DC cardioversion. Late onset of ventricular fibrillation and its control with temporary endocardial pacing.
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Biomedical subjects
Publications and source records attributed to G Cherian.
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A 70-year-old woman presented with unstable angina following a myocardial infarction. At cardiac catheterisation she had inferoapical dyskinesia, blocked right and circumflex arteries and an 80% stenosis of the left anterior descending artery. When free of angina, the ECG showed a Wolff-Parkinson-White (WPW) pattern consistent with a posterior free wall accessory pathway. However, during some episodes of angina at rest, she reverted to normal conduction and back again to the WPW pattern after the angina subsided with sublingual nitrate. The disappearance of the WPW pattern during angina can be explained by transient ischaemia blocking conduction in the accessory pathway.
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This study demonstrates that total surgical correction in tetralogy of Fallot is a gratifying procedure even with advancing age especially when one reckons that a great majority of these patients showed pronounced disability at the time of surgery without the benefit of previous palliative procedures. However, there are technical difficulties in accomplishing repair in the fibrotic hearts of older patents. The early mortality and long term benefits in this age group closely parallel those in our over all experience with surgery for this anomaly. There was a 12.5% early and 10% late mortality in this series. Surviving patients have been followed up for a period ranging from 1 to 10 years (mean 18 months) and are found to be leading normal active lives.
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