Struck by Lightning

Leiria, Tiago Luiz Luz; Pires, Leonardo Martins; Kruse, Marcelo Lapa; Lima, Gustavo Glotz de

doi:10.1161/circep.112.000150

Cited by 6 publications

(3 citation statements)

References 3 publications

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“…19 Less sinister arrhythmias such as atrial fibrillation have also been reported, which can readily cardiovert to sinus rhythm in the ensuing days, especially with beta-blocker therapy. [20][21][22] Other important ECG changes which have not been linked with any arrhythmias include QT prolongation, likely due to repolarisation abnormalities. Several mechanisms can be attributed to this, including alterations in intracellular calcium metabolism.…”

Section: Cardiac Effects Of Lightning Strikesmentioning

confidence: 99%

Cardiac Effects of Lightning Strikes

Christophides

Khan

Ahmad

et al. 2017

Arrhythmia &Amp; Electrophysiology Review

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Lightning strikes are a common and leading cause of morbidity and mortality. Multiple organ systems can be involved, though the effects of the electrical current on the cardiovascular system are one of the main modes leading to cardiorespiratory arrest in these patients.Cardiac effects of lightning strikes can be transient or persistent, and include benign or life-threatening arrhythmias, inappropriate therapies from cardiac implantable electronic devices, cardiac ischaemia, myocardial contusion, pericardial disease, aortic injury, as well as cardiomyopathy with associated ventricular failure. Prolonged resuscitation can lead to favourable outcomes especially in young and previously healthy victims.

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Section: Cardiac Effects Of Lightning Strikesmentioning

confidence: 99%

Cardiac Effects of Lightning Strikes

Christophides

Khan

Ahmad

et al. 2017

Arrhythmia &Amp; Electrophysiology Review

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show abstract

“…40 Leiria and colleagues provide an unusual case illustrating the dangerously rapid ventricular response that can occur during atrial fibrillation in the presence of a rapidly conducting accessory pathway. 41 Although accessory pathways are most commonly encountered in patients without other forms of heart disease, they are associated with a number of genetic disorders, which are important to consider, as reviewed by Koneru and colleagues. 42 Atrial tachycardia originating from the junction of the right atrium and a diverticulum of the inferior vena cava.…”

Section: Editors' Perspective: Difficult Accessory Pathways and Ventrmentioning

confidence: 99%

Fundamental Concepts in Electrophysiology in Cases and Reviews

Stevenson

Asirvatham²

2013

Circ: Arrhythmia and Electrophysiology

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A ssimilating the increasing body of knowledge required for the treatment of patients with cardiac arrhythmias is a substantial task. The trainee is bombarded with chapters and reviews that are important for providing the frame work from which to develop a detailed and nuanced knowledge acquired from clinical experience and ongoing education. Images and Case Reports provide succinct observations of not only a novel or unusual finding, but often of the fundamentals that must be appreciated to place novel findings in context. The Teaching Points series in Circulation Arrhythmia and Electrophysiology provides a more indepth synthesis of case-based learning building on common and uncommon clinical findings. The purpose of this Casebased Curriculum in Clinical Electrophysiology is to provide the clinician and trainee with an easily accessible body of current reviews, cases and Teaching Points that cover a broad range of the field. Links to the individual articles are provided to facilitate using this article as a spring board for review. Fundamentals of Electrophysiology, Mapping, Ablation, and ElectrocardiographyEmergence of complex behavior: An interactive model of cardiac excitation provides a powerful tool for understanding electric propagation. Spector PS, et al. 1 To facilitate an understanding of the relations between electrophysiologic properties and geometry that govern conduction, block and reentry, Spector and colleagues have developed an interactive model that allows the student to study the effects of varying parameters on conduction, block, reentry and even entrainment (http://circep.ahajournals.org/cgi/content/full/CIRCEP.110.961524/DC1). Munoz F, et al. 4 Teaching points with 3-dimensional mapping of cardiac arrhythmia: Mechanism of arrhythmia and accounting for the cycle length. Del Carpio Munoz F, et al. 5 Accurate activation sequence mapping of cardiac arrhythmias is a fundamental skill in cardiac electrophysiology. For complex arrhythmias an electroanatomic mapping system, which allows the mapping data to be displayed on a representation of the anatomy is often employed, as discussed in a series of articles Del Carpio Munoz and colleagues. [3][4][5][6] Accurate mapping requires selecting an appropriate reference point and mapping window and identification of the electrogram that indicates local activation. In applying a mapping strategy it is important to recognize features of macroreentrant, as compared to focal arrhythmias, and to recognize that seemingly small errors in assigning activation times, reference electrograms, or mapping windows, can render a map uninterpretable or meaningless. These issues are discussed in detail. Munoz F, et al. 6 Endocardial unipolar voltage mapping to detect epicardial ventricular tachycardia substrate in patients with nonischemic left ventricular cardiomyopathy. Hutchinson MD, et al. 7 Substrate mapping is a term that refers to localization of the likely arrhythmia substrate, during sinus or paced rhythm rather than during VT, and is of...

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“…However, commonly it is seen in association with ischaemic or structural heart disease [4]. Only a handful of electrocution induced new onset AF incidents have been reported [2,5-9], including AF precipitated by a lightning strike [10,11] and a case of a marine diver being electrocuted by a torpedo(electric) ray [12]. The mechanism leading to injury can be explained by the pathway taken by the transient circuit created when electrocution takes place, as it determines the tissue at risk.…”

Section: Introductionmentioning

confidence: 99%

A case of paroxysmal atrial fibrillation following low voltage electrocution

2013

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BackgroundElectrical injury may result in arrhythmias, however atrial fibrillation following low voltage electrocution is not a common occurrence.Case presentationA 70-year-old South-Asian woman with no prior history of cardiovascular disease presented following an accidental low voltage electrocution with loss of consciousness. On initial assessment she was found to be in atrial fibrillation with a moderate to rapid ventricular rate. Troponin I and 2D echo were normal. Transient rise in markers of muscle damage were noted. The arrhythmia resolved spontaneously without active intervention.ConclusionLoss of consciousness and the path of electrical conduction involving the heart may herald cardiac involvement following electrocution. Low voltage electrocution may cause cardiac insult. Conservative management may suffice in management of atrial fibrillation without cardiovascular compromise.

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Struck by Lightning

Cited by 6 publications

References 3 publications

Cardiac Effects of Lightning Strikes

Cardiac Effects of Lightning Strikes

Fundamental Concepts in Electrophysiology in Cases and Reviews

A case of paroxysmal atrial fibrillation following low voltage electrocution

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