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Warning: A bradycardiac response is associated with rheolytic thrombectomy, and backup transvenous pacing should be available.
"Whenever we used the device, we put in a pacemaker prophylactically during the case," says Gina Marone, RN, BSN, clinical study coordinator on the AngioJet Rheolytic Thrombectomy System (Possis Medical, Minneapolis) at Allegheny University Hospitals Hahnemann in Philadelphia. "The pacemaker would kick in when the patient’s heart rate went down — in case patients brady-downed." A couple of our study patients went into asystole, but recovered right after Marone and McCormick shut off the device. Marone says that when you do any type of similar intervention, you expect that response.
"We did notice it was associated with the AngioJet, however," she says.
(For more information on bradycardiac response, see paper published by Ochsnes Medical Institu-tions, New Orleans, "Bradyarrhythmias during rheolytic thrombectomy" at www.ochsner.org/ cardiology/pdf/laacc/1996/rt.pdf.)