When an implantable cardioverter defibrillator can kill your patient!

Abstract Inappropriate therapy due to noise oversensing caused a true ventricular fibrillation (VF) and a life-threatening event in a patient. A 19-year-old patient with surgically corrected congenital heart disease and systolic dysfunction had an implantable cardioverter defibrillator implanted for primary prevention in 2013. This patient was admitted at the Emergency Department in June 2018 after receiving eight shocks from the device on the same day, with a prolonged syncope after the third shock. Another noise-induced VF detection occurred, and two inappropriate shocks followed sequentially, causing true VF. Four appropriate shocks were subsequently needed until sinus rhythm was finally restored.

Suporte social dos hipertensos de uma comunidade em Gaspar-SC

Objetivos: Traçar um perfil dos pacientes hipertensosatendidos por uma Unidade Básica de Saúde de Gaspar,SC; com ênfase nos fatores de risco cardiovascular esuporte social.Métodos: Participantes foram selecionados usandoseo cadastro do Programa HIPERDIA da Unidade deSaúde. Foi aplicado, em domicílio, questionáriodemográfico e de fatores de risco cardiovascular, estilode vida, estresse e suporte social. Foi medida acircunferência abdominal na mesma ocasião.Resultados: Foi encontrada elevada prevalência defatores de risco cardiovascular, tais como diabetesmelitus (20,3%) e circunferência abdominal aumentada(69,6%). Avaliando o suporte social, as principaisdiferenças ocorreram entre brancos e não-brancos(83,77 vs 77,54, p=0,06) e entre casados e não-casados(85,36 vs 77,1, p=0,04). Aqueles com maior rede socialobtiveram melhores escores de suporte social quandocomparados com indivíduos com menor rede social(p=0,01).Conclusão: Uma maior ênfase na educação sobresaúde preventiva pode ser benéfica. Os programaseducacionais que existem se mostram inefetivos,portanto, pode-se pensar em uma mudança de estratégia.O suporte social encontrado foi bom, mas falta asensação de união na comunidade, o que talvez expliqueem parte um suporte tão baixo entre os não-casados.

Objective: describe the profile of the hypertensivepatients assisted by a Basic Health Unit of Gaspar, SC;emphasizing cardiovascular risk factors and socialsupport.Methods: participants were selected by using theHIPERDIA Program (a program for the control ofHypertension by the Brazilian Ministry of Health) of theHealth Unit. The interviews were done at theparticipants? residences, an inventory concerningdemographic information, cardiovascular risk factors, lifestyle, stress and social support was applied. The waistcircumference was measured at the same occasion.Results: a high prevalence of cardiovascular riskfactors was found, such as diabetes mellitus (20. 3%),high abdominal circumference (69.6%). Approaching thesocial support, the main differences occurred betweenwhite and non-white subjects (83.77 vs 77.54; p=0.06)and between married and unmarried people (85.36 vs77,1; p=0,04). Those with greater social network hadbetter scores of social support in comparison with subjectswith lower social network (p=0. 01).Conclusion: a greater emphasis on the lifestylechange among hypertensive patients in this communitycould be benefical. The education programs that existhave a low attendance by the population, and that leadus to think about changing educational strategies. Also,we have an impression that the community doesn?t havea sense of unity, which may help explain the lack ofsupport among unmarried people.