Circulation. 1998;97:1429-1430
(Circulation. 1998;97:1429-1430.)
© 1998 American Heart Association, Inc.
Defibrillation Aboard a Commercial Aircraft
Richard L. Page, MD;
Mohamed H. Hamdan, MD;
; David K. McKenas, MD, MPH
From the Department of Medicine (Cardiology and Clinical Cardiac
Electrophysiology) (R.L.P., M.H.H.), The University of Texas Southwestern
Medical Center at Dallas, and American Airlines (D.K.M.). Dr Page, through UT
Southwestern, is a consultant to American Airlines. Dr McKenas is Director,
Corporate Medical Department, American Airlines.
Correspondence to Richard L. Page, MD, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75235-9047.
A 53-year-old
executive (6 ft 3 in tall; 327 lb) with a history of diabetes mellitus,
hypertension, and coronary artery disease (coronary
artery angioplasty in 1995) was traveling with his wife on vacation and
ran to catch a connecting flight. The plane had closed the doors for
takeoff when his wife noted that he was unresponsive. A flight
attendant brought out the on-board automatic external defibrillator
(AED; "ForeRunner," Heartstream) and was assisted by a passenger
with paramedic training. The device was applied and successfully
defibrillated the patient with a single 130-J biphasic shock (see
Figure
). The patient regained pulse and blood pressure and was never
intubated. His first blood pressure measurement was 150/92 mm Hg.
He was transferred to a nearby hospital, where myocardial infarction
was ruled out by serial creatine phosphokinase and troponin I
measurements. He underwent cardiac catheterization
(which revealed severe 3-vessel disease with preserved left
ventricular function) and coronary artery bypass
graft surgery. An implantable cardioverter-defibrillator was implanted
because of concern that poor distal vessels had made the
revascularization incomplete. He was discharged
from the hospital 11 days after the cardiac arrest.
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Figure 1. Playback of electrogram and device activity as recorded
on PC memory card from automated external defibrillator. Electrogram is
recorded between shocking patches (at upper right anterior and left
lateral chest). A, Ventricular fibrillation is recognized
and converted with a single shock after 12 seconds. Resulting rhythm is
sinus bradycardia at 51 bpm with 2:1 conduction (arrows point to p
waves). Note device . . . [Full Text of this Article] |
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