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Obszański B, Tułecki Ł, Kutarski A, Kleinrok A. Lightning-induced pacing system malfunction: a case report. EUROPEAN HEART JOURNAL-CASE REPORTS 2019; 3:5519815. [PMID: 31449643 PMCID: PMC6601167 DOI: 10.1093/ehjcr/ytz092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 12/04/2018] [Accepted: 05/27/2019] [Indexed: 11/14/2022]
Abstract
BACKGROUND Atmospheric electrical discharge is an extremely powerful natural phenomenon which can have dangerous and lethal effects on the human body. However, there is no evidence to indicate whether and, if so, to what extent the electric current travelling through the body can affect proper pacemaker function. CASE SUMMARY An 80-year-old patient admitted to emergency department after being struck by a lightning bolt while riding a bike. The patient had a DDD pacemaker implanted 4 years prior to the incident. The ECG on admission depicted pacemaker spikes and native sinus rhythm at 50-60 b.p.m. On the 3rd day after admission the patient developed recurrent pacing-induced tachycardia. Pacemaker interrogation showed high pacing thresholds (failure to pace in the atrial channel). When the patient's condition stabilized she was transferred to the tertiary hospital for transcutaneous lead extraction. The extracted pacing system was sent to Biotronik for thorough evaluation. DISCUSSION Injuries due to a lightning strike are considered a rare occurrence but being struck by lightning with a pacemaker or an ICD is even less common. In the present case, the cause of cardiac arrhythmia was most probably electrical burn at the endocardial-electrode interface and a sudden elevation of the pacing threshold leading to transient pacing failure in both PM channels. To the best of our knowledge, in this case presentation we first described permanent lightning-induced pacemaker dysfunction.
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Affiliation(s)
- Bogdan Obszański
- Department of Cardiology, The Pope John Paul II Province Hospital of Zamosc, Al. Jana Pawla II nr 10, Zamosc, Poland
| | - Łukasz Tułecki
- Department of Cardiac Surgery, The Pope John Paul II Province Hospital of Zamosc, Al. Jana Pawla II nr 10, Zamosc, Poland
| | - Andrzej Kutarski
- Department of Cardiology, Medical University of Lublin, Aleje Racławickie 1, Lublin, Poland
| | - Andrzej Kleinrok
- Medical Department, The University of Information Technology and Management, Sucharskiego 2, Rzeszów, Poland
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Eyerly-Webb SA, Solomon R, Lee SK, Sanchez R, Carrillo EH, Davare DL, Kiffin C, Rosenthal A. Lightning Burns and Electrical Trauma in a Couple Simultaneously Struck by Lightning. Clin Pract Cases Emerg Med 2018; 1:246-250. [PMID: 29849308 PMCID: PMC5965181 DOI: 10.5811/cpcem.2017.4.33706] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 04/13/2017] [Accepted: 04/19/2017] [Indexed: 11/11/2022] Open
Abstract
More people are struck and killed by lightning each year in Florida than any other state in the United States. This report discusses a couple that was simultaneously struck by lightning while walking arm-in-arm. Both patients presented with characteristic lightning burns and were admitted for hemodynamic monitoring, serum labs, and observation and were subsequently discharged home. Despite the superficial appearance of lightning burns, serious internal electrical injuries are common. Therefore, lightning strike victims should be admitted and evaluated for cardiac arrhythmias, renal injury, and neurological sequelae.
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Affiliation(s)
| | - Rachele Solomon
- Memorial Regional Hospital, Division of Acute Care Surgery and Trauma, Hollywood, Florida
| | - Seong K Lee
- Memorial Regional Hospital, Division of Acute Care Surgery and Trauma, Hollywood, Florida
| | - Rafael Sanchez
- Memorial Regional Hospital, Division of Acute Care Surgery and Trauma, Hollywood, Florida
| | - Eddy H Carrillo
- Memorial Regional Hospital, Division of Acute Care Surgery and Trauma, Hollywood, Florida
| | - Dafney L Davare
- Memorial Regional Hospital, Division of Acute Care Surgery and Trauma, Hollywood, Florida
| | - Chauniqua Kiffin
- Memorial Regional Hospital, Division of Acute Care Surgery and Trauma, Hollywood, Florida
| | - Andrew Rosenthal
- Memorial Regional Hospital, Division of Acute Care Surgery and Trauma, Hollywood, Florida
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Kruja J, Kuqo A, Grabova S, Rroji A, Vyshka G. Right Hemispheric Leukoencephalopathy as an Incidental Finding Following a Lightning Strike. Open Access Maced J Med Sci 2016; 4:692-694. [PMID: 28028416 PMCID: PMC5175524 DOI: 10.3889/oamjms.2016.141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 11/25/2016] [Accepted: 11/30/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Lightning injuries may produce a variety of medical conditions, and specific neurological complications have been identified, with the character of immediate aftershock effects or even long-term consequences. AIM The authors describe the incidental finding following a routine unenhanced brain MRI performed to a young female patient, suffering from a headache. CASE REPORT Diffuse white matter changes with the character of a leukoencephalopathy were seen, which strictly interested only the right cerebral hemisphere. The parents referred that she suffered from an indoor lightning strike at age of seven months, although she survived with almost no external burns or signs, and recovered uneventfully at that time. A discussion over the effects of electrocution and lightning strike on the human body in general, and over the nervous system, is made. Particular attention must be shown when making the differential diagnosis of leukoencephalopathies with a strictly one-hemisphere extension since several other conditions might resemble each other under the radiological aspect, here including brain viral infections, genetic disorders, and so on. CONCLUSION The particularity of the long-term aftershock effects of the lightning strike on the central nervous system raise again the necessity of collecting data and duly reporting every electrical accident, lightning events included.
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Affiliation(s)
- Jera Kruja
- Department of Neurology, Neurosurgery and Psychiatry, Faculty of Medicine, University of Medicine in Tirana, Tirana, Albania
| | - Altin Kuqo
- Department of Neurology, Neurosurgery and Psychiatry, Faculty of Medicine, University of Medicine in Tirana, Tirana, Albania
| | - Serla Grabova
- Department of Neurology, Neurosurgery and Psychiatry, Faculty of Medicine, University of Medicine in Tirana, Tirana, Albania
| | - Arben Rroji
- Department of Radiology, University Hospital Centre “Mother Theresa”, Tirana, Albania
| | - Gentian Vyshka
- Biomedical and Experimental Department, Faculty of Medicine, University of Medicine in Tirana, Tirana, Albania
- Correspondence: Gentian Vyshka. Biomedical and Experimental Department, Faculty of Medicine, University of Medicine in Tirana, Tirana, Albania. E-mail:
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Davis C, Engeln A, Johnson EL, McIntosh SE, Zafren K, Islas AA, McStay C, Smith WR, Cushing T. Wilderness Medical Society practice guidelines for the prevention and treatment of lightning injuries: 2014 update. Wilderness Environ Med 2015; 25:S86-95. [PMID: 25498265 DOI: 10.1016/j.wem.2014.08.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 08/24/2014] [Accepted: 08/26/2014] [Indexed: 11/26/2022]
Abstract
To provide guidance to clinicians about best practices, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for the treatment and prevention of lightning injuries. These guidelines include a review of the epidemiology of lightning and recommendations for the prevention of lightning strikes, along with treatment recommendations organized by organ system. Recommendations are graded on the basis of the quality of supporting evidence according to criteria put forth by the American College of Chest Physicians. This is an updated version of the original WMS Practice Guidelines for Prevention and Treatment of Lightning Injuries published in Wilderness & Environmental Medicine 2012;23(3):260-269.
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Affiliation(s)
- Chris Davis
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO (Drs Davis, McStay, and Cushing).
| | - Anna Engeln
- Department of Emergency Medicine, Denver Health Medical Center/University of Colorado School of Medicine, Denver, Colorado (Dr Engeln)
| | - Eric L Johnson
- Department of Wound Healing and Hyperbaric Medicine, St. Alphonsus Hospital, Boise, ID, and Emergency Services, Teton Valley Hospital, Driggs, ID (Dr Johnson)
| | - Scott E McIntosh
- Division of Emergency Medicine, University of Utah School of Medicine, Salt Lake City, UT (Dr McIntosh)
| | - Ken Zafren
- Division of Emergency Medicine, Stanford University Medical Center, Palo Alto, CA, the Department of Emergency Medicine, Alaska Native Medical Center, Anchorage, AK, and the International Commission for Mountain Emergency Medicine (Dr Zafren)
| | - Arthur A Islas
- Department of Family & Community Medicine, Paul L. Foster School of Medicine (Dr Islas)
| | - Christopher McStay
- Department of Emergency Medicine, University of Washington School of Medicine, Seattle, WA
| | - William R Smith
- Department of Emergency Medicine, St. John's Medical Center, Jackson, WY (Dr Smith)
| | - Tracy Cushing
- Department of Emergency Medicine, Denver Health Medical Center/University of Colorado School of Medicine, Denver, Colorado (Dr Engeln)
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Davis C, Engeln A, Johnson E, McIntosh SE, Zafren K, Islas AA, McStay C, Smith W‘WR, Cushing T. Wilderness Medical Society Practice Guidelines for the Prevention and Treatment of Lightning Injuries. Wilderness Environ Med 2012; 23:260-9. [DOI: 10.1016/j.wem.2012.05.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Revised: 05/09/2012] [Accepted: 05/21/2012] [Indexed: 11/24/2022]
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Abstract
The desire to modify a person's outer appearance is a phenomenon that can be traced back to the beginning of humankind. Body modifications have been practiced among all cultures around the globe to differing extents. The authors present medical complications through jewelry in a series of 35 consecutive patients. Patient charts were evaluated for age, gender, type and sequelae of injury, complications, and treatment results. The male-to-female ratio was 1:2.2. Most of the recorded complications were related to the new vogue of piercing, with the ear affected most commonly. Usually the complications were minor; however, 2 patients sustained disfiguring damage to their auricular cartilage as a result of high ear piercing, a child nearly asphyxiated on an aspirated earring, and 2 patients experienced severe dysphagia as a result of tongue piercing. The most severe complication was a lethal strangulation injury in a female patient whose necklace got trapped in the headrest of her car seat during a front-end collision.
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Affiliation(s)
- Benedikt J Folz
- Department of Otolaryngology, Head and Neck Surgery, Philipps-University Marburg, Deutschhausstrasse 3, D-35037 Marburg, Germany
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Affiliation(s)
- L Conrad
- Department of Emergency Medicine, St. Joseph Hospital/Kaiser Permanente, Denver, CO, USA
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Celiköz B, Işik S, Türegün M, Selmanpakoğlu N. An unusual case of lightning strike: full-thickness burns of the cranial bones. Burns 1996; 22:417-9. [PMID: 8840045 DOI: 10.1016/0305-4179(95)00155-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
An unusual full-thickness burn of the scalp and cranial bones due to a lightning strike is reported. A thick nylon cover protected the head from the direct effects of the lightning injury, but heated water over the thick nylon cover caused full-thickness burn of the scalp and cranial bones. The relevant literature has been reviewed.
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Affiliation(s)
- B Celiköz
- Department of Plastic and Reconstructive Surgery, Gülhane Military Medical Academy and Medical School, Ankara, Turkey
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