revive the patient. I appreciated the fact that there
is much more to learn than the mere 5 years in medical school and good grades. The circumstances
behind the patient's condition further enlightened me to think logically. A good doctor needs to be
alert and updated all the time

Why Is Atrial Fibrillation ( A Fib ) Is The Most Common...
When one begins to discuss issues that arise with an intrinsic organ, things get serious.
Unfortunately, vital organs like the heart and liver that are causing problems can't be removed like
the appendix or the kidney and "cure" people of issues such as Appendicitis or constant dealings
with gallstones. This is true when things begin to go awry within the heart and conditions begin to
arise. Atrial Fibrillation (A–fib) is the most common type of arrhythmia, or issue with the heart rate
or rhythm. Though A–fib is not a condition that is life–threatening, depending on the severity and
lack of treatment, this condition leads to more serious issues like heart disease, and even heart
attacks and strokes, which are usually what end up being the cause of death in individuals diagnosed
with the condition. Because of A–fib leading to other more detrimental problems, such as the ones
listed above, it is difficult to identify and pinpoint if someone has it or had it, which is why it is
known as one of the contributors to the "silent killer," also known as the heart attack. In this paper,
gaining a deeper understanding of Atrial Fibrillation will be accomplished through the exploration
of: causes, diagnosis, symptoms and treatment, the variation of types, what all is affected within the
body as a result, what happens physically, and what occurs at the cellular level when diagnosed with
this disorder. All in all, Atrial Fibrillation should be taken seriously and further research is

An Anonymous Patient 's Medication Essay
This report is an analysis of an anonymous patient's medications and how they relate to his health
issues. Please note that the patient will be referred to as patient Afib in order to protect his privacy.
Patient Afib is a 58 year old male with a recent onset of atrial fibrillation (AF) that has been cured
using ablation and antiarrhythmic medications. This report discusses how physicians treated patient
Afib's AF, the medications patient Afib is currently taking and their mechanism of action, and how
these medications relate to the patient's disease. Medications discussed in this analysis include
Proair HFA, Multaq, Toprol XL, and Coumadin. Proair HFA, a rescue inhaler used to treat asthma,
was prescribed to patient Afib in order to determine if AF or underlying asthma caused his shortness
of breath. Multaq is an antiarrhythmic drug used to keep patient Afib in a normal sinus rhythm.
Toprol XL is a medication used in the treatment of hypertension that also exhibits rate controlling
properties which prove beneficial for patient Afib. Coumadin, an anticoagulant, is used to reduce the
risk of stroke for patient Afib should his AF ever spontaneously return without his knowledge.
Patient Afib does not like the regime of pills he is required to take but understands their necessity.
Patient Overview Patient Afib is a 58 year old, Caucasian, married male. The patient has been
healthy most of his life with no significant health issues until the

Atherosclerosis Coronary Disease Case Studies
PROBLEM LIST 1. Atherosclerosis coronary disease. A. Coronary artery bypass grafting ___
[DATE]. B. Ejection fraction 25% at catheterization ___ [DATE] but 60% at echocardiogram ___
[DATE]. 2. Atrial fibrillation (___) A.Onset after bypass. 3. Hypertension. 4. (Hypolipidemia). 5.
Cerebral vascular accident. A. Carotid ultrasound ___ [DATE], mild bilateral disease. B. MRI ___
[DATE], chronic atrophy. C. Good functional recovery. 6. Current (near syncope) evaluated at ___
[PLACE]. A. Normal electrophysiology study. B. Normal Holter monitor. MEDICATIONS:
(amiodarone) 100 mg daily, lisinopril 2.5 mg daily, simvastatin 20 mg daily, aspirin 1 tablet daily.
ALLERGIES: None. CHIEF COMPLAINT: Routine followup. ... Show more content on
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Postoperatively, he had transient atrial fibrillation but 1 month later atrial fibrillation was again
identified and cardioversion performed. He was felt to be a poor candidate for Coumadin and 2 days
later had a cerebral vascular accident. After transfer to ___ [PLACE], he was found to be in
recurrent atrial fibrillation. Echocardiogram showed ejection fraction of 25% and repeat carotid
ultrasound was normal. He made a good functional recovery. (Amiodarone) was started and he
converted spontaneously to sinus rhythm. He subsequently had a possible (TIA) with no further
deficit. While in ___ [PLACE], he had recurrent syncope, echocardiogram was normal with normal
ejection fraction, Holter monitor was normal, and electrophysiology study by Dr. ___ [NAME] was
normal. Mr. ___ [NAME] has been doing well will mild dyspnea on insertion. He walks 1 and 1/2
miles without limitations. He has not had chest discomfort, palpitations, near syncope, or

Descriptive Essay On A Stopping Event
A Heart Stopping Event
For more than two minutes, my older brother lay completely dead on the hot, worn out concrete of
Chowan College and I couldn't do anything to help. He was only sixteen years old and this tragic
event happened to him. Though this brought my family closer together, as well as closer to God, I
still think about that day all of the time. I tell myself to enjoy the little things in life, because you
never know when you may lose it.
The day started out great. I went to the Ahoskie Heritage Day Festival in the morning to sell shirts
for my community service hours. When I returned home, I quickly jumped into the shower, leaving
my telephone in the next room over. While in the shower, I missed a call from my mother. I called
her back, and I was stunned to learn that my brother, Dakota, was in the emergency room. He had
passed out and required CPR as well as cardioversion. (being shocked)
After the telephone call, my father and I instantly headed for the hospital where my brother was.
Some of our family were already there in the waiting room, yet my father and I didn't pay any
attention to them. We strolled straight through to Dakota's room. It didn't really sink in what had
happened to my brother until I saw him lying in the hospital bed. That is the point at which I lost it,
and began crying into his shoulder. I took notice that my strong father who never cries teared up a
bit too.
The event was horrific in our eyes, yet it still wasn't over. After things

Perioperative Elderly Management
Perioperative Management of the Elderly Patient with a Fractured Hip The perioperative
management of an elderly patient has received increased scrutiny as they undergo a variety of
surgeries. Geriatric patients respond to anesthesia and stress of surgery to a lesser extent when
compared to the younger patients that cause an increase in morbidity and mortality in the elderly
patients (Singh and Antogini, 2010). It is challenging to provide continuous, consistent quality care
with associated complex needs to elderly patients, but can be achieved by performing a thorough
preoperative assessment and developing a personalized plan of care. Anesthesia providers play a
vital role in the better outcome for elderly patients by understanding the profound

Research Paper On Atrial Fibrillation

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