History and Physical Examination 1

Collinsphy King
Patient Name: JACK DAVID
2012/12/28
MRN: 100010
OPERATIVE REPORT
Patient Name: ZIMMERMAN, ROBERT J.
MRN: 100100
Billing No: 100000100
Admit Date: 07/24/2013
Discharge Date:
Service Date:
Surgery Date: 07/24/2013
ESA Attending Dr:
Report Status:
Extra Copies: 1
INDICATION: Atrial fibrillation, non-ischemic cardiomyopathy believed to be from tachycardia mediated mechanism.
PROCEDURE: Electrical cardioversion.
After discussing the procedure in detail with the patient, the risks of the procedure, the alternatives were discussed with the patient. The patient was initially scheduled to have this performed with Dr. Loka; however, unfortunately, because he was detained by an ongoing procedure, I was asked to perform the cardioversion. The patient being fully informed of the risks of the procedure, the alternatives, despite this, is willing to proceed with an elective cardioversion.
The patient subsequently was placed in routine hemodynamic telemetry monitoring. The patient was confirmed to be in persistent atrial fibrillation. The patient subsequently underwent sedation utilizing a combination of 50 mg of IV Benadryl, IV Fentanyl, as well as, IV Versed. After attaining adequate sedation and once again confirming the patient to be in persistent atrial fibrillation, 200 joules of biophasic energy was applied with pads in the right upper sternal and left ventricular apical orientation. First cardioversion did not result in successful conversion. The patient subsequently underwent repeat attempt at cardioversion once again using 200 joules of biophasic energy with successful conversion to a sinus mechanism.
His pacemaker was interrogated during the procedure with atrial EGM clearly showing atrial fibrillation preceding the procedure and subsequent atrial EGM post procedure showing resolution of atrial fibrillation.
COMPLICATIONS: None.
*Primary care provider

Procedure Note Update

Collinsphy King
Patient Name: JACK DAVID
2012/12/28
MRN: 100010
OPERATIVE REPORT
Patient Name: ZIMMERMAN, ROBERT J.
MRN: 100100
Billing No: 100000100
Admit Date: 07/24/2013
Discharge Date:
Service Date:
Surgery Date: 07/24/2013
ESA Attending Dr:
Report Status:
Extra Copies: 1
INDICATION: Atrial fibrillation, non-ischemic cardiomyopathy believed to be from tachycardia mediated mechanism.
PROCEDURE: Electrical cardioversion.
After discussing the procedure in detail with the patient, the risks of the procedure, the alternatives were discussed with the patient. The patient was initially scheduled to have this performed with Dr. Loka; however, unfortunately, because he was detained by an ongoing procedure, I was asked to perform the cardioversion. The patient being fully informed of the risks of the procedure, the alternatives, despite this, is willing to proceed with an elective cardioversion.
The patient subsequently was placed in routine hemodynamic telemetry monitoring. The patient was confirmed to be in persistent atrial fibrillation. The patient subsequently underwent sedation utilizing a combination of 50 mg of IV Benadryl, IV Fentanyl, as well as, IV Versed. After attaining adequate sedation and once again confirming the patient to be in persistent atrial fibrillation, 200 joules of biophasic energy was applied with pads in the right upper sternal and left ventricular apical orientation. First cardioversion did not result in successful conversion. The patient subsequently underwent repeat attempt at cardioversion once again using 200 joules of biophasic energy with successful conversion to a sinus mechanism.
His pacemaker was interrogated during the procedure with atrial EGM clearly showing atrial fibrillation preceding the procedure and subsequent atrial EGM post procedure showing resolution of atrial fibrillation.
COMPLICATIONS: None.
*Primary care provider

Procedure Note Update

Collinsphy King
Patient Name: JACK DAVID
2012/12/28
MRN: 100010
OPERATIVE REPORT
Patient Name: ZIMMERMAN, ROBERT J.
MRN: 100100
Billing No: 100000100
Admit Date: 07/24/2013
Discharge Date:
Service Date:
Surgery Date: 07/24/2013
ESA Attending Dr:
Report Status:
Extra Copies: 1
INDICATION: Atrial fibrillation, non-ischemic cardiomyopathy believed to be from tachycardia mediated mechanism.
PROCEDURE: Electrical cardioversion.
After discussing the procedure in detail with the patient, the risks of the procedure, the alternatives were discussed with the patient. The patient was initially scheduled to have this performed with Dr. Loka; however, unfortunately, because he was detained by an ongoing procedure, I was asked to perform the cardioversion. The patient being fully informed of the risks of the procedure, the alternatives, despite this, is willing to proceed with an elective cardioversion.
The patient subsequently was placed in routine hemodynamic telemetry monitoring. The patient was confirmed to be in persistent atrial fibrillation. The patient subsequently underwent sedation utilizing a combination of 50 mg of IV Benadryl, IV Fentanyl, as well as, IV Versed. After attaining adequate sedation and once again confirming the patient to be in persistent atrial fibrillation, 200 joules of biophasic energy was applied with pads in the right upper sternal and left ventricular apical orientation. First cardioversion did not result in successful conversion. The patient subsequently underwent repeat attempt at cardioversion once again using 200 joules of biophasic energy with successful conversion to a sinus mechanism.
His pacemaker was interrogated during the procedure with atrial EGM clearly showing atrial fibrillation preceding the procedure and subsequent atrial EGM post procedure showing resolution of atrial fibrillation.
COMPLICATIONS: None.
*Primary care provider

Procedure Note Update

Collinsphy King
Patient Name: JACK DAVID
2012/12/28
MRN: 100010
OPERATIVE REPORT
Patient Name: ZIMMERMAN, ROBERT J.
MRN: 100100
Billing No: 100000100
Admit Date: 07/24/2013
Discharge Date:
Service Date:
Surgery Date: 07/24/2013
ESA Attending Dr:
Report Status:
Extra Copies: 1
INDICATION: Atrial fibrillation, non-ischemic cardiomyopathy believed to be from tachycardia mediated mechanism.
PROCEDURE: Electrical cardioversion.
After discussing the procedure in detail with the patient, the risks of the procedure, the alternatives were discussed with the patient. The patient was initially scheduled to have this performed with Dr. Loka; however, unfortunately, because he was detained by an ongoing procedure, I was asked to perform the cardioversion. The patient being fully informed of the risks of the procedure, the alternatives, despite this, is willing to proceed with an elective cardioversion.
The patient subsequently was placed in routine hemodynamic telemetry monitoring. The patient was confirmed to be in persistent atrial fibrillation. The patient subsequently underwent sedation utilizing a combination of 50 mg of IV Benadryl, IV Fentanyl, as well as, IV Versed. After attaining adequate sedation and once again confirming the patient to be in persistent atrial fibrillation, 200 joules of biophasic energy was applied with pads in the right upper sternal and left ventricular apical orientation. First cardioversion did not result in successful conversion. The patient subsequently underwent repeat attempt at cardioversion once again using 200 joules of biophasic energy with successful conversion to a sinus mechanism.
His pacemaker was interrogated during the procedure with atrial EGM clearly showing atrial fibrillation preceding the procedure and subsequent atrial EGM post procedure showing resolution of atrial fibrillation.
COMPLICATIONS: None.
*Primary care provider

Procedure Note Update

Collinsphy King
Patient Name: JACK DAVID
2012/12/28
MRN: 100010
OPERATIVE REPORT
Patient Name: ZIMMERMAN, ROBERT J.
MRN: 100100
Billing No: 100000100
Admit Date: 07/24/2013
Discharge Date:
Service Date:
Surgery Date: 07/24/2013
ESA Attending Dr:
Report Status:
Extra Copies: 1
INDICATION: Atrial fibrillation, non-ischemic cardiomyopathy believed to be from tachycardia mediated mechanism.
PROCEDURE: Electrical cardioversion.
After discussing the procedure in detail with the patient, the risks of the procedure, the alternatives were discussed with the patient. The patient was initially scheduled to have this performed with Dr. Loka; however, unfortunately, because he was detained by an ongoing procedure, I was asked to perform the cardioversion. The patient being fully informed of the risks of the procedure, the alternatives, despite this, is willing to proceed with an elective cardioversion.
The patient subsequently was placed in routine hemodynamic telemetry monitoring. The patient was confirmed to be in persistent atrial fibrillation. The patient subsequently underwent sedation utilizing a combination of 50 mg of IV Benadryl, IV Fentanyl, as well as, IV Versed. After attaining adequate sedation and once again confirming the patient to be in persistent atrial fibrillation, 200 joules of biophasic energy was applied with pads in the right upper sternal and left ventricular apical orientation. First cardioversion did not result in successful conversion. The patient subsequently underwent repeat attempt at cardioversion once again using 200 joules of biophasic energy with successful conversion to a sinus mechanism.
His pacemaker was interrogated during the procedure with atrial EGM clearly showing atrial fibrillation preceding the procedure and subsequent atrial EGM post procedure showing resolution of atrial fibrillation.
COMPLICATIONS: None.
*Primary care provider

Operative Report

Collinsphy King
Patient Name: JACK DAVID
2012/12/28
MRN: 100010
OPERATIVE REPORT
Patient Name: ZIMMERMAN, ROBERT J.
MRN: 100100
Billing No: 100000100
Admit Date: 07/24/2013
Discharge Date:
Service Date:
Surgery Date: 07/24/2013
ESA Attending Dr:
Report Status:
Extra Copies: 1
INDICATION: Atrial fibrillation, non-ischemic cardiomyopathy believed to be from tachycardia mediated mechanism.
PROCEDURE: Electrical cardioversion.
After discussing the procedure in detail with the patient, the risks of the procedure, the alternatives were discussed with the patient. The patient was initially scheduled to have this performed with Dr. Loka; however, unfortunately, because he was detained by an ongoing procedure, I was asked to perform the cardioversion. The patient being fully informed of the risks of the procedure, the alternatives, despite this, is willing to proceed with an elective cardioversion.
The patient subsequently was placed in routine hemodynamic telemetry monitoring. The patient was confirmed to be in persistent atrial fibrillation. The patient subsequently underwent sedation utilizing a combination of 50 mg of IV Benadryl, IV Fentanyl, as well as, IV Versed. After attaining adequate sedation and once again confirming the patient to be in persistent atrial fibrillation, 200 joules of biophasic energy was applied with pads in the right upper sternal and left ventricular apical orientation. First cardioversion did not result in successful conversion. The patient subsequently underwent repeat attempt at cardioversion once again using 200 joules of biophasic energy with successful conversion to a sinus mechanism.
His pacemaker was interrogated during the procedure with atrial EGM clearly showing atrial fibrillation preceding the procedure and subsequent atrial EGM post procedure showing resolution of atrial fibrillation.
COMPLICATIONS: None.
*Primary care provider