Ventricular Fibrillation

Report:

Sinus tachycardia 118/min

VEB

Ventricular fibrillation

DC cardioversion artefact (middle of third strip)

CPR artefact

Junctional rhythm

Sinus rhythm and tachycardia, VEB & SVEBs (bottom strip)

Marked ST segment elevation post-cardioversion

Comment:

The disturbing aspect of the recording is complete absence of any CPR movement artefact during the VF. The same thing happened during the next episode (below, Fig 195a). The saying “Things happen in a big hospital” includes, of course, things that don’t happen as well.

The degree of ST segment elevation made the staff think that the VF was a marker of another acute infarction, but the elevation resolved, each time, within minutes. It was, in this case, a marker of severe ischæmia, more specific but apparently less lethal (as a substrate for VF), than the antecedent ST/T changes.

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