[Successful termination of ventricular fibrillation using the precordial thump]

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Electrophysiology

Background:

• Coronary artery restenosis following bare metal stent implantation is a known complication.
• Interventional procedures for restenosis carry inherent risks, including cardiac arrhythmias.
• Ventricular fibrillation (VF) is a life-threatening arrhythmia requiring immediate intervention.

Observation:

• During a drug-eluting stent implantation for right coronary artery restenosis, the patient developed ventricular fibrillation (VF) upon stent retrieval.
• The medical team prepared for defibrillation.
• A precordial thump was administered by the operating physician.

Findings:

• The precordial thump immediately terminated the ventricular fibrillation (VF).
• The arrhythmia converted to atrial fibrillation.
• The patient regained consciousness without requiring an electrical DC shock.

Implications:

• The precordial thump can be an effective emergent treatment for specific intraprocedural arrhythmias like VF.
• This technique offers a non-invasive alternative to electrical defibrillation in select critical situations.
• Highlights the importance of immediate, decisive action and knowledge of alternative resuscitation techniques in interventional cardiology.