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Doctor Q&A for Dr. Sergio Cossu

A 56-year-old female asked:
Dr. Sergio Cossu
Cardiology 33 years experience
For refractory VT: Vt is a reentrant rhythm occurringusually in the region of previous scar tissue in the left ventricle (previous infarct). The primary therapy for patients with cardiomyopathy is implantation of an icd. Patients who have recurrent therapy from thier icd and unresponsive to antiarrhythmic drugs then ablation is considered. There are VT ablations performed in patients with normal hearts as well.
A 30-year-old member asked:
Dr. Sergio Cossu
Cardiology 33 years experience
Sudden cardiac death: Icd's are utilized in patients who are at risk for sudden cardiac death or ventricular arrhythmias. These can be patients who already have significant structural heart disease or may have already suffered a sudden death episode. Also they are utilized in patient's who have certain familial conditions which may predispose them to sudden death.
A 31-year-old member asked:
Dr. Sergio Cossu
Cardiology 33 years experience
Only if slow: A pacemaker will revive you from a dangerously slow heart rhythm. Most fatal arrhythmias however are due to ventricular arrhythmias that lead to cardiac arrest. These are very fast rhythms in which a pacemaker won't do anything for but an implantable defibrillator would help.
A 41-year-old member asked:
Dr. Sergio Cossu
Cardiology 33 years experience
No: A pacemaker will only keep the heart rate at above a certain level if your intrinsic heart rate drops to that level. A defibrillator will shock the heart similar to an external shock from a paramedic or er doc in a situation of cardiac arrest or sudden cardiac death. This is most lilely the situation you are referring to.
A 41-year-old member asked:
Dr. Sergio Cossu
Cardiology 33 years experience
None really: Pacemakers are pretty much standard these days. Present day pacemakers provide synchrony between the top and bottom chambers of the heart and some also between both chambers. Pacemakers in the past were stuck at a certain rate clearly making it less than physiological. Current devices will increase the rate of pacing based on the amount of activity you are doing utilizing sensors.
A 28-year-old female asked:
Dr. Sergio Cossu
Cardiology 33 years experience
Try changing Rx: In young patients who are very active and require beta blockers for control of their arrhythmias sometimes i utilize pindolol. This beta blocker has "intrinsic sympathomimetic activity" and as such won't drop the blood pressure as much but will also not make as you tired as well as being able to suppress your arrhythmias.
A 36-year-old member asked:
Dr. Sergio Cossu
Cardiology 33 years experience
Never: Digitalis is used to control the ventricular rates of some abnormal fast atrial arrhythmias or svt. In atrial fibrillation it is utilized to control the fast rate. It does not "cure" the problem nor does it actually prevent the atrial arrhythmias, as antiarrhythmic medications would.
A 22-year-old female asked:
Dr. Sergio Cossu
Cardiology 33 years experience
Tachycardia: The causes of a fast heart rhtyhm needs to be evaluated first, some may be due to abnormal circuits in the heart or may actually be due to normal variants ie inappropriate sinus tachycardia. Maintaining an elevated heart rate for a prolonged periodof time can put you at risk for a tachycardia induced cardiomyopathy and congestive heart failure. You must seek evluation for this.
A 31-year-old member asked:
Dr. Sergio Cossu
Cardiology 33 years experience
Many causes: The causes of heart fluttering (pslpitations) are many. They may be caused from abnormal rhythms in the heart or may be even normal variants. Sometimes they may be due to atrial or ventricular premature beats (extra beats) which are usually benign. Work up with a holter or event monitor may be helpful.
A 34-year-old female asked:
Dr. Sergio Cossu
Cardiology 33 years experience
Kidney function : During a catheterization dye will be administered which may affect the kidneys. Giver previous history they should be cautious about these potential effects and safeguard against them. Renal failure is a potential complication.
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