title: Extracorporeal CPR and intra-aortic balloon pumping in tachycardia-induced cardiomyopathy complicating cardiac arrest.
abstract: Although tachycardia-induced cardiomyopathy (TIC) due to atrial fibrillation occurs frequently, it is under-recognized in clinical settings. TIC has a wide range of clinical manifestations, from asymptomatic tachycardia to cardiomyopathy leading to end stage heart failure. We present a case of a 48year-old-woman who presented as cardiogenic shock, and rapidly progressed to cardiac arrest from recently diagnosed but undertreated atrial fibrillation, resulting TIC in the emergency department (ED). She was rescued by extracorporeal cardiopulmonary resuscitation (E-CPR) for refractory cardiac arrest in the ED, and received concomitant intra-aortic balloon counterpulsation (IABP) support for severe left ventricular failure. Cardiogenic shock can present as an initial manifestation of TIC, and E-CPR and subsequent IABP support can be a valuable rescue therapy for severe TIC.
authors.affiliation: Emergency ICU, Regional Emergency Center, Chungnam National University Hospital, Daejeon, South Korea. Electronic address: u2leecs@cnuh.co.kr.
authors.forename: Jun Wan
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Surgical ICU, Chungnam National University Hospital, Daejeon, South Korea.
authors.forename: Hong Joon
authors.initials: HJ
authors.lastname: Ahn
authors.affiliation: Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, South Korea.
authors.forename: Youn Ho
authors.initials: YH
authors.lastname: Yoo
authors.affiliation: Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, South Korea.
authors.forename: Jin Woong
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, South Korea.
authors.forename: Seung Whan
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Cardiology, Chungnam National University Hospital, Daejeon, South Korea.
authors.forename: Si Wan
authors.initials: SW
authors.lastname: Choi
mesh_terms: D001281:Atrial Fibrillation / Q000150:complications / Q000503:physiopathology*; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004636:Emergency Service, Hospital; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006323:Heart Arrest / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000379:methods*; D008875:Middle Aged; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome
keywords: Atrial fibrillation; Cardiomyopathies; Cardiopulmonary resuscitation; Extracorporeal membrane oxygenation; Heart arrest