Rapid ventricular pacing

Rapid ventricular pacing (RVP) is a procedure that temporarily lowers blood pressure by increasing heart rate and reducing ventricular filling time. RVP has been widely used to reduce blood vessel tension in many cardiovascular surgeries.

Rapid ventricular pacing (RVP) has recently been reintroduced into cerebrovascular surgery. It is more predictable than adenosine in response time and, thus, can be used during unanticipated complications, such as aneurysmal rupture. It also induces a shorter period of hypotension compared with adenosine. However, RVP is more invasive and more complex from an anesthesia standpoint. Vascular neurosurgeons should be familiar with these techniques and know their applications and limitations 1).


A 46-year-old man came to the Huashan Hospital Fudan University, Shanghai, China with intermittent right-side headache for 5 years, and left lower limb numbness for 3 months.

Magnetic resonance imaging (MRI) of the head and digital subtraction angiography confirmed the diagnosis of right middle cerebral artery (MCA) aneurysm.

Considering the large size of this MCA aneurysm, Rapid ventricular pacing (RVP) was used to reduce blood pressure during MCA aneurysm repair, and to lower the risk of intracranial hemorrhage during procedure.

Post procedure, there was no abnormality detected. Seven weeks after surgery, the patient’s muscle tone of right side extremities were grade V and left side extremities were grade IV. Computed tomography angiography confirmed no MCA aneurysm.

In cases of aneurysm rupture, RVP will induce a transient “very low pressure” condition, and give a valuable time frame to clip the ruptured aneurysm. Therefore RVP is a safe and effective method to provide transient reduction of cardiac output in intracranial aneurysm patients 2).1) Rangel-Castilla L, Russin JJ, Britz GW, Spetzler RF. Update on transient cardiac standstill in cerebrovascular surgery. Neurosurg Rev. 2015 Oct;38(4):595-602. doi: 10.1007/s10143-015-0637-z. Epub 2015 May 1. PubMed PMID: 25931209.2) Ping Y, Gu H. A case report on middle cerebral artery aneurysm treated by rapid ventricular pacing: A CARE compliant case report. Medicine (Baltimore). 2018 Nov;97(48):e13320. doi: 10.1097/MD.0000000000013320. PubMed PMID: 30508924.

The Greenberg Rapid Review: A Companion to the 8th Edition

The Greenberg Rapid Review: A Companion to the 8th Edition

The Greenberg Rapid Review: A Companion to the 8th Edition

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Written by an esteemed educator and founder of the renowned Chicago Review Course in Neurological Surgery™, this updated review reflects substantive content additions to the 8th edition. The two prior editions of the Rapid Review were must-have companions that fully leveraged the vast knowledge contained within Greenberg’s legendary tome.
Through repetition and spot-on questions, this book brings clarity to a specialty whose sheer depth and breadth presents comprehension and retention challenges. This book helps readers determine if they are retaining key data and information, thereby providing a robust self-assessment study tool for American Board of Neurological Surgery certification.
The 7th companion generated glowing reviews, such as: “A wonderful example of how to turn the classic Greenberg text into a study guide rather than an encyclopedic reference to a young neurosurgeon” –AANS Young Neurosurgeons News
Key Highlights

  • Question formats include fill in the blank, open-ended questions, true/false, matching, and identification of various elements in diagrams/figures
  • Mnemonic devices, helpful hints, clinical pearls, and study charts aid in comprehension and long-term retention
  • Greenberg chapter headings are used (e.g. 4.2.3), thereby providing clear-cut Handbook references

This book is designed to help neurosurgical residents prepare for the ABNS primary examination and/or rounds. It will enable practicing neurosurgeons, neurologists, neuroradiologists, and neuropathologists to develop a storehouse of knowledge required to efficaciously examine, analyze, diagnose, and treat neurosurgical patients.


Product Details

  • Published on: 2016-11-15
  • Original language: English
  • Dimensions: 7.00″ h x .0″ w x 10.00″ l,
  • Binding: Paperback
  • 576 pages

Neurosurgery : Multiple Choice Questions and Rapid Revision of Surgery

Neurosurgery : Multiple Choice Questions and Rapid Revision of Surgery

Neurosurgery : Multiple Choice Questions and Rapid Revision of Surgery
By Ahmed El-Bishry, Amr Mohsen

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Product Description

We appreciate the need for a rapid revision guide for surgery. This book contains 756 questions with explanatory answers and “Key facts to remember”. We hope the book will be of value for undergraduate as well as postgraduate students.


Product Details

  • Published on: 2014-01-13
  • Released on: 2014-01-13
  • Format: Kindle eBook

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