Changing Patient Position Can Eliminate Arrhythmias Developing During Extracorporeal Shockwave Lithotripsy
Bibliographic record
Abstract
INTRODUCTION: Extracorporeal shockwave lithotripsy (SWL) has a low complication rate. While serious complications are rare, cardiac arrhythmias, such as ventricular tachycardia, may occur. The etiology of these arrhythmias is poorly understood, but it appears to be due to stimulation of the heart by the shock waves. OBJECTIVE: This study examines the effect of rotating the patient 15° to 20° when an arrhythmia occurs. METHODS: Eight hundred nineteen patients were prospectively evaluated for arrhythmias during SWL. The initial patient position was dependent on the location of the stone and the body mass index (BMI) of the patient. If a sustained arrhythmia developed, treatment was withheld for 2 minutes and then recommenced. If the patient developed an arrhythmia again, the patient was rotated 15°-20° away from the original position and treatment recommenced. RESULTS: Twenty patients developed significant arrhythmias during SWL. Arrhythmias occurred more frequently in patients with a lower BMI (p < 0.01), of younger age (p = 0.01), and with right-sided stones (p = 0.035). After the first rotation, 11 patients had no further arrhythmias, and 4 patients had a reduction of their arrhythmia to unsustained minor arrhythmias that did not require cessation of the treatment. The remaining five patients required a second repositioning. Three of these patients required gated SWL to abolish the arrhythmia. CONCLUSION: Changing the position of the patient by rotating the patient by 15 to 20° can eliminate arrhythmias that develop during SWL.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".