Scenario: After surviving a sudden cardiac arrest at home, a 68-year-old man was admitted to the cardiac intensive care unit (ICU). Pertinent history includes hypertension, atrial fibrillation (AF), and nonischemic heart failure with a functional ejection fraction of 35%. The patient was intubated in the field, and mechanical ventilation was started upon his hospital arrival. The initial level of high-sensitivity troponin T was 0.31 ng/L (normal <14 ng/L). It was decided to stabilize him before taking him to the cardiac catheterization laboratory to assess coronary perfusion to rule out myocardial ischemia as a cause of the cardiac arrest. The nurses noted that the patient had frequent premature ventricular contractions (PVCs) during monitoring. Shown below are 2 separate rhythm strips in leads II and V1 with an accompanying arterial blood pressure waveform. Panel A was recorded approximately 3 minutes before panel B. Panel B was recorded 15 hours after...
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1 March 2024
ECG Puzzler|
March 01 2024
The Refractory Period in Cardiac Physiology
Mary G. Carey, PhD, RN;
Mary G. Carey, PhD, RN
Mary G. Carey is director of clinical nursing research, Strong Memorial Hospital at University of Rochester Medical Center, Rochester, New York.
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Michele M. Pelter, PhD, RN
Michele M. Pelter, PhD, RN
Michele M. Pelter is an associate professor in the Department of Physiological Nursing at University of California, San Francisco.
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Am J Crit Care (2024) 33 (2): 155–156.
Citation
Mary G. Carey, Michele M. Pelter; The Refractory Period in Cardiac Physiology. Am J Crit Care 1 March 2024; 33 (2): 155–156. doi: https://doi.org/10.4037/ajcc2024689
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