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Sample records for automatic defibrillator implantation

  1. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available Automatic Implantable Cardiac Defibrillator February 19, 2009 Halifax Health Medical Center, Daytona Beach, FL Welcome to Halifax Health Daytona Beach, Florida. Over the next hour you' ...

  2. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... Over the next hour you'll see the implantation of an automated implantable cardiac defibrillator. The surgery ... evening we're going to be discussing the implantation of a defibrillator. It’s a battery-powered implantable ...

  3. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... discussing the implantation of a defibrillator. It’s a battery-powered implantable device that saves patients from deadly ... next doctor or whoever come to replace the battery and then to change the generator, they cannot -- ...

  4. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... quality healthcare for all patients. "OR Live" makes it easy for you to learn more. Just click ... to be discussing the implantation of a defibrillator. It’s a battery-powered implantable device that saves patients ...

  5. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... rate of infection, how many device, how many experience the implanter has. That's make a different because every case, you learning from every single case. Every patient different. There ...

  6. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... Health’s commitment to provide quality healthcare for all patients. "OR Live" makes it easy for you to ... It’s a battery-powered implantable device that saves patients from deadly arrhythmias in the heart. If at ...

  7. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... they're implanted. And then, depending on the recommendations for that specific device, eventually that goes over ... them say, “I feel so great.” And they travel, they forget to take your -- they stop taking ...

  8. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... to see tonight the implantation of a very complex, sophisticated device to save people’s lives. But the ... It doesn't require a device that’s this complex to get the heart back into rhythm and ...

  9. Patient ECG recording control for an automatic implantable defibrillator

    Science.gov (United States)

    Fountain, Glen H. (Inventor); Lee, Jr., David G. (Inventor); Kitchin, David A. (Inventor)

    1986-01-01

    An implantable automatic defibrillator includes sensors which are placed on or near the patient's heart to detect electrical signals indicative of the physiology of the heart. The signals are digitally converted and stored into a FIFO region of a RAM by operation of a direct memory access (DMA) controller. The DMA controller operates transparently with respect to the microprocessor which is part of the defibrillator. The implantable defibrillator includes a telemetry communications circuit for sending data outbound from the defibrillator to an external device (either a patient controller or a physician's console or other) and a receiver for sensing at least an externally generated patient ECG recording command signal. The patient recording command signal is generated by the hand held patient controller. Upon detection of the patient ECG recording command, DMA copies the contents of the FIFO into a specific region of the RAM.

  10. Automatic implantable cardioverter/defibrillator discharges and acute myocardial injury

    Energy Technology Data Exchange (ETDEWEB)

    Avitall, B.; Port, S.; Gal, R.; McKinnie, J.; Tchou, P.; Jazayeri, M.; Troup, P.; Akhtar, M. (Univ. of Wisconsin-Milwaukee Clinical Campus (USA))

    1990-05-01

    Multiple defibrillations by the automatic implantable cardioverter/defibrillator (AICD) have been reported to result in localized epicardial damage. No data exist, however, regarding whether this damage can be detected in the clinical setting or whether it interferes with the detection of true myocardial infarction. Forty-nine patients who received defibrillations by patch electrodes were studied prospectively. We attempted to document the presence of myocardial injury with the following three commonly used modalities for the detection of myocardial infarction: serial electrocardiographic changes, serial creatine phosphokinase (CPK) and CPK-MB release, and technetium 99m pyrophosphate scanning. Fifteen patients received defibrillations by AICD patches at the time of AICD generator replacement. Nine patients received defibrillations at the time of new AICD lead placement. The average total energy delivered was 85 +/- 29 J. None of these patients had detectable myocardial injury. Ten patients had defibrillations by the AICD patches at the time of bypass operation. One patient in this group developed acute myocardial infarction in the inferior wall after posterior descending coronary bypass operation, as detected by electrocardiogram, 99mTc pyrophosphate scanning, and CPK-MB analysis. Fifteen patients were evaluated for spontaneous AICD discharges. Thirteen had a maximum of five consecutive shocks, and cumulative energy delivered was not greater than 330 J. None of these patients had detectable injury. Two patients had CPK-MB release of 15.3% and 7.5%, respectively. One of these patients had a positive 99mTc pyrophosphate scan. These two patients received 12 and 17 rapid and consecutive AICD discharges, respectively, with cumulative delivered energy of 360 and 510 J, respectively.

  11. Implantable Cardioverter Defibrillator

    Science.gov (United States)

    ... NHLBI on Twitter. What Is an Implantable Cardioverter Defibrillator? An implantable cardioverter defibrillator (ICD) is a small ... pacemakers and defibrillators. Comparison of an Implantable Cardioverter Defibrillator and a Pacemaker The image compares an ICD ...

  12. Implantable cardioverter defibrillator - discharge

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000108.htm Implantable cardioverter defibrillator - discharge To use the sharing features on this ... chest wall. A device called an implantable cardioverter-defibrillator (ICD) was inserted under your skin and muscle. ...

  13. Pacemakers and Implantable Defibrillators

    Science.gov (United States)

    ... need a cardiac pacemaker or an implantable cardioverter defibrillator (ICD). They are devices that are implanted in ... can act as both a pacemaker and a defibrillator. Many ICDs also record the heart's electrical patterns ...

  14. Implantable cardioverter-defibrillator

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007370.htm Implantable cardioverter-defibrillator To use the sharing features on this page, please enable JavaScript. An implantable cardioverter-defibrillator (ICD) is a device that detects any life- ...

  15. Postoperative infection with the automatic implantable cardioverter defibrillator: clinical presentation and use of the gallium scan in diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, P.A.; Wallace, S.; Tucker, B.; Hurvitz, R.J.; Ilvento, J.; Mirabel, G.S.; Cannom, D.S.

    1988-08-01

    This report describes three patients with infection involving an automatic implantable cardioverter defibrillator. All three patients presented with fever, fluid in the pulse generator pocket, leukocytosis and an elevated erythrocyte sedimentation rate. A gallium scan, together with aspiration and culture of the fluid from the pocket, confirmed the diagnosis in each case.

  16. Bipolar Radiofrequency Neurotomy to Treat Neck and Back Pain in Patients with Automatic Implantable Cardioverter Defibrillator.

    Science.gov (United States)

    Bautista, Alexander; Dadabayev, Alisher; Rosenquist, Ellen; Cheng, Jianguo

    2016-03-01

    We report 2 cases of successful treatment of neck and back pain with bipolar radiofrequency ablation (RFA) of the cervical and lumbar facet joints in patients with an automatic implantable cardioverter defibrillator (AICD).Two patients with complex cardiac histories and AICD devices were treated with bipolar RFA of the facet joints. One presented with axial neck pain and the other with axial back pain. The histories and physical examinations were consistent with facetogenic pain. Diagnostic medial branch block resulted in more than 70% pain relief lasting for several days, allowing patients to perform routine daily activities without significant pain. However, we were concerned about the use of conventional RFA of the medial branches of nerves for the fear of interference with the function of AICD by the RF currents and energy. We took advantage of the localized and limited current of bipolar RFA to perform this procedure for the cervical or lumbar facet joints avoiding any interference with the function of AICD. The procedures provided long-term pain relief to the patients, and marked improvement in their functional status without any evident complications related to the function of their AICD.This case report describes the safe and successful completion of bipolar RFA of the medial branch nerves to treat cervical and lumbar facetogenic pain in patients with AICD. This modality of treatment may be considered in patients with AICD. We are finding it to be increasingly common that patients who present with chronic neck and back pain have AICDs in place. PMID:27008309

  17. Impact of carvedilol and metoprolol on inappropriate implantable cardioverter-defibrillator therapy

    DEFF Research Database (Denmark)

    Ruwald, Martin H; Abu-Zeitone, Abeer; Jons, Christian;

    2013-01-01

    The goal of this study was to evaluate the effects of carvedilol and metoprolol on the endpoint of inappropriate implantable cardioverter-defibrillator therapy in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation With Cardiac Resynchronization Therapy) study.......The goal of this study was to evaluate the effects of carvedilol and metoprolol on the endpoint of inappropriate implantable cardioverter-defibrillator therapy in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation With Cardiac Resynchronization Therapy) study....

  18. Elderly Benefit from Using Implantable Defibrillators

    Science.gov (United States)

    ... org Learn More Elderly benefit from using implantable defibrillators June 17, 2013 Categories: Heart News Study Highlights: Older people may benefit from implantable cardioverter defibrillators (ICDs) as much as younger people. Overall health, ...

  19. Influence of diabetes mellitus on inappropriate and appropriate implantable cardioverter-defibrillator therapy and mortality in the Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy (MADIT-RIT) Trial

    DEFF Research Database (Denmark)

    Ruwald, Martin H.; Zareba, Wojciech; Jons, Christian;

    2013-01-01

    The relationship between diabetes mellitus and risk of inappropriate or appropriate therapy in patients receiving an implantable cardioverter-defibrillator (ICD) and resynchronization therapy has not been investigated thoroughly. The effect of innovative ICD programming on therapy delivery in these...

  20. Model Checking Implantable Cardioverter Defibrillators

    OpenAIRE

    Abbas, Houssam; Jang, Kuk Jin; Jiang, Zhihao; Mangharam, Rahul

    2015-01-01

    Ventricular Fibrillation is a disorganized electrical excitation of the heart that results in inadequate blood flow to the body. It usually ends in death within seconds. The most common way to treat the symptoms of fibrillation is to implant a medical device, known as an Implantable Cardioverter Defibrillator (ICD), in the patient's body. Model-based verification can supply rigorous proofs of safety and efficacy. In this paper, we build a hybrid system model of the human heart+ICD closed loop...

  1. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... candidate for this kind of procedures. Okay, well let’s go ahead and go into the procedure. And Dr. ... we try to restore in those patients. Okay, let’s go ahead and go into the procedure. We starting ...

  2. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... we try to create a triangle where we project all the energy into the distal coil inside the heart. This ... important to understand all of your options and alternatives. Why ... tissue will create energy, will make energy, electricity go slow and then ...

  3. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... doing, we're going to do to get access. We're going to do access on the left subclavian vein. We don't ... a railroad to get the lead and the access to the heart. This is that we looking ...

  4. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... mentioned before, you get a shock in your sleep or you was doing something and suddenly it ... okay? You get shock yesterday night during your sleep. You feel okay? And the patient say, “What? ...

  5. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... And in those patient the heart is so weak, so damage, it’s getting scar, therefore below 30 ... if you know the patient has a very weak heart. Sometimes because the heart is open and ...

  6. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... discover the precision and experience required to successfully use this technology, and Halifax Health’s commitment to provide ... introducer because the lead we're going to use is an acceptable size lead and it has ...

  7. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... OR Live" makes it easy for you to learn more. Just click on the “Request Information” button on your Webcast screen, and open the door to informed medical care. Welcome and ...

  8. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... is very well educated. They go to the Internet, they do their research, they call their peers ... to realize we talk about battery life and changing the battery, you don't just open the ...

  9. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... like to the heart with the maximum predictable heart rate is 220 minus age. And then we can ... delivering a shock to the heat restore the heart rate or restore somebody’s heart? Is like we reset ...

  10. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... or emphysema, automobile or accidents of all kind, diabetes -- all combined. You put them all together and ... because every case, you learning from every single case. Every patient different. ... go at patient who call with he get a report to there in the office. He was shocked ...

  11. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... weeks and can go to nominal activity or lifting weights in four to six weeks. And as ... is covered over its surface with arteries that carry blood out to the muscle and veins that ...

  12. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... you use it. It’s like you have a radio, battery-power radio, or cell phone. How many call you make ... do, you put something in your house, a transmitter and by your phone. You can be passing ...

  13. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... time we would like to pace both the right and left ventricle to make them work together, but in ... there was no way to get from the right side to the left side of the heart without opening the chest. ...

  14. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... outcome. 8 Our rate of dislodgement is very low. Our rate of infection, the infection really superior. ... talking about one percent will not even be low -- 0.2, 0.1 percent. [ Would a patient ...

  15. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... point. And this is very -- this device that tests is, which is right here behind us, is ... in pacemakers, we would have to program to test each increment that we wanted to test, do ...

  16. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... blood’s not pumped from the heart to the brain, the brain immediately shuts down. Then you have the impression ... rescued. If blood doesn't go to your brain in five seconds you're out, you pass ...

  17. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... that saves patients from deadly arrhythmias in the heart. If at any point in this discussion and ... where are we right now, Dr. Stoner, with heart disease? Well, Matt, we're going to see ...

  18. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... screen, and open the door to informed medical care. Welcome and thank you for joining us this ... by treating the patient’s general heath and medical care. You fix the valve if the valve’s not ...

  19. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... maximum go through the heart. Most of the energy this person will be loss. This is what ... show you that. This is a triangle of energy we use in basically. We can use -- this ...

  20. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... you have any questions please feel free to send them. Before we get into the procedure, first ... They make sure to call you or they send an error to your system and you download, ...

  1. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... is very well educated. They go to the Internet, they do their research, they call their peers ... problems. They do make it a more complex issue that has to be dealt with. One last ...

  2. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... we have to worry about at couple of things. You're going to see further down the road where we pacing with a big difference, a great difference. But the issue, the heart is moved so much, we're ...

  3. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... was sleeping and he’s a gentleman very well functional. We putting the leads in the pocket and ... have to be careful. This is a foreign structure you put into the body. You going to ...

  4. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... to allow a person to live a normal life and eventually will die of heart failure. That's ... it’s watching on you every second of your life. And if you have this palpitation, it shock ...

  5. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... syncope. You have the heart disease, you have coronary artery disease, you have dilated cardiomyopathy, you have bypass, you ... My heart is not pumping well, I have coronary artery disease, what my chance of sudden is very high, ...

  6. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... this technology, and Halifax Health’s commitment to provide quality healthcare for all patients. "OR Live" makes it ... mailbox or walk the dog. This is the quality of life we try to restore in those ...

  7. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... Exactly. This is perfectly illustrated. Next -- well the movie -- yes, at this point if you realize, we ... us this evening for this panel discussion and review of the surgery. I'd also like to ...

  8. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... the chances of survival in people at high risk for arrhythmias. You'll also discover the precision ... men to have heart disease, that mean their risk of sudden death is high. So what are ...

  9. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... can be passing by and pick up the information and transmit it to the center. Through the telephone. Through the telephone. And there is company right now, this big company, they have a center. ...

  10. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... risk at that point. If you have any issue, any symptom, go to your doctor. Your doctor ... a big difference, a great difference. But the issue, the heart is moved so much, we're ...

  11. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... a commercial -- you buy an electronic TV or computer, you buy some insurance on it. And there ... battery in. You have to change the whole computer device so that the whole generator comes out ...

  12. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... to do it is to talk to our doctor. You see a doctor. My heart is not pumping well, I have ... have any issue, any symptom, go to your doctor. Your doctor will do a couple of study ...

  13. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... is very well educated. They go to the Internet, they do their research, they call their peers ... tachycardia. We know the cycle length or the speed of the ventricular tachycardia. When we get that, ...

  14. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... this is a great potion. This is a dream position but we have the phrenic nerve going ... a rapid heart rate due to exercise or activity and a rapid heart rate that could be ...

  15. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... tapered off a tiny bit towards the last five years or so, it really has stayed extremely ... try and squeeze with three fingers instead of five you'd find that you just couldn't ...

  16. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... has to be made by a physician who’s monitoring it carefully and understands all of the implications of any changes because any change can have an effect, adversely, on the whole system. Just want to say thank you to everybody ...

  17. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... metal device again. And when you walk through security you'll set off the security alarms probably. And so somebody wants to know ... are recognized and honored very, very clearly at security checkpoints. And you just present them, explain the ...

  18. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... hospital for cardiovascular disease compared to many other causes of illness. And if you look at the ... It claims as many lives as the next causes, including cancer, chronic obstructive lung disease or emphysema, ...

  19. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... get access to that vein. It’s called coronary sinus. There’s multiple branch. One, we're looking for ... sorry, Dr. Stoner. I get in the coronary sinus. I get a couple of bridge here. I' ...

  20. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... as many lives as the next causes, including cancer, chronic obstructive lung disease or emphysema, automobile or accidents of all kind, diabetes -- all combined. You put them all together and we lose more ... death from breast cancer, which women seem to be very concerned about, ...

  1. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... in the United States. So where are we right now, Dr. Stoner, with heart disease? Well, Matt, ... going from there and go straight to the right atrium, that the impression of the heart. If ...

  2. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... you can do is just try to do something. Whenever nobody can do nothing, they call, “Hanscy, ... well, or opening the chest wall and sewing something over the outside of it. The advancement here ...

  3. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... four to six weeks and can go to nominal activity or lifting weights in four to six ... get us to that successful outcome. 8 Our rate of dislodgement is very low. Our rate of ...

  4. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... therefore below 30 percent. At that level, any tissue of the heart can provoke this bad arrhythmia. ... is just under the skin and the fat tissue. Those wires are inside the blood vessel that ...

  5. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... chronic obstructive lung disease or emphysema, automobile or accidents of all kind, diabetes -- all combined. You put ... up in an emergency room -- say an automobile accident or something -- and somebody recognizes there’s a pacemaker ...

  6. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... a computer. This is the most intelligent machine, human being is. And then at this point, if ... yourself is very important just like knowing what medicine you're on. And how often did you ...

  7. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... crosstalk] faster, like a microchip, is like the cell phone you have in the past, it was ... thing and right now you got a smaller cell phone and faster than -- It does everything all ...

  8. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... of them can be fixed just reprogramming the software, redo the software, communicate with it; you don't have to ... heart disease. But it’s all a sequence of evaluation in advance of intervention that requires someone who’s ...

  9. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... this is a great potion. This is a dream position but we have the phrenic nerve going ... there things out in the world that could cause trouble for them? We've heard about microwave ...

  10. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... crosstalk] faster, like a microchip, is like the cell phone you have in the past, it was big thing and right now you got a smaller cell phone and faster than -- It does everything all at ...

  11. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... blue -- somebody asked maybe not that good of light, but there's a blue spot at the bottom. ... what about, you know, the airport, going through safety checks at the airport? Well, you're given ...

  12. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... there’s very little blood here. The pocket’s very clean. It’s been cleaned with antibiotics. It will be ... good outcome when you have a nice, tight, clean pocket like this, it’s much less likely to ...

  13. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... precision and experience required to successfully use this technology, and Halifax Health’s commitment to provide quality healthcare ... has a cut on it so in the future if we need to remove this lead, it ...

  14. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... or you're in a restaurant, or in Disney, or in Vegas in one of the casino, ... the telephone. Through the telephone. And there is company right now, this big company, they have a ...

  15. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... ll see on this next slide, you're looking at discharges from the hospital for cardiovascular disease, ... four in the pocket, a sponge. What we looking is antibiotics so the patient can be sterile ...

  16. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... to open heart vessels that were impregnated with medicine to keep them open, we had to study ... that they were boasting about getting with the drug-eluding stents. And we had a cardiology meeting ...

  17. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... this bad arrhythmia. It’s that provoking that can lead you to sudden death. You got patient who ... was talking is a railroad to get the lead and the access to the heart. This is ...

  18. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... the tip, are somewhat curved and very, very soft. And, as you pointed out, this is minimally ... that allows us access, but they're so soft that they can be moved back and forward ...

  19. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... we'll see an illustration of ventricular fibrillation. These are the most common causes of death that ... who’s standing at your side to help control these leads. And by manipulating them, moving them backward ...

  20. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... to freeze. And also if this lead is capture, what might capture, I have to -- how many voltage I need. ... the next morning you check, there is no capture or you go to X-ray, you see ...

  1. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... OR Live" makes it easy for you to learn more. Just click on the “Request Information” button ... That's make a different because every case, you learning from every single case. Every patient different. There ...

  2. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... have here, you'll notice that deaths from cardiovascular disease have been declining over the last decade or ... re looking at discharges from the hospital for cardiovascular disease, you'll see that although it may have ...

  3. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... the telephone. Through the telephone. And there is company right now, this big company, they have a center. When the pacer realizes ... know, we were just talking about also external environments. Can you -- what about, you know, the airport, ...

  4. Automatic Implantable Cardiac Defibrillator

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    Full Text Available ... the lead again because it’s a very important process. You can lose all those work, all this ... re overweight, try and get the weight down, control blood pressure, do all the things that help ...

  5. Automatic Implantable Cardiac Defibrillator

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    Full Text Available ... the leads, or infection. In a good, clean environment, sterile environment, a very clean dry pocket helps get us ... know, we were just talking about also external environments. Can you -- what about, you know, the airport, ...

  6. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... to open heart vessels that were impregnated with medicine to keep them open, we had to study ... lives. Many penicillin, we have also used as medicine. But you got every single day people die ...

  7. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... lead can I place. And in the future, nature will provide your stability. You say that, but ... have to do the job, as mentioned before. Nature will do the rest for you at this ...

  8. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... t realize that, and then they transmit the information to the doctor office. They make sure to call you or they send an error to your system and you download, you see what’s going on, ...

  9. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... an example of the need to have a team that works together. You’ve right now got three different ... and Lee and Steve, we have a great team to work with. It's at the level of any university ...

  10. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... right ventricle. Exactly. We tried to coordinate the movement of both sides of the heart. We call ... one we have, either displacement of the leads, movement of the leads, or infection. In a good, ...

  11. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... moment, perhaps we could look at a heart model and show you what Dr. Seide is explaining ... the future we expect in two to our months, tissue will grow, as you mentioned, around the ...

  12. Automatic Implantable Cardiac Defibrillator

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    Full Text Available ... including cancer, chronic obstructive lung disease or emphysema, automobile or accidents of all kind, diabetes -- all combined. ... was leaning across the alternator of a race car, which is generating a whole lot of electricity. ...

  13. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... have here, you'll notice that deaths from cardiovascular disease have been declining over the last decade ... re looking at discharges from the hospital for cardiovascular disease, you'll see that although it may ...

  14. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... a medical problem and show up in an emergency room -- say an automobile accident or something -- and ... taking it at all and then drop into emergency room with heart failure. It’s something to help ...

  15. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... is Matt Petkus. I'm the Director of Cardiology here at Halifax Health. And joining me this ... the drug-eluding stents. And we had a cardiology meeting to discuss how we wanted to use ...

  16. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... a normal life and eventually will die of heart failure. That's the second way of dying. And the ... all and then drop into emergency room with heart failure. It’s something to help that doesn't replace ...

  17. Automatic Implantable Cardiac Defibrillator

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    Full Text Available ... get across the septum, this muscle in the middle of the heart, to get into the left ... heart over here. Instead of going through the middle of the heart and poking a hole through ...

  18. Automatic Implantable Cardiac Defibrillator

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    Full Text Available ... brain or for the spinal. Those can create noise, can create interference with the pacemaker. Before you ... any changes because any change can have an effect, adversely, on the whole system. Just want to ...

  19. Automatic Implantable Cardiac Defibrillator

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    Full Text Available ... the pocket, a sponge. What we looking is antibiotics so the patient can be sterile and at ... The pocket’s very clean. It’s been cleaned with antibiotics. It will be flushed again as you'll ...

  20. Automatic Implantable Cardiac Defibrillator

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    Full Text Available ... explain why does delivering a shock to the heat restore the heart rate or restore somebody’s heart? Is like we reset it. We got the heat going on. There is some circuit. The scar ...

  1. Automatic Implantable Cardiac Defibrillator

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    Full Text Available ... precision and experience required to successfully use this technology, and Halifax Health’s commitment to provide quality healthcare ... very important here that we have the latest technology available to the physicians to do these procedures. ...

  2. Automatic Implantable Cardiac Defibrillator

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    Full Text Available ... the telephone. Through the telephone. And there is company right now, this big company, they have a center. When the pacer realizes ... have to be careful. This is a foreign structure you put into the body. You going to ...

  3. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... high. In fact, over our lifetimes it’s continued increase. So we have a great deal of cardiovascular ... put a wire in in this case to help you be able to navigate and manipulate. I' ...

  4. Automatic Implantable Cardiac Defibrillator

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    Full Text Available ... put a wire in in this case to help you be able to navigate and manipulate. I' ... a technician who’s standing at your side to help control these leads. And by manipulating them, moving ...

  5. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... do nothing, just reprogramming. Those are very intelligent machine. They don't stop because we don't want them to. They are truly amazing devices because of their complexity, but as you pointed out also, because of their utter reliability. It’s mind-boggling when you think of the number of ...

  6. Automatic Implantable Cardiac Defibrillator

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    Full Text Available ... is very well educated. They go to the Internet, they do their research, they call their peers ... can be passing by and pick up the information and transmit it to the center. Through the ...

  7. Automatic Implantable Cardiac Defibrillator

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    Full Text Available ... the lead in the pocket. And these are electronic system. People will ask about the rate of ... m not doing a commercial -- you buy an electronic TV or computer, you buy some insurance on ...

  8. Automatic Implantable Cardiac Defibrillator

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    Full Text Available ... difference between a rapid heart rate due to exercise or activity and a rapid heart rate that could be potentially deadly for a patient? This is why we program. We set up the device. Before we put ...

  9. Automatic Implantable Cardiac Defibrillator

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    Full Text Available ... right ventricle and be able to put it against the muscle in this right ventricle. That allows ... allows -- in fact it encourages -- once it’s up against the wall of the heart for the tissue ...

  10. Automatic Implantable Cardiac Defibrillator

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    Full Text Available ... police by you or you're in a restaurant, or in Disney, or in Vegas in one ... very important here that we have the latest technology available to the physicians to do these procedures. ...

  11. Automatic Implantable Cardiac Defibrillator

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    Full Text Available ... the telephone. Through the telephone. And there is company right now, this big company, they have a center. When the pacer realizes ... the device. We have a couple of patient, Medicare patient, live in nursing home or some assisted ...

  12. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... technology, and Halifax Health’s commitment to provide quality healthcare for all patients. "OR Live" makes it easy ... the maximum predictable heart rate is 220 minus age. And then we can take 10 from them, ...

  13. Automatic Implantable Cardiac Defibrillator

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    Full Text Available ... electricity. You get in collision with the two wave. That give you time for the load to ... you get shocked, you use a lot of energy and then the battery even shorter. 12 And ...

  14. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... use them because our success rate with bare metal stents was actually better than the success rate ... because that’s a huge magnet and these are metal. And we'd hate to see you sort ...

  15. Automatic Implantable Cardiac Defibrillator

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    Full Text Available ... it and cause it to contract and have control over it. No way, man. I don't ... technician who’s standing at your side to help control these leads. And by manipulating them, moving them ...

  16. Automatic Implantable Cardiac Defibrillator

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    Full Text Available ... everything, so I can navigate better. There’s better traffic there. I'm in the right ventricle but ... another and you're at the same time monitoring all of the effect that’s going on with ...

  17. Automatic Implantable Cardiac Defibrillator

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    Full Text Available ... it. It’s like you have a radio, battery-power radio, or cell phone. How many call you ... level. It’s like there is a hurricane, your power is out, you've got to produce power ...

  18. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... any point here. This is just under the skin and the fat tissue. Those wires are inside ... than the device basically. We put under your skin and then we try to create a triangle ...

  19. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... can you give us a little bit of background on the patient that you're doing this ... They go to the Internet, they do their research, they call their peers and figure out where ...

  20. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... The heart is made up, just like a house, it has walls -- the muscles -- it has pipes ... the antenna do, you put something in your house, a transmitter and by your phone. You can ...

  1. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... we're talking about little tiny amounts of electricity that if it’s delivered in the right place ... the axis, how it’s look like, where the electricity coming from. One lead may be deceiving but ...

  2. Automatic Implantable Cardiac Defibrillator

    Science.gov (United States)

    ... it this way because there’s a lot of shadows in the heart, we don't want to get there. We -- dancing, is ... because you have to be careful so you don't dislodge your blade. Because all the work you spent hour doing, it get lost in a fraction of second and you have to restart again. So you’ ...

  3. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... it this way because there’s a lot of shadows in the heart, we don't want to get there. We -- dancing, is ... because you have to be careful so you don't dislodge your blade. Because all the work you spent hour doing, it get lost in a fraction of second and you have to restart again. So you’ ...

  4. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... that we have here, you'll notice that deaths from cardiovascular disease have been declining over the ... talk about to women, if we talk about death from breast cancer, which women seem to be ...

  5. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... right now, this big company, they have a center. When the pacer realizes something was wrong with the patient, even the patient doesn't realize that, and then they transmit the information to the doctor office. They make sure to call you or they send an error to your ...

  6. Automatic Implantable Cardiac Defibrillator

    Medline Plus

    Full Text Available ... that they were boasting about getting with the drug-eluding stents. And we had a cardiology meeting ... even to this day, we use far fewer drug-eluding stents than many hospitals because of the ...

  7. Pacemakers and implantable cardioverter defibrillators.

    Science.gov (United States)

    Allen, M

    2006-09-01

    An increasing number of patients are now treated cardiac pacemakers and implantable cardioverter defibrillators and the technology of these is constantly changing. It is vital to have a good understanding of how they function and what the real risks are. Understanding how the device should work when functioning normally, and the possible effects of electromagnetic interference, is paramount to their safe management in the peri-operative period. Knowing when a device should be disabled or reprogrammed requires careful consideration. Information from the patient's pacemaker clinic should be sought whenever possible and can be invaluable. In addition, the Medicines Healthcare products Regulatory Agency have published the first set of UK guidelines on the management of implantable devices in the presence of surgical diathermy and this will undoubtedly provide a firm foundation on which anaesthetists can base much of their practice. PMID:16922756

  8. Psychological intervention following implantation of an implantable defibrillator

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; van den Broek, Krista C; Sears, Samuel F

    2007-01-01

    The medical benefits of the implantable cardioverter defibrillator (ICD) are unequivocal, but a subgroup of patients experiences emotional difficulties following implantation. For this subgroup, some form of psychological intervention may be warranted. This review provides an overview of current...

  9. How Will Having an Implantable Cardioverter Defibrillator Affect My Lifestyle?

    Science.gov (United States)

    ... NHLBI on Twitter. How Will an Implantable Cardioverter Defibrillator Affect My Lifestyle? The low-energy electrical pulses ... short time. Devices That Can Disrupt Implantable Cardioverter Defibrillator Functions Once you have an ICD, you have ...

  10. Living with an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Pedersen, Susanne S; Knudsen, Charlotte; Dilling, Karen;

    2016-01-01

    AIMS: The clinical management and care of patients with an implantable cardioverter defibrillator (ICD) has shifted from face-to-face in-clinic visits to remote monitoring. Reduced interactions between patients and healthcare professionals may impede patients' transition to adapting post......-implant. We examined patients' needs and preferences for information provision and care options and overall satisfaction with treatment. METHODS AND RESULTS: Patients implanted with a first-time ICD or defibrillator with cardiac resynchronization therapy (n = 389) within the last 2 years at Odense University...

  11. Intra-operative defibrillation testing and clinical shock efficacy in patients with implantable cardioverter-defibrillators

    DEFF Research Database (Denmark)

    Bänsch, Dietmar; Bonnemeier, Hendrik; Brandt, Johan;

    2015-01-01

    AIMS: This trial was designed to test the hypothesis that shock efficacy during follow-up is not impaired in patients implanted without defibrillation (DF) testing during first implantable cardioverter-defibrillator (ICD) implantation. METHODS AND RESULTS: Between February 2011 and July 2013, 1077...... within 30 days in 94 patients (17.6%) tested compared with 89 events in 74 patients (13.9%) not tested (P = 0.095). CONCLUSION: Defibrillation efficacy during follow-up is not inferior in patients with a 40 J ICD implanted without DF testing. Defibrillation testing during first time ICD implantation...

  12. Concerns about the implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; van Domburg, Ron T; Theuns, Dominic A M J;

    2005-01-01

    Patients with an implantable cardioverter defibrillator (ICD) are at increased risk of anxiety disorders. In turn, anxiety has been identified as a precipitant of ventricular arrhythmias. Anxiety may in part be attributed to concerns about the ICD firing, but the relationship between ICD concerns...

  13. Reliability systems for implantable cardiac defibrillator batteries

    Energy Technology Data Exchange (ETDEWEB)

    Takeuchi, E.S. [Wilson Greatbatch Ltd., Clarence, NY (United States)

    1995-03-01

    The reliability of the power sources used in implantable cardiac defibrillators is critical due to the life-saving nature of the device. Achieving a high reliability power source depends on several systems functioning together. Appropriate cell design is the first step in assuring a reliable product. Qualification of critical components and of the cells using those components is done prior to their designation as implantable grade. Product consistency is assured by control of manufacturing practices and verified by sampling plans using both accelerated and real-time testing. Results to date show that lithium/silver vanadium oxide cells used for implantable cardiac defibrillators have a calculated maximum random failure rate of 0.005% per test month. (orig.)

  14. Reliability systems for implantable cardiac defibrillator batteries

    Science.gov (United States)

    Takeuchi, Esther S.

    The reliability of the power sources used in implantable cardiac defibrillators is critical due to the life-saving nature of the device. Achieving a high reliability power source depends on several systems functioning together. Appropriate cell design is the first step in assuring a reliable product. Qualification of critical components and of the cells using those components is done prior to their designation as implantable grade. Product consistency is assured by control of manufacturing practices and verified by sampling plans using both accelerated and real-time testing. Results to date show that lithium/silver vanadium oxide cells used for implantable cardiac defibrillators have a calculated maximum random failure rate of 0.005% per test month.

  15. Advances in implantable cardioverter defibrillator therapy.

    Science.gov (United States)

    Rickard, John; Wilkoff, Bruce L

    2016-03-01

    Since the first implant in 1980, implantable cardioverter defibrillator (ICD) technology has progressed rapidly. Modern ICD's have hundreds of programmable options with the general goal of preventing inappropriate shocks and providing shocks for truly life threatening symptomatic ventricular arrhythmias. New studies on ICD programming have shown the benefits of prolonged detection intervals in reaching this goal. Anti-tachycardia pacing (ATP) therapy has become an important adjunct to defibrillator shocks. Remote monitoring technologies have surfaced which have been shown to identify arrhythmias and problems with the device in an expedient fashion. The subcutaneous ICD offers the advantage of avoiding intravascular leads and their inherent risks. Lastly, the current understanding of the effects of MRI in ICD patients has advanced creating new opportunities to provide MRI safely to such patients. PMID:26653411

  16. Cardiomyopathy and the use of implanted cardio-defibrillators in children.

    Science.gov (United States)

    Kaminer, S J; Pickoff, A S; Dunnigan, A; Sterba, R; Wolff, G S

    1990-05-01

    Children and adults with cardiomyopathy and ventricular dysrhythmias have a uniformly poor prognosis, despite medical therapy. The use of automatic implantable cardio-defibrillators in adult patients with medically resistant ventricular dysrhythmias has resulted in a positive impact on survival. Because of its size and former lack of programmability, the device has been used rarely in children. Four patients with cardiomyopathy, in whom refractory ventricular dysrhythmias were managed with automatic implantable cardio-defibrillators, are presented. Two of these children are the youngest and smallest known in whom the device has been used; one of them received the first programmable model. The use of the automatic implantable cardio-defibrillator may enhance survival in selected young patients. PMID:1693196

  17. The effect of intermittent atrial tachyarrhythmia on heart failure or death in cardiac resynchronization therapy with defibrillator versus implantable cardioverter-defibrillator patients

    DEFF Research Database (Denmark)

    Ruwald, Anne-Christine; Pietrasik, Grzegorz; Goldenberg, Ilan;

    2014-01-01

    OBJECTIVES: This study aimed to investigate the effect of both history of intermittent atrial tachyarrhythmias (IAT) and in-trial IAT on the risk of heart failure (HF) or death comparing cardiac resynchronization therapy with defibrillator (CRT-D) to implantable cardioverter-defibrillator (ICD......, respectively, a history of IAT at baseline and time-dependent development of in-trial IAT during follow-up in 1,264 patients with LBBB enrolled in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy) study. RESULTS: The overall beneficial effect of CRT...... in-trial atrial tachyarrhythmias. (MADIT-CRT: Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy; NCT00180271)....

  18. Questions to Ask Your Doctor--Implantable Cardioverter Defibrillator (ICD)

    Science.gov (United States)

    ... Blood Pressure Tools & Resources Stroke More Questions to Ask Your Doctor - Implantable Cardioverter Defibrillator (ICD) Updated:Nov ... or your family member before and after implantation, ask your doctor or healthcare team any questions you ...

  19. Many People with Implantable Defibrillators Can Participate in Vigorous Sports

    Science.gov (United States)

    ... people with implantable defibrillators can participate in vigorous sports May 20, 2013 Categories: Heart News Study Highlights : ... may safely participate in a number of vigorous sports. The study challenges some current science recommendations advising ...

  20. The assessment of stress reactions of patients with implanted defibrillators

    Directory of Open Access Journals (Sweden)

    Daria Schneider-Matyka

    2016-02-01

    Full Text Available Background. Although they save life, implantable defibrillators have psychological side effects and increase the number of patients who experience anxiety, depressive symptoms and, in extreme cases, post-traumatic stress disorder (PT SD. Escalation of PT SD symptoms depends on patients’ ability to cope with stress. Objectives . The aim of this study was to assess the reactions of patients after defibrillator implantation, and their ways to cope with stress, as well as to analyze the relationship between the ways of coping with stress and PT SD symptoms. Material and methods. The study was conducted using the Mini-Cope, the Impact of Event Scale-Revised (IES-R, and the author’s questionnaire. It involved 111 patients with implanted defibrillators at the mean age of 60 years, including 88 (79.3% men. The majority of the patients had secondary education – 38 (34.2% and were married – 85 (76.6%. 51 (45.9% were one year after defibrillator implantation. Results. It was demonstrated that 49 (44.1% of the surveyed experienced intracardiac discharges, out of whom 8 (17.1% went through an ‘electrical storm’. This group obtained higher PT SD scores in all three IES-R domains comparing to those without implanted defibrillators. The most common strategy to cope with stress was acceptance of the situation and searching for emotional support. Conclusions . 1. Intracardiac discharges are the vital problem of patients after defibrillator implantation. 2. Searching for emotional support and acceptance of the situation are the most common strategies to cope with stress. 3. There is a relationship between PT SD symptoms occurring in patients after implantation of a defibrillator and their strategies to cope with stress.

  1. Pacemakers and implantable cardioverter defibrillators - general and anesthetic considerations

    Directory of Open Access Journals (Sweden)

    Amy G. Rapsang

    2014-06-01

    Full Text Available A pacemaking system consists of an impulse generator and lead or leads to carry the electrical impulse to the patient's heart. Pacemaker and implantable cardioverter defibrillator codes were made to describe the type of pacemaker or implantable cardioverter defibrillator implanted. Indications for pacing and implantable cardioverter defibrillator implantation were given by the American College of Cardiologists. Certain pacemakers have magnet-operated reed switches incorporated; however, magnet application can have serious adverse effects; hence, devices should be considered programmable unless known otherwise. When a device patient undergoes any procedure (with or without anesthesia, special precautions have to be observed including a focused history/physical examination, interrogation of pacemaker before and after the procedure, emergency drugs/temporary pacing and defibrillation, reprogramming of pacemaker and disabling certain pacemaker functions if required, monitoring of electrolyte and metabolic disturbance and avoiding certain drugs and equipments that can interfere with pacemaker function. If unanticipated device interactions are found, consider discontinuation of the procedure until the source of interference can be eliminated or managed and all corrective measures should be taken to ensure proper pacemaker function should be done. Post procedure, the cardiac rate and rhythm should be monitored continuously and emergency drugs and equipments should be kept ready and consultation with a cardiologist or a pacemaker-implantable cardioverter defibrillator service may be necessary.

  2. Temporal Influence of Heart Failure Hospitalizations Prior to Implantable Cardioverter Defibrillator or Cardiac Resynchronization Therapy With Defibrillator on Subsequent Outcome in Mild Heart Failure Patients (from MADIT-CRT)

    DEFF Research Database (Denmark)

    Lee, Andy Y; Moss, Arthur J; Ruwald, Martin H;

    2015-01-01

    effects on subsequent outcomes and benefit from cardiac resynchronization therapy with a defibrillator (CRT-D). Multivariate Cox models were used to determine the temporal influence of previous HF hospitalization on the end point of HF or death within all left bundle branch block implantable cardioverter-defibrillator...... (ICD) and CRT-D patients enrolled in the Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy (MADIT-CRT) trial (n = 1,250) and to evaluate the clinical benefit of CRT-D implantation, comparing CRT-D patients with ICD patients within each previous HF hospitalization...

  3. Risk of chronic anxiety in implantable defibrillator patients

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; den Broek, Krista C van; Theuns, Dominic A M J;

    2011-01-01

    Little is known about the prevalence of chronic anxiety in patients with an implantable cardioverter defibrillator (ICD). In a multi-center, prospective study, we examined 1) the prevalence of chronic anxiety (i.e., patients anxious at implantation and 12 months), and 2) predictors of chronic...

  4. Pre-implantation implantable cardioverter defibrillator concerns and Type D personality increase the risk of mortality in patients with an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; van den Broek, Krista C; Erdman, Ruud A M;

    2010-01-01

    Little is known about the influence of psychological factors on prognosis in implantable cardioverter defibrillator (ICD) patients. We examined the influence of the distressed personality (Type D) and pre-implantation device concerns on short-term mortality in ICD patients.......Little is known about the influence of psychological factors on prognosis in implantable cardioverter defibrillator (ICD) patients. We examined the influence of the distressed personality (Type D) and pre-implantation device concerns on short-term mortality in ICD patients....

  5. Pre implantation psychological functioning preserved in majority of implantable cardioverter defibrillator patients 12 months post implantation

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Hoogwegt, Madelein T; Jordaens, Luc; Theuns, Dominic A M J

    2013-01-01

    The impact of ICD therapy on patient well being has typically focused on mean differences between groups, thereby neglecting changes within individuals. Using an intra-individual approach, we examined (i) the prevalence of implantable cardioverter defibrillator (ICD) patients maintaining their pr...... implantation level of psychological functioning at 12 months, and (ii) factors associated with deterioration in functioning....

  6. Implantable cardioverter-defibrillator oversensing due to electric shock

    Directory of Open Access Journals (Sweden)

    Jurčević Ružica

    2010-01-01

    Full Text Available Introduction. We described the first case of oversensing due to electric shock in Serbia, in a 54-year-old man who had implantable cardioverter-defibrillator (ICD. Case Outline. In July 2002, the patient had acute anteroseptal myocardial infarction and ventricular fibrillation (VF which was terminated with six defibrillation shocks of 360 J. Coronary angiography revealed 30% stenosis of circumflex artery, the left anterior descending coronary artery was recanalized and the right coronary artery was without stenosis. Left ventricular ejection fraction was 20%. In December 2003, an electrophysiology study was performed and ventricular tachycardia (VT was induced and terminated with 200 J defibrillation shock. Single chamber ICD Medtronic Gem III VR was implanted in January 2004 and defibrillation threshold was 12 J. The patient was followed up during three years every three months and there were no VT/VF episodes and VT/VF therapies. In December 2007, the patient experienced electric shock through the fork while he was making barbecue on the electric grill. ICD recognized this event in VF zone (oversensing and delivered defibrillation shock of 18 J. The electrogram of the episode showed ventricular sensing - intrinsic sinus rhythm with electric shock potentials which were misidentified as VF. After charge time of 3.16 seconds, ICD delivered defibrillation shock and sinus rhythm was still present. Conclusion. Oversensing of ICD has different aetiology and the most common cause is supraventricular tachyarrhythmia.

  7. Worldwide experience with a totally subcutaneous implantable defibrillator

    DEFF Research Database (Denmark)

    Lambiase, Pier D; Barr, Craig; Theuns, Dominic A M J;

    2014-01-01

    AIMS: The totally subcutaneous implantable-defibrillator (S-ICD) is a new alternative to the conventional transvenous ICD system to minimize intravascular lead complications. There are limited data describing the long-term performance of the S-ICD. This paper presents the first large international...

  8. Phantom shocks in patients with implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Moons, Philip; Zwisler, Ann-Dorthe;

    2013-01-01

    The aim of this trial was to assess a combined rehabilitation intervention including an exercise training component and a psycho-educational component in patients treated with implantable cardioverter defibrillator (ICD). The hypothesis was that the intervention would reduce the occurrence of...

  9. Defibrillator Implantation in Patients with Nonischemic Systolic Heart Failure

    DEFF Research Database (Denmark)

    Køber, Lars; Thune, Jens J; Nielsen, Jens C;

    2016-01-01

    Background The benefit of an implantable cardioverter-defibrillator (ICD) in patients with symptomatic systolic heart failure caused by coronary artery disease has been well documented. However, the evidence for a benefit of prophylactic ICDs in patients with systolic heart failure that is not due...

  10. Behavioral interventions in patients with an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Habibović, Mirela; Burg, Matthew M; Pedersen, Susanne S.

    2013-01-01

    The implantable cardioverter defibrillator (ICD) is the first-line treatment for primary and secondary prevention of sudden cardiac death. A subgroup of patients experience psychological distress postimplant, and no clear evidence base exists regarding how best to address patients' needs. The aim...

  11. Making post-mortem implantable cardioverter defibrillator explantation safe

    DEFF Research Database (Denmark)

    Räder, Sune B E W; Zeijlemaker, Volkert; Pehrson, Steen;

    2009-01-01

    AIMS: The aim of this study is to investigate whether protection with rubber or plastic gloves during post-mortem explantation of an implantable cardioverter defibrillator (ICD) offers enough protection for the explanting operator during a worst-case scenario (i.e. ICD shock). METHODS AND RESULTS...

  12. Venous thromboembolism in patients with implantable cardioverter-defibrillators

    DEFF Research Database (Denmark)

    Pedersen, Susanne Bendesgaard; Hjortshøj, Søren Pihlkjær; Bøtker, Hans Erik;

    2016-01-01

    AIMS: To examine the incidence of venous thromboembolism (VTE) and its risk factors among patients with implantable cardioverter-defibrillators (ICDs). METHODS AND RESULTS: All first-time ICD recipients in Denmark during 2000-12 were identified from medical databases. Incident VTEs were ascertained...

  13. Phantom shocks in patients with implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Moons, Philip; Zwisler, Ann-Dorthe;

    2013-01-01

    AIMS: The aim of this trial was to assess a combined rehabilitation intervention including an exercise training component and a psycho-educational component in patients treated with implantable cardioverter defibrillator (ICD). The hypothesis was that the intervention would reduce the occurrence of...

  14. Cost effectiveness of the implantable cardioverter defibrillator: a preliminary analysis

    OpenAIRE

    O'Brien, Bernie J; Buxton, Martin J; Rushby, Julia A

    1992-01-01

    Background—An implantable cardioverter defibrillator (ICD) may be effective in reducing the risk of sudden cardiac death. The high cost of ICD treatment, however, compared with alternatives raises the question of whether this new technology is an efficient use of scarce health care resources.

  15. Implantable cardioverter-defibrillators in congenital heart disease

    OpenAIRE

    Chubb, H; Rosenthal, E

    2016-01-01

    Implantable cardioverter-defibrillators (ICD) have an important role in reducing sudden cardiac death in patients with congenital heart disease (CHD); however, the benefit of ICDs needs to be weighed up against both short-term and long-term adverse effects, which are difficult to evaluate in the heterogeneous CHD population. A tailored approach, taking into account risk stratification and patient-specific factors, is needed to select the most appropriate strategy. This review discusses primar...

  16. The occupational routine of patients implanted with cardioverter-defibrillator

    Directory of Open Access Journals (Sweden)

    Juliana Mannini

    2015-03-01

    Full Text Available Implantable cardioverter-defibrillators (ICD have become a reference as to the standard of care for patients with potentially lethal ventricular arrhythmias. The ICD treats the symptoms of the disease with no impact on its cause; however, the electrical discharge originating from the operating mechanism of this device has been the source of many studies addressing the quality of life of this population. The specific literature points to limitations of patients implanted with cardioverter-defibrillators regarding activities such as working and driving, but little has been discussed whether other areas of occupational performance are also limited. The purpose of this prospective exploratory research, which uses a case study design of quantitative nature, is to know the routine of patients implanted with cardioverter-defibrillator. Fifteen subjects with ICD participated in the study; they were outpatients in the arrhythmia sector of the ‘Clementino Fraga Filho’ University Hospital - HUCFF. The instruments for data collection included an initial interview, SF36 inventory, Role Checklist, and an open question. The results showed interference in the routine occupational performance and occupational roles evaluated, as well as in the fields of mental health and vitality, with greater focus on influences arising from the pathology than the mechanism of the device.

  17. Prevention of sudden cardiac death by the implantable cardioverter defibrilator

    Directory of Open Access Journals (Sweden)

    Kovačević Dragan V.

    2011-01-01

    Full Text Available Introduction. Sudden cardiac death or, as it is also called, a modern man’s killer occurs a few hours after the beginning of the disease. Sudden death is the one that happens within an hour from the onset of the subjective discomforts regardless of the existence of any previous disease. According to modern statistics, 450.000 people die suddenly in the USA and 150,000 in Germany. Causes of sudden death. The most frequent causes of sudden death are cardiologic or, in other words, a heart rhythm disorder such as ventricular tachycardia, ventricular fibrillation and bradycardiac rhythm disorder. All these reasons can be efficiently prevented by the implantation of the cardioverter defibrillators. Implantable cardioverter defibrillator. In comparison with the already known medications, the defibrillator seems to be the most efficient in prevention of sudden cardiac death. This fact has been confirmed by large multicentre studies. The implantation itself is a routine procedure. It lasts about an hour and it often passes without any complications. The patient leaves the hospital a few days after the procedure. About 150 of these procedures are performed per year at the Institute of Cardiovascular Diseases Vojvodina. The Social Insurance Fund bears medical costs and the patient only pays the participation fee, which is symbolical if compared to the value and use of the device. Owing to this fact, this device is available to every patient thus making the efficient sudden cardiac death prevention possible.

  18. Monitoring device acceptance in implantable cardioverter defibrillator patients using the Florida Patient Acceptance Survey

    DEFF Research Database (Denmark)

    Versteeg, Henneke; Starrenburg, Annemieke; Denollet, Johan;

    2012-01-01

    Patient device acceptance might be essential in identifying patients at risk for adverse patient-reported outcomes following implantation of an implantable cardioverter defibrillator (ICD). We examined the validity and reliability of the Florida Patient Acceptance Scale (FPAS) and identified...

  19. [Implantable cardioverter/defibrillator: long-term stability of the defibrillation threshold with a unipolar electrode configuration (active-can")].

    Science.gov (United States)

    Knuefermann, P; Wolpert, C; Spehl, S; Korte, T; Manz, M; Lüderitz, B; Jung, W

    2000-09-01

    The majority of cardioverter/defibrillator (ICD) implantations are currently performed with a non-thoracotomy approach. From November 1993 to January 1995, 46 patients underwent implantation of a PCD 7219C with an "active-can" lead configuration at our institution. While the chronic stability of the defibrillation threshold (DFT) for an epicardial lead system is well established, the results are still inconsistent for non-thoracotomy lead systems. Accordingly, the aim of the present study was to compare the acute and chronic defibrillation thresholds of the ICDs implanted with an "active-can" lead system in order to assess the chronic stability of these systems. The defibrillation energy requirements were measured at implant, prior to hospital discharge, three, six and twelve months after implantation of the defibrillator. The patient group consisted of 8 females and 38 males with a mean age of 57.2 years. The mean left ventricular ejection fraction was 43.8%. The most frequent underlying heart disease was coronary artery disease in 31 of 46 patients. Eight patients had idiopathic dilated cardiomyopathy. In 39 of 46 patients, the defibrillation threshold could be successfully determined at all 4 time points after implantation. The mean defibrillation energy requirement at the time of implantation was 9.2 +/- 5.9 Joules (J). The subsequent mean energy requirements were 7.6 +/- 4.8 J at pre-hospital discharge, 8.6 +/- 5.7 J at the 3 month, 8.1 +/- 6.0 J at the 6 month and 8.6 +/- 5.8 J at the 12 month follow-up visits. The mean defibrillation threshold was lowest at the time of prehospital discharge, significantly lower than at the time of initial implantation (p = 0.021). However, at all later time points up to one year, there was no significant difference in the DFT as compared with the time of initial implantation. Comparing the DFT at the time of implantation and the DFT at all other time points, there were no significant differences (9.23 vs. 8.56 J, p = 0

  20. Acute hyperkalemia detected by alert from implantable cardioverter-defibrillator.

    Science.gov (United States)

    Kuriachan, Vikas; Tedrow, Usha; Antman, Elliott; Epstein, Laurence M

    2012-09-01

    Two cases of implantable cardioverter-defibrillator lead impedance changes that corresponded with changes in serum potassium are described. In the first case, an audible lead alert was triggered due to a significant change in lead impedance caused by hyperkalemia. In the second case, a patient was admitted with hyperkalemia and renal failure. Device interrogation revealed a change in lead impedance corresponding to changes in serum potassium. As devices and leads become more sophisticated, their role for monitoring parameters and triggering alerts may expand to include electrolyte and other metabolic changes. PMID:22817110

  1. Implantable cardioverter defibrillator specific rehabilitation improves health cost outcomes

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Zwisler, Ann-Dorthe; Koch, Mette Bjerrum;

    2015-01-01

    after 3 years for implantable cardioverter defibrillator therapy or mortality between rehabilitation and usual care. Time to first admission did not differ. The cost of rehabilitation was 335 USD/276 Euro per patient enrolled in rehabilitation. The total attributable cost of rehabilitation after 3 years...... was -6,789 USD/-5,593 Euro in favour of rehabilitation. CONCLUSION: No long-term health outcome benefits were found for the rehabilitation programme. However, the rehabilitation programme resulted in a reduction in total attributable direct costs....

  2. AUTOMATIC IMPLANTABLE CARDIOVERTER DEFIBRILLATOR - COST-EFFECTIVENESS

    NARCIS (Netherlands)

    HAUER, RNW; WEVER, EFD; CRIJNS, HJGM

    1993-01-01

    Unexpected out-of-hospital cardiac arrest is in most cases due to ventricular fibrillation or rapid ventricular tachycardia. The usual therapeutic strategy in survivors starts with drug treatment, in case of failure followed by nonpharmacological therapy, which may include catheter ablation, ablativ

  3. Clinical effects and implications of cardiac rehabilitation for implantable cardioverter defibrillator patients

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Moons, Philip; Christensen, Anne Vingaard;

    2015-01-01

    BACKGROUND:: The Copenhagen Outpatient ProgrammE-Implantable Cardioverter Defibrillator trial was a randomized clinical trial that compared a complex rehabilitation intervention including exercise training and psychoeducational interventions with usual care. A significant difference between......-time implantable cardioverter defibrillator implantation were randomized (1:1) to comprehensive cardiac rehabilitation (12 weeks of exercise training and 1 year of psychoeducational follow-up) versus treatment as usual. Two primary outcomes, perceived health (Short Form-36) and peak oxygen uptake, were used. Cohen...

  4. Driving restrictions after implantable cardioverter defibrillator implantation: an evidence-based approach

    OpenAIRE

    Thijssen, Joep; Borleffs, C. Jan Willem; van Rees, Johannes B.; de Bie, Mihály K; van der Velde, Enno T.; Van Erven, Lieselot; Bax, Jeroen J; Cannegieter, Suzanne C.; Schalij, Martin J

    2011-01-01

    Aims Little evidence is available regarding restrictions from driving following implantable cardioverter defibrillator (ICD) implantation or following first appropriate or inappropriate shock. The purpose of the current analysis was to provide evidence for driving restrictions based on real-world incidences of shocks (appropriate and inappropriate). Methods and results A total of 2786 primary and secondary prevention ICD patients were included. The occurrence of shocks was noted during a medi...

  5. Correlation of geomagnetic activity with implantable cardioverter defibrillator shocks and antitachycardia pacing

    Czech Academy of Sciences Publication Activity Database

    Ebrille, E.; Konecny, T.; Konecny, D.; Špaček, R.; Jones, P.; Ambrož, Pavel; DeSimone, C.V.; Powel, B.D.; Hayes, D.L.; Friedman, P.A.; Asirvatham, S.J.

    2015-01-01

    Roč. 90, č. 2 (2015), s. 202-208. ISSN 0025-6196 Institutional support: RVO:67985815 Keywords : geomagnetic activity * implantable cardioverter defibrillator Subject RIV: DE - Earth Magnetism, Geodesy, Geography Impact factor: 6.262, year: 2014

  6. Economic evaluations of implantable cardioverter defibrillators: a systematic review.

    Science.gov (United States)

    García-Pérez, Lidia; Pinilla-Domínguez, Pilar; García-Quintana, Antonio; Caballero-Dorta, Eduardo; García-García, F Javier; Linertová, Renata; Imaz-Iglesia, Iñaki

    2015-11-01

    The aim of this paper was to review the cost-effectiveness studies of implantable cardioverter defibrillators (ICD) for primary or secondary prevention of sudden cardiac death (SCD). A systematic review of the literature published in English or Spanish was performed by electronically searching MEDLINE and MEDLINE in process, EMBASE, NHS-EED, and EconLit. Some keywords were implantable cardioverter defibrillator, heart failure, heart arrest, myocardial infarction, arrhythmias, syncope, sudden death. Selection criteria were the following: (1) full economic evaluations published after 1995, model-based studies or alongside clinical trials (2) that explored the cost-effectiveness of ICD with or without associated treatment compared with placebo or best medical treatment, (3) in adult patients for primary or secondary prevention of SCD because of ventricular arrhythmias. Studies that fulfilled these criteria were reviewed and data were extracted by two reviewers. The methodological quality of the studies was assessed and a narrative synthesis was prepared. In total, 24 studies were included: seven studies on secondary prevention and 18 studies on primary prevention. Seven studies were performed in Europe. For secondary prevention, the results showed that the ICD is considered cost-effective in patients with more risk. For primary prevention, the cost-effectiveness of ICD has been widely studied, but uncertainty about its cost-effectiveness remains. The cost-effectiveness ratios vary between studies depending on the patient characteristics, methodology, perspective, and national settings. Among the European studies, the conclusions are varied, where the ICD is considered cost-effective or not dependent on the study. PMID:25323413

  7. Beam Profile Disturbances from Implantable Pacemakers or Implantable Cardioverter-Defibrillator Interactions

    Energy Technology Data Exchange (ETDEWEB)

    Gossman, Michael S., E-mail: mgossman@tsrcc.com [Tri-State Regional Cancer Center, Medical Physics Section, Ashland, KY (United States); Comprehensive Heart and Vascular Associates, Heart and Vascular Center, Ashland, KY (United States); Medtronic, Inc., External Research Program, Mounds View, MN (United States); Nagra, Bipinpreet; Graves-Calhoun, Alison; Wilkinson, Jeffrey [Tri-State Regional Cancer Center, Medical Physics Section, Ashland, KY (United States); Comprehensive Heart and Vascular Associates, Heart and Vascular Center, Ashland, KY (United States); Medtronic, Inc., External Research Program, Mounds View, MN (United States)

    2011-01-01

    The medical community is advocating for progressive improvement in the design of implantable cardioverter-defibrillators and implantable pacemakers to accommodate elevations in dose limitation criteria. With advancement already made for magnetic resonance imaging compatibility in some, a greater need is present to inform the radiation oncologist and medical physicist regarding treatment planning beam profile changes when such devices are in the field of a therapeutic radiation beam. Treatment plan modeling was conducted to simulate effects induced by Medtronic, Inc.-manufactured devices on therapeutic radiation beams. As a continuation of grant-supported research, we show that radial and transverse open beam profiles of a medical accelerator were altered when compared with profiles resulting when implantable pacemakers and cardioverter-defibrillators are placed directly in the beam. Results are markedly different between the 2 devices in the axial plane and the sagittal planes. Vast differences are also presented for the therapeutic beams at 6-MV and 18-MV x-ray energies. Maximum changes in percentage depth dose are observed for the implantable cardioverter-defibrillator as 9.3% at 6 MV and 10.1% at 18 MV, with worst distance to agreement of isodose lines at 2.3 cm and 1.3 cm, respectively. For the implantable pacemaker, the maximum changes in percentage depth dose were observed as 10.7% at 6 MV and 6.9% at 18 MV, with worst distance to agreement of isodose lines at 2.5 cm and 1.9 cm, respectively. No differences were discernible for the defibrillation leads and the pacing lead.

  8. Prognostic importance of distressed (Type D) personality and shocks in patients with an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Denollet, Johan; Tekle, Fetene B; Pedersen, Susanne S.;

    2013-01-01

    Clinical trials have shown the benefit of implantable cardioverter defibrillator (ICD) treatment. In this study, we examined the importance of chronic psychological distress and device shocks among ICD patients seen in clinical practice.......Clinical trials have shown the benefit of implantable cardioverter defibrillator (ICD) treatment. In this study, we examined the importance of chronic psychological distress and device shocks among ICD patients seen in clinical practice....

  9. Implanted Cardiac Defibrillator Care in Radiation Oncology Patient Population

    International Nuclear Information System (INIS)

    Purpose: To review the experience of a large cancer center with radiotherapy (RT) patients bearing implantable cardiac defibrillators (ICDs) to propose some preliminary care guidelines as we learn more about the devices and their interaction with the therapeutic radiation environment. Methods and Materials: We collected data on patients with implanted ICDs treated with RT during a 2.5-year period at any of the five Memorial Sloan-Kettering clinical campuses. Information regarding the model, location, and dose detected from the device, as well as the treatment fields, fraction size, and treatment energy was collected. During this time, a new management policy for these patients had been implemented requiring treatment with low-energy beams (6 MV) and close surveillance of the patients in partnership with their electrophysiologist, as they received RT. Results: During the study period, 33 patients were treated with an ICD in place. One patient experienced a default of the device to its initial factory setting that was detected by the patient hearing an auditory signal from the device. This patient had initially been treated with a 15-MV beam. After this episode, his treatment was replanned to be completed with 6-MV photons, and he experienced no further events. Conclusion: Patients with ICDs and other implanted computer-controlled devices will be encountered more frequently in the RT department, and proper management is important. We present a policy for the safe treatment of these patients in the radiation oncology environment.

  10. Can nurses in cardiology areas prepare patients for implantable cardioverter defibrillator implant and life at home?

    Science.gov (United States)

    Tagney, Jenny

    2004-01-01

    This study explored nurses' confidence and competence in preparing patients for having an implantable cardioverter defibrillator implanted and for life at home after discharge. Whilst research has identified various physical and psychosocial effects to patients and their partners associated with device implant and subsequent lifestyle adjustments, no research has explored nurses' knowledge of the device or these effects. A survey was designed using a purposive sample of 152 nurses from cardiology areas in four large teaching hospitals and a 28-point postal questionnaire to explore knowledge of the device and its impact. Most subjects were not confident in their abilities to prepare patients for implant or life at home after implant. Knowledge of the device and its effects appeared poorly understood by all nurses, irrespective of additional qualifications, length of time since qualifying or area of work. Many participants were aware of the poor knowledge level of nurses and identified it as a weakness in current care practices. Lack of understanding may impair preparation of patients for implantation of or for living with an implantable cardioverter defibrillator, and feasible strategies to change this situation will require careful consideration and further investment. PMID:15152752

  11. The association between biventricular pacing and cardiac resynchronization therapy-defibrillator efficacy when compared with implantable cardioverter defibrillator on outcomes and reverse remodelling

    DEFF Research Database (Denmark)

    Ruwald, Anne-Christine; Kutyifa, Valentina; Ruwald, Martin H;

    2015-01-01

    AIMS: Previous studies on biventricular (BIV) pacing and cardiac resynchronization therapy-defibrillator (CRT-D) efficacy have used arbitrarily chosen BIV pacing percentages, and no study has employed implantable cardioverter defibrillator (ICD) patients as a control group. METHODS AND RESULTS...

  12. Assessment of a remote monitoring system for implantable cardioverter defibrillators.

    Science.gov (United States)

    Masella, Cristina; Zanaboni, Paolo; Di Stasi, Francesca; Gilardi, Serena; Ponzi, Patrizia; Valsecchi, Sergio

    2008-01-01

    We conducted a multicentre study in five Italian hospitals to assess the feasibility of a remote monitoring service for the follow-up of implanted cardiac devices. The system was designed to monitor device performance as well as physiological aspects of the patient's condition. Sixty-seven patients (mean age 64 years) affected by chronic heart failure and with a biventricular implantable cardioverter defibrillator for cardiac re-synchronization therapy (CRT-D) were enrolled for a three-month observation period. A total of 267 device recordings were transmitted through the ordinary telephone network, with a success rate of 99%. The telemonitoring service was more efficient than conventional face-to-face follow-up in terms of the time savings: both for physicians (4.7 minutes versus 15 minutes for remote and conventional monitoring) and for patients (6.6 minutes versus 116.3 minutes). In addition, a total of 23 clinical events occurred during the study, but only two cases required a clinic visit, thus reducing inappropriate hospital admissions. Finally, the service was well accepted by all the users. PMID:18776073

  13. Infarct size and recurrence of ventricular arrhythmias after defibrillator implantation

    Energy Technology Data Exchange (ETDEWEB)

    Sutter, J. de; Tavernier, R.; Kazmierckzak, J.; Buyzere, M. de; Clement, D.L. [Department of Cardiology, University Hospital Gent, Gent (Belgium); Wiele, C. van de; Dierckx, R.A. [Department of Nuclear Medicine, University Hospital Gent (Belgium); Jordaens, L. [Thoraxcenter, University Hospital Rotterdam-Dijkzigt (Netherlands)

    2000-07-01

    Infarct size as determined by perfusion imaging is an independent predictor of mortality after implantable cardioverter defibrillator (ICD) implantation in patients with coronary artery disease (CAD) and life-threatening ventricular arrhythmias (VA). However, its value as a predictor of VA recurrence and hospitalisation after ICD implantation is unknown. Therefore, the objective of this study was to evaluate whether infarct size as determined by perfusion imaging can help to identify patients who are at high risk for recurrence of VA and hospitalisation after ICD implantation. We studied 56 patients with CAD and life-threatening VA. Before ICD implantation, all patients underwent a uniform study protocol including a thallium-201 stress-redistribution perfusion study. A defect score as a measurement of infarct size was calculated using a 17-segment 5-point scoring system. Study endpoints during follow-up were documented episodes of appropriate anti-tachycardia pacing and/or shocks for VA and cardiac hospitalisation for electrical storm (defined as three or more appropriate ICD interventions within 24 h), heart failure or angina. After a mean follow-up of 470{+-}308 days, 22 patients (39%) had recurrences of VA. In univariate analysis, predictors for recurrence were: (a) ventricular tachycardia (VT) as the initial presenting arrhythmia (86% vs 59% for patients without ICD therapy, P=0.04), (b) treatment with {beta}-blockers (36% vs 68%, P=0.03) and (c) a defect score (DS) {>=}20 (64% vs 32%, P=0.03). In multivariate analysis, VT as the presenting arrhythmia ({chi}2=5.51, P=0.02) and a DS {>=}20 ({chi}2=4.22, P=0.04) remained independent predictors. Cardiac hospitalisation was more frequent in patients with a DS {>=}20 (44% vs 13% for patients with DS <20, P=0.015) and this was particularly due to more frequent hospitalisations for electrical storm (24% vs 3% for patients with DS<20, P=0.037). The extent of scarring determined by perfusion imaging can separate

  14. Implantable defibrillator lead extraction with optimized standard extraction techniques

    Institute of Scientific and Technical Information of China (English)

    Xian-Ming Chu; Xue-Bin Li; Ping Zhang; Yi An; Jiang-Bo Duan; Long Wang; Ding Li; Bing Li; Ji-Hong Guo

    2013-01-01

    Background Implantable cardioverter-defibrillator (ICD) leads might not be extracted especially in developing countries because of the high cost and lack of specialized tools. We aimed to evaluate transvenous extraction of ICD leads using optimized standard techniques. Methods We prospectively analyzed clinical characteristics, optimized extraction techniques and the feasibility of extraction for 40 patients (33 males; mean age 47.9 ± 16.1 years) with 42 ICD leads. Results Complete procedural success rate was 95.2% (40/42), and the clinical success rate was 97.6% (41/42). One ICD lead required cardiothoracic surgery. Minor complications occurred in three cases (7.5%), and no major complications or death occurred. Locking stylets were used to extract most leads (34, 81.0%) and almost half of the leads (20, 47.6%) required mechanical dilatation to free fibrotic adhesions; these leads had been implanted for a longer period of time than the others (43.7 ± 18.2 vs. 18.4 ± 13.4 months, P < 0.05). Three-quarters of the leads (30, 71.4%) were extracted with locking stylets plus manual traction (12, 28.6%), or mechanical dilatation with counter-traction (18, 42.8%) by the superior vena cava approach and one-quarter of the leads (11, per lead. Linear regression analysis showed that the extraction time was significantly correlated with implant duration (r = 0.70, P < 0.001). optimized procedure for transvenous extraction of ICD leads provides a practical and low-cost method for standard procedures.

  15. Programming implantable cardioverter-defibrillators in primary prevention: higher or later.

    Science.gov (United States)

    Clementy, Nicolas; Pierre, Bertrand; Simeon, Edouard; Lallemand, Bénédicte; Fauchier, Laurent; Babuty, Dominique

    2014-05-01

    Defibrillator shocks, appropriate or not, are associated with significant morbidity, as they decrease quality of life, can be involved in depression and anxiety, and are known to be proarrhythmic. Most recent data have even shown an association between shocks and overall mortality. As opposed to other defibrillator-related complications, the rate of inappropriate and unnecessary shocks can (and should) be decreased with adequate programming. This review focuses on the different programming strategies and tips available to reduce the rate of shocks in primary prevention patients with left ventricular dysfunction implanted with a defibrillator, as well as some of the manufacturers' device specificities. PMID:24834904

  16. Relation of statin therapy to psychological functioning in patients with an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Hoogwegt, Madelein T; Theuns, Dominic A M J; Kupper, Nina;

    2013-01-01

    patients, in general, and patients with an implantable cardioverter defibrillator (ICD), in particular. We investigated the association between statin therapy and symptoms of anxiety and depression and patients' health status during the 12 months after implantation, reckoning with statin type and dosage...

  17. Dual-chamber implantable cardioverter-defibrillator. Is it useful in patient with permanent atrial fibrillation?

    Science.gov (United States)

    Porres-Aracama, José M; Cerezuela, José Luis; García-Urra, Francisco; Luque-Lezcano, Oscar; Herrero, Vicente

    2016-08-01

    In patients with permanent atrial fibrillation (AF) and implantable cardioverter-defibrillator (ICD) implant indication, a single-chamber device is the choice because AF does not provide interesting information for the treatment. It is very unusual to find patients with permanent AF that coexist with atrial tachycardia with various degree of Atrioventricular block. PMID:27525075

  18. Attrition and Adherence in a Web-Based Distress Management Program for Implantable Cardioverter Defibrillator Patients (WEBCARE): Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Habibovic, M.; Cuijpers, P.; Alings, M.;

    2014-01-01

    Background: WEB-Based Distress Management Program for Implantable CARdioverter defibrillator Patients (WEBCARE) is a Web-based randomized controlled trial, designed to improve psychological well-being in patients with an implantable cardioverter defibrillator (ICD). As in other Web-based trials, we...

  19. Inappropriate shocks delivered by implantable cardiac defibrillators during oversensing of activity of diaphagmatic muscle

    Science.gov (United States)

    Babuty, D; Fauchier, L; Cosnay, P

    1999-01-01

    Two cases are reported (both men, one 72 and one 54 years old) of inappropriate shocks delivered by an implantable cardiac defibrillator (ICD) device, which oversensed the myopotentials induced by deep breathing and Valsalva manoeuvre. No damage to leads was associated with the oversensing of myopotentials. The mechanism of the inappropriate shocks was determined using real time electrograms. Modification of the duration of ventricular detection and decrease in sensitivity made it possible to avoid the oversensing of myopotentials and to deliver ICD treatment.

 Keywords: implantable cardiac defibrillator;  inappropriate shocks;  myopotentials PMID:10220554

  20. Intensity of primary emotions in patients after implantation of an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Stoier, Louise; Pedersen, Preben Ulrich; Berg, Selina Kikkenborg

    2013-01-01

    Background: Experienced emotions can affect the outcome of, and adherence to a cardiac rehabilitation program, and patients coping with an illness. With more awareness of the expressed emotions, health professionals might be better able to understand the reactions of patients and to improve...... receiving an Implantable Cardioverter Defibrillator was measured by a survey using the Emotions and Health Scale. The survey was carried out as part of a randomized clinical trial the COPE-ICD trial (ID: NCT00569478) and is regarded as post-hoc explorative analysis. All data were collected from October 2007...... and surprise. No difference was found regarding the intensity of the primary emotions when the group of patients was divided according to occupation or age. A significant increase in the negative emotions sadness, disgust, anger and surprise was observed in women and in patients who receive the Implantable...

  1. Experiences of patients with implantable cardioverter defibrillator in Turkey: A qualitative study

    Directory of Open Access Journals (Sweden)

    Özgür Aslan

    2012-01-01

    Full Text Available Background. There has been an increase in the number of patients with implantable cardioverter defibrillator (ICD. It isimportant to understand ICD patients’ experiences with it.Aim. The aim of this study was to describe experiences of patients with implantable cardioverter defibrillator (ICD.Methodology. A qualitative approach was used. Focus group interviews were used to obtain data from 19 patients whowere implanted cardioverter defibrillator at two centers in Izmir, Turkey. The patients were assigned into four groups. Thedata was analyzed using qualitative content analysis.Results. The analysis revealed six main themes: activities of daily living, social life, familial relationships, emotionalchanges, implantable cardioverter defibrillator shocks and experiences with receiving information and counselling fromhealth care providers.Conclusions. It can be concluded that patients with ICD experience physical and psychological problems and are not offeredthe education they need. To reduce the fears of the patients and their families and to prepare them for possible life stylechanges, comprehensive training programs that start in the pre-implantation period and continue into the post-implantationperiod should be organized.

  2. Inappropriate shock delivery due to interference between a washing machine and an implantable cardioverter defibrillator.

    Science.gov (United States)

    Kolb, Christof; Schmieder, Sebastian; Schmitt, Claus

    2002-12-01

    Electromagnetic interference with implantable cardioverter defibrillators (ICD) can cause inappropriate delivery of therapies or temporary inhibition of ICD functions. The presented case describes electromagnetic interference between a washing machine and an ICD resulting in an inappropriate discharge of the device due to false detection of ventricular fibrillation. PMID:12510137

  3. Inappropriate shock delivery by implantable cardioverter defibrillator due to electrical interference with washing machine.

    Science.gov (United States)

    Chongtham, Dhanaraj Singh; Bahl, Ajay; Kumar, Rohit Manoj; Talwar, K K

    2007-05-31

    We report a patient with hypertrophic cardiomyopathy who received an inappropriate implantable cardioverter defibrillator shock due to electrical interference from a washing machine. This electrical interference was detected as an episode of ventricular fibrillation with delivery of shock without warning symptoms. PMID:17395291

  4. Spinal cord stimulation for refractory angina in patients implanted with cardioverter defibrillators: five case reports

    DEFF Research Database (Denmark)

    Enggaard, Thomas P; Andersen, Claus; Scherer, Christian

    2010-01-01

    Patients implanted with a cardioverter defibrillator (ICD) who are suffering from refractory angina pectoris could benefit from spinal cord stimulation (SCS) due to the well-documented pain relieving effect. However, the combined treatment remains controversial. The aim of the study is to report ...

  5. Shock as a determinant of poor patient-centered outcomes in implantable cardioverter defibrillator patients

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Van Den Broek, Krista C; Van Den Berg, Martha;

    2010-01-01

    The medical benefits of the implantable cardioverter defibrillator (ICD) are well established, but ICD shocks are known to influence patient-centered outcomes. In this viewpoint, we examine the strength of the evidence as found in primary and secondary prevention trials that used quality of life ...

  6. Undertreatment of anxiety and depression in patients with an implantable cardioverter-defibrillator

    DEFF Research Database (Denmark)

    Hoogwegt, Madelein T; Kupper, Nina; Theuns, Dominic A M J;

    2012-01-01

    Twenty-five to 33% of patients with an implantable cardioverter-defibrillator (ICD) experience anxiety and depression, but it is not known whether their symptoms are adequately treated. We investigated (a) whether patients with clinically relevant symptoms of distress received appropriate treatment...

  7. Comprehensive cardiac rehabilitation improves outcome for patients with implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Pedersen, Preben Ulrich; Zwisler, Ann-Dorthe;

    2015-01-01

    Aims:The aim of this randomised clinical trial was to assess a comprehensive cardiac rehabilitation intervention including exercise training and psycho-education vs 'treatment as usual' in patients treated with an implantable cardioverter defibrillator (ICD).Methods:In this study 196 patients with...

  8. Relation between emotional distress and heart rate variability in patients with an implantable cardioverter-defibrillator

    DEFF Research Database (Denmark)

    Hoogwegt, Madelein T; Pedersen, Susanne S.; Theuns, Dominic A M J;

    2014-01-01

    We investigated the relationship between Type D personality, depression, and anxiety, and heart rate variability (HRV) in 64 patients with an implantable cardioverter-defibrillator (ICD). HRV was obtained via 24-h Holter monitoring, and 24-h, 30-min daytime rest and 30-min nighttime sleep HRV were...

  9. Gender disparities in anxiety and quality of life in patients with an implantable cardioverter-defibrillator

    DEFF Research Database (Denmark)

    Habibović, Mirela; van den Broek, Krista C; Theuns, Dominic A M J;

    2011-01-01

    A paucity of studies in implantable cardioverter-defibrillator (ICD) patients has examined gender disparities in patient-reported outcomes, such as anxiety and quality of life (QoL). We investigated (i) gender disparities in anxiety and QoL and (ii) the magnitude of the effect of gender vs. New...

  10. Ventricular Tachyarrhythmias and Mortality in Patients With an Implantable Cardioverter Defibrillator

    DEFF Research Database (Denmark)

    Mastenbroek, Mirjam H; Versteeg, Henneke; Jordaens, Luc;

    2014-01-01

    Objective We examined whether depression is independently associated with implantable cardioverter defibrillator (ICD) therapy for ventricular tachyarrhythmias and mortality. Methods A cohort of 430 consecutive patients with a first-time ICD (79% men; mean [standard deviation] age = 57.8 [12...

  11. E-Health to Manage Distress in Patients With an Implantable Cardioverter-Defibrillator

    DEFF Research Database (Denmark)

    Habibović, Mirela; Denollet, Johan; Cuijpers, Pim;

    2014-01-01

    UNLABELLED: The Web-based distress management program for patients with an implantable cardioverter-defibrillator (ICD; WEBCARE) was developed to mitigate distress and enhance health-related quality of life in ICD patients. This study investigated the treatment effectiveness at 3-month follow...

  12. Patients' perspective on deactivation of the implantable cardioverter-defibrillator near the end of life

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Chaitsing, Rismy; Szili-Torok, Tamas;

    2013-01-01

    Recent guidelines have emphasized the importance of discussing the issue of deactivation near the end of life with patients with an implantable cardioverter-defibrillator (ICD). Few studies have examined the patient perspective and patients' wishes. We examined patients' knowledge and wishes for ...

  13. Psychological vulnerability, ventricular tachyarrhythmias and mortality in implantable cardioverter defibrillator patients

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Brouwers, Corline; Versteeg, Henneke

    2012-01-01

    Implantable cardioverter defibrillator (ICD) therapy is the first-line treatment for the prevention of sudden cardiac death. Despite the demonstrated survival benefits of the ICD, predicting which patients will die from a ventricular tachyarrhythmia remains a major challenge. So far, psychological...

  14. Washing machine associated 50 Hz detected as ventricular fibrillation by an implanted cardioverter defibrillator.

    Science.gov (United States)

    Sabaté, X; Moure, C; Nicolás, J; Sedó, M; Navarro, X

    2001-08-01

    This case report describes a patient with an automatic ICD who suffered a defibrillation shock without warning symptoms. An electrical interference can be observed in the stored EGM of the episode. The patient explained that the moment he felt the shock he was touching a washing machine. After correct grounding of this machine the patient did not suffer more inappropriate shocks. PMID:11523615

  15. The dilemma of implantable cardioverter-defibrillator therapy in the geriatric population

    Institute of Scientific and Technical Information of China (English)

    Diana Revenco; James P Morgan; Lana Tsao

    2011-01-01

    Current guidelines for implantable cardioverter-defibrillator(ICD)therapy in heart failure patients were established by multiple device trials;however,very few geriatric patients(patients≥65 years old)were included in these studies.This article explores the controversies of ICD implantation in the geriatric population,management of delivered ICD therapy in this age group,and the end of life care in patients with ICD.

  16. Radiotherapy in patients with pacemakers and implantable cardioverter defibrillators

    DEFF Research Database (Denmark)

    Zaremba, Tomas; Jakobsen, Annette Ross; Søgaard, Mette;

    2016-01-01

    defibrillators malfunctioning at low radiation doses. Besides scant knowledge about optimal safety measures, only little is known about the exact prevalence of patients with devices undergoing RT. In this review, we provide a short overview of the principles of RT and present the current evidence on the...

  17. Impact of implantable defibrillators and resynchronization therapy on outcome in patients with left ventricular dysfunction--a meta-analysis

    DEFF Research Database (Denmark)

    Abdulla, Jawdat; Haarbo, Jens; Køber, Lars;

    2006-01-01

    BACKGROUND: The clinical benefits of cardiac resynchronization therapy (CRT) and primary prophylactic implantable cardioverter defibrillator (ICD) in patients with left ventricular systolic dysfunction (LVSD) are debated. OBJECTIVE: To evaluate by a meta-analysis the effect of CRT and prophylacti...

  18. Effects of an alert system on implantable cardioverter defibrillator-related anxiety

    DEFF Research Database (Denmark)

    Duru, Firat; Dorian, Paul; Favale, Stefano;

    2010-01-01

    Implantable cardioverter defibrillators (ICD) can prevent sudden cardiac death by delivering high-energy shocks in patients at risk of life-threatening ventricular tachyarrhythmias. Patients may be anxious about receiving inappropriate shocks in case of device or lead system malfunction, or about......) is a multicentre, randomized, clinical trial designed to examine the effects of the awareness of an active vibrating alert system on device-related anxiety....

  19. Association of Air Pollution with Increased Incidence of Ventricular Tachyarrhythmias Recorded by Implanted Cardioverter Defibrillators

    OpenAIRE

    Dockery, Douglas W.; Luttmann-Gibson, Heike; Rich, David Q.; Link, Mark S.; Mittleman, Murray A.; Gold, Diane R.; Koutrakis, Petros; Schwartz, Joel D.; Verrier, Richard L.

    2005-01-01

    Epidemiologic studies have demonstrated a consistent link between sudden cardiac deaths and particulate air pollution. We used implanted cardioverter defibrillator (ICD) records of ventricular tachyarrhythmias to assess the role of air pollution as a trigger of these potentially life-threatening events. The study cohort consisted of 203 cardiac patients with ICD devices in the Boston metropolitan area who were followed for an average of 3.1 years between 1995 and 2002. Fine particle mass and ...

  20. Prophylactic use of implantable cardioverter-defibrillators in the elderly population

    Institute of Scientific and Technical Information of China (English)

    Yuchuan LIU; Hue-Teh Shih

    2005-01-01

    @@ Introduction Sudden cardiac death (SCD) accounts for approximately 300,000 deaths each year in the United States. Ventricular fibrillation, as the initial event, had been reported in 65%-85% of these patients.1 An implantable cardioverterdefibrillator (ICD) is the single most effective life saving device to date. The advances in medicine and technology have led to wide spread utilization of defibrillators in developed countries.

  1. Spiritual well-being may buffer psychological distress in patients with implantable cardioverter defibrillators (ICD)

    OpenAIRE

    Salmoirago-Blotcher, Elena; Crawford, Sybil; Tran, Chau; Goldberg, Robert; Rosenthal, Lawrence; Ockene, Ira

    2012-01-01

    Psychological distress is common in patients with implantable cardioverter defibrillators (ICDs) and has been associated with a worse prognosis. The authors examined whether spiritual wellbeing is associated with reduced psychological distress in patients with ICDs. The Functional Assessment of Chronic Illness Therapy-Spiritual Wellbeing (FACIT-SWB) questionnare and the Hospital Anxiety and Depression Scale (HADS) were used to measure spiritual wellbeing and overall psychological distress. Mu...

  2. Indications for dual-chamber (DDD) pacing in implantable cardioverter-defibrillator patients.

    Science.gov (United States)

    Santini, M; Ansalone, G; Auriti, A; Magris, B; Pandozi, C; Altamura, G

    1996-09-12

    New technologic development of implantable cardioverter-defibrillators (ICDs) keeps up with the exponential increase of their use for primary and secondary prevention of sudden cardiac death. The first-generation ICD with limited shock capability alone could be considered adequate in most cardiac arrest victims, but it was not suitable for sudden death prevention in all high-risk patients with cardiac disease. The second-generation ICD was comprised of hybrid pacemaker-defibrillator systems that provided on-demand ventricular antibradycardia pacing. The third-generation devices include additional functions, such as antitachycardia pacing for ventricular tachycardia (VT) reversion and low-energy ventricular cardioversion, in addition to ventricular defibrillation and single-chamber ventricular demand pacing. In the near future, advanced dual-chamber atrioventricular (AV) pacing and defibrillating systems will also be available. The dual chamber ICD will allow atrial inhibited/dual-chamber (AAI/DDD) rate-responsive pacing, simultaneous atrial and ventricular sensing to optimize the arrhythmia identification, and ICD shock delivery in the proper arrhythmia-related chamber. Clinical benefits of these devices compared with their cost and complexity will require careful evaluation. PMID:8820847

  3. Cardioverter-Defibrillator: A Treatment for Arrhythmia

    Science.gov (United States)

    MENU Return to Web version Arrhythmia | Cardioverter-Defibrillator: A Treatment for Arrhythmia What is an implantable cardioverter-defibrillator? An implantable cardioverter-defibrillator (often called an ICD) is a device that keeps ...

  4. The Medtronic Sprint Fidelis Lead Advisory Notification Has No Adverse Impact on Patient Reported Outcomes in Danish Implantable Cardioverter Defibrillator Patients

    DEFF Research Database (Denmark)

    Pedersen, Susanne Møller; Versteeg, Henneke; Nielsen, Jens C.;

    The Medtronic Sprint Fidelis Lead Advisory Notification Has No Adverse Impact on Patient Reported Outcomes in Danish Implantable Cardioverter Defibrillator Patients.......The Medtronic Sprint Fidelis Lead Advisory Notification Has No Adverse Impact on Patient Reported Outcomes in Danish Implantable Cardioverter Defibrillator Patients....

  5. The Medtronic Sprint Fidelis Lead Advisory Notification has no adverse impact on patient reported outcomes in Danish implantable cardioverter defibrillator patients

    DEFF Research Database (Denmark)

    Pedersen, Susanne Møller; Versteeg, Henneke; Nielsen, Jens C.;

    The Medtronic Sprint Fidelis Lead Advisory Notification has no adverse impact on patient reported outcomes in Danish implantable cardioverter defibrillator patients.......The Medtronic Sprint Fidelis Lead Advisory Notification has no adverse impact on patient reported outcomes in Danish implantable cardioverter defibrillator patients....

  6. Debate: Do all patients with heart failure require implantable defibrillators to prevent sudden death?

    Directory of Open Access Journals (Sweden)

    Marchlinski Francis E

    2000-10-01

    Full Text Available Abstract Sudden death is a major cause of mortality in patients with ventricular dysfunction. The highest risk occurs among patients with less severe functional impairment. Current methods of risk stratification are inadequate, and a rational therapy for prevention of sudden death is not available. The implantable cardioverter-defibrillator (ICD has proven to be more effective than drugs in reducing sudden-death risk in some subsets of patients. Empiric ICD therapy, targeting the general population with mild to moderate heart failure, will maximize the impact of such a strategy to prevent sudden death and improve long-term survival.

  7. Ventricular Arrhythmias in Apparently Normal Hearts: Who Needs an Implantable Cardiac Defibrillator?

    Science.gov (United States)

    Tan, Alex Y; Ellenbogen, Kenneth

    2016-09-01

    Idiopathic ventricular tachycardia is often considered a benign form of ventricular arrhythmia in patients without apparent structural heart disease. However, a subset of patients may develop malignant ventricular arrhythmias and present with syncope and sudden cardiac arrest. Survivors of cardiac arrest are candidates for implantable cardiac defibrillators (ICDs). The indications for ICDs in patients with less than a full-blown cardiac arrest presentation but with electrocardiographically high-risk ectopy features remain uncertain. This article addresses some of the uncertainties and pitfalls in ICD risk stratification in this patient group and explores potential mechanisms for malignant conversion of benign premature ventricular complexes to sustained arrhythmia. PMID:27521094

  8. Development of a hybrid battery system for an implantable biomedical device, especially a defibrillator/cardioverter (ICD)

    Science.gov (United States)

    Drews, Jürgen; Wolf, R.; Fehrmann, G.; Staub, R.

    An implantable defibrillator battery has to provide pulse power capabilities as well as high energy density. Low self-discharge rates are mandatory and a way to check the remaining available capacity is necessary. These requirements are accomplished by a system consisting of a lithium/manganese dioxide 6 V battery, plus a lithium/iodine-cell. The use of a high rate 6 V double-cell design in combination with a high energy density cell reduces the total volume required by the power source within an implantable defibrillator. The design features and performance data of the hybrid system are described.

  9. Development of a hybrid battery system for an implantable biomedical device, especially a defibrillator/cardioverter (ICD)

    Energy Technology Data Exchange (ETDEWEB)

    Drews, J.; Wolf, R.; Fehrmann, G.; Staub, R. [Litronik GmbH und Co., Pirna (Germany)

    1999-07-01

    An implantable defibrillator battery has to provide pulse power capabilities as well as high energy density. Low self-discharge rates are mandatory and a way to check the remaining available capacity is necessary. These requirements are accomplished by a system consisting of a lithium/manganese dioxide 6 V battery, plus a lithium/iodine-cell. The use of a high rate 6 V double-cell design in combination with a high energy density cell reduces the total volume required by the power source within an implantable defibrillator. The design features and performance data of the hybrid system are described. (orig.)

  10. Psychological indices as predictors for phantom shocks in implantable cardioverter defibrillator recipients

    DEFF Research Database (Denmark)

    Starrenburg, Annemieke; Kraaier, Karin; Pedersen, Susanne; Scholten, Marcoen; Van Der Palen, Job

    2014-01-01

    Background A phantom shock - the sensation of an implantable cardioverter defibrillator (ICD) discharge in the absence of an actual discharge - is a phenomenon that can occur in ICD patients. Little is known about the influence of psychological factors on the incidence of phantom shocks. We...... evaluated psychological correlates of phantom shocks 2 years post-ICD implant in a cohort of Dutch ICD recipients. Methods Consecutive patients (N = 300; 87.5% men; mean age = 62.3) willing to participate in a prospective study (Twente ICD Cohort Study) on psychological factors in ICD recipients received an...... ICD between September 2007 and February 2010. At baseline, patients complete the 36-item Short Form Health Survey, Hospital Anxiety and Depression Scale, and the Type D Scale. Lifetime presence of anxiety and depression was assessed with the MINI structural interview. Results During a follow-up of 24...

  11. Patient-reported outcomes in Danish implantable cardioverter defibrillator patients with a Sprint Fidelis lead advisory notification

    DEFF Research Database (Denmark)

    Pedersen, Susanne S; Versteeg, Henneke; Nielsen, Jens Cosedis;

    2011-01-01

    Few studies have investigated the association between implantable cardioverter defibrillators (ICDs) and lead advisory notifications and patient-reported outcomes (PROs). We examined (i) whether the mode used to inform patients about a device advisory is associated with PROs, and (ii) whether pat...

  12. Monitoring treatment expectations in patients with an implantable cardioverter-defibrillator using the EXPECT-ICD scale

    DEFF Research Database (Denmark)

    Habibovic, Mirela; Pedersen, Susanne S.; van den Broek, Krista C;

    2014-01-01

    AIMS: Patient treatment expectations may affect cardiac outcomes; however, till date, no validated instruments have been developed to monitor treatment expectations in patients with an implantable cardioverter-defibrillator (ICD). This study evaluates the predictive value of the newly developed 10...

  13. General anaesthesia for insertion of an automated implantable cardioverter defibrillator in a child with Brugada and autism

    Directory of Open Access Journals (Sweden)

    Shwetal Goraksha

    2010-01-01

    Full Text Available A 14-year-old autistic boy presented with acute gastroenteritis and hypotension. The electrocardiogram showed a ventricular fibrillation rhythm - he went into cardiorespiratory arrest and was immediately resuscitated. On investigation, the electrocardiogram showed a partial right bundle branch block with a "coved" pattern of ST elevation in leads v 1 -v 3 . A provisional diagnosis of Brugada syndrome was made, for which an automated implantable cardioverter defibrillator (AICD implantation was advised. Although the automated implantable cardioverter defibrillator implantation is usually performed under sedation, because this was an autistic child, he needed general anaesthesia. We performed the procedure uneventfully under general anaesthesia and he was discharged after a short hospital stay.

  14. 62. Gap in the application of implantable defibrillator and cardiac resynchronization therapy guidelines in heart failure patients

    OpenAIRE

    A. Hersi; A. Al Hammad; T. Al Doheyan; D. Al Munif; J. Alaskar; A. Haifa

    2016-01-01

    Literature review revealed no studies were done regarding the application of implantable defibrillator and cardiac resynchronization therapy guidelines in Saudi Arabia. Therefore, our aim was to identify the gap in the application of the guidelines for acute on chronic systolic heart failure patients in Saudi Arabia. Design and setting: We used data from the heart function assessment registry trial in Saudi Arabia (HEARTS) to explore the rate of device implantation. In consecutive cohort a...

  15. Effect of age on survival and causes of death after primary prevention implantable cardioverter-defibrillator implantation.

    Science.gov (United States)

    Fauchier, Laurent; Marijon, Eloi; Defaye, Pascal; Piot, Olivier; Sadoul, Nicolas; Perier, Marie-Cecile; Gras, Daniel; Klug, Didier; Algalarrondo, Vincent; Bordachar, Pierre; Deharo, Jean-Claude; Leclercq, Christophe; Babuty, Dominique; Boveda, Serge

    2015-05-15

    The benefit of implantable cardioverter-defibrillators (ICDs) remains controversial in elderly patients and may be attenuated by a greater risk of nonarrhythmic death. We examined the effect of age on outcomes after prophylactic ICD implantation. All patients with coronary artery disease or dilated cardiomyopathy implanted with an ICD for primary prevention of sudden cardiac death in 12 French medical centers were included in a retrospective observational study. The 5,534 ICD recipients were divided according to age: 18 to 59 years (n = 2,139), 60 to 74 years (n = 2,693), and ≥75 years (n = 702). Greater prevalences of coronary artery disease and atrial fibrillation at the time of implant were observed with increasing age (both p 75 years). Proportions of cardiac deaths (55.2%, 57.6%, and 57.0%, p = 0.84), including ICD-unresponsive sudden death (9.9%, 6.0%, and 10.6%, p = 0.08), and rates of appropriate ICD therapies were similar in the 3 age groups. Older age was independently associated with a higher rate of early complications and a lower rate of inappropriate therapies. In conclusion, older patients exhibited higher global mortality after ICD implantation for primary prevention, whereas rates of sudden deaths and of appropriate device therapies were similar across age groups. PMID:25784518

  16. Rationale and design of a prospective study of the efficacy of a remote monitoring system used in implantable cardioverter defibrillator follow-up: the Lumos-T Reduces Routine Office Device Follow-Up Study (TRUST) study.

    Science.gov (United States)

    Varma, Niraj

    2007-12-01

    Increased implantable cardioverter defibrillator (ICD) implant volumes (and product advisories/recalls) pose management challenges. Most device interrogations at 3- to 6-month routine follow-up visits are "nonactionable," that is, require no clinically significant reprogramming, lead revision, or initiation or up-titration of antiarrhythmic medications. Conversely, implanted devices collect important diagnostic data (eg, atrial fibrillation onset, system integrity) that remain concealed between device interrogations. Remote monitoring may resolve some of these challenges, but has not been studied in a large-scale clinical trial. Home Monitoring (HM) uses automatic (without patient intervention) data and electrogram transmissions with rapid (automatically occur between periodic checks for compromised system integrity (battery, lead parameters, high-voltage circuitry) or arrhythmia occurrence (eg, atrial fibrillation, ventricular arrhythmia). All study patients will have a final office visit 15 months after implant. The results of TRUST may confirm the role of remote monitoring as an intensive surveillance mechanism for device management. PMID:18035071

  17. Prophylactic implantable defibrillator in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia and no prior ventricular fibrillation or sustained ventricular tachycardia.

    LENUS (Irish Health Repository)

    Corrado, Domenico

    2010-09-21

    The role of implantable cardioverter-defibrillator (ICD) in patients with arrhythmogenic right ventricular cardiomyopathy\\/dysplasia and no prior ventricular fibrillation (VF) or sustained ventricular tachycardia is an unsolved issue.

  18. Attitudes towards implantable cardioverter-defibrillator therapy: a national survey in Danish health-care professionals

    DEFF Research Database (Denmark)

    Johansen, Jens B; Mortensen, Peter T; Videbæk, Regitze;

    2011-01-01

    Aims The aim of this study was to examine health-care professionals attitudes towards implantable cardioverter-defibrillator (ICD) therapy and issues discussed with patients. Methods and results Survey of 209 health-care professionals providing specialized treatment and care of ICD patients at the......-physicians. Physicians were less likely to believe that their personal attitude towards ICD treatment has no influence on how they deal professionally with patients (27.8 vs. 43.6%; P = 0.04). Physicians and non-physicians were equally positive towards ICD therapy as primary prophylaxis in ischaemic cardiomyopathy (87...... discussing ICD treatment with candidate patients. At the same time, physicians are more aware that their attitude towards ICD treatment may influence how they deal professionally with patients compared with non-physicians....

  19. Legal and organizational aspects of remote cardiac monitoring: the example of implantable cardioverter defibrillators.

    Science.gov (United States)

    Vinck, Imgard; De Laet, Chris; Stroobandt, Serge; Van Brabandt, Hans

    2012-09-01

    The remote monitoring of implantable cardioverter defibrillators (ICDs) recently emerged as an attractive technological innovation that proved to be reasonably safe in partially replacing the in-clinic follow-ups of ICD patients with no or only mild symptoms. Apart from the fact that strong evidence about any additional clinical benefits and/or cost-efficiency are still awaited, legal and organizational hurdles remain in place, hampering any possibility for adoption of remote cardiac monitoring. This paper identifies a number of legal and organizational constraints which urgently need to be addressed. An elaboration of the specific juridical guidance for the interpretation and application of the relevant legislation is called for. PMID:22345377

  20. Gender disparities in psychological distress and quality of life among patients with an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Brouwers, Corline; van den Broek, Krista C; Denollet, Johan;

    2011-01-01

    disparities in psychological distress and QoL in ICD patients by means of a systematic review, and (2) provide recommendations for future research and clinical implications. A systematic search of the literature identified 18 studies with a sample size ≥ 100 that examined gender disparities in anxiety......A subset of patients with an implantable cardioverter defibrillator (ICD) reports psychological distress and poor quality of life (QoL). Gender is one of the factors that has been proposed to explain individual differences in these outcomes. In this viewpoint, we (1) review the evidence for gender....../depression and QoL in ICD patients (mean prevalence of women = 21%; mean age = 62 years). Our review shows that there is insufficient evidence to conclude that gender per se is a major autonomous predictor for disparities in psychological distress and QoL in ICD patients. Women had a higher prevalence of anxiety...

  1. Pacemakers and implantable cardioverter defibrillators, unknown to chest radiography: Review, complications and systematic reading

    International Nuclear Information System (INIS)

    Highlights: •Radiologists have an important function in the evaluation of these devices. •We revise their radiological appearances and possible complications. •The knowledge in normal aspects and complications is important for radiologist. •To ensure an accurate reading of the chest x-ray, we present a systematic approach. -- Abstract: Chest X-ray is the imaging technique of choice for an initial study of pacemakers and implantable cardio-defibrillators (ICD). Radiologists have an important role in the evaluation of its initial placement and in the assessment during its follow-up. For this reason, it is necessary to know not only the different existing devices and its components but also the reasons of malfunction or possible complications. The purpose of this article is to do a systematic review of the different types of pacemakers and ICD. We review their usual radiological appearances, the possible complications which might take place and its causes of malfunctioning

  2. Pacemakers and implantable cardioverter defibrillators, unknown to chest radiography: Review, complications and systematic reading

    Energy Technology Data Exchange (ETDEWEB)

    Alandete Germán, Salvador Pascual, E-mail: salaiger@gmail.com; Isarria Vidal, Santiago, E-mail: isarria@comv.es; Domingo Montañana, María Luisa, E-mail: domingo.luimon@gmail.com; De la vía Oraá, Esperanza, E-mail: esviao82@gmail.com; Vilar Samper, José, E-mail: vilarsamper@gmail.com

    2015-03-15

    Highlights: •Radiologists have an important function in the evaluation of these devices. •We revise their radiological appearances and possible complications. •The knowledge in normal aspects and complications is important for radiologist. •To ensure an accurate reading of the chest x-ray, we present a systematic approach. -- Abstract: Chest X-ray is the imaging technique of choice for an initial study of pacemakers and implantable cardio-defibrillators (ICD). Radiologists have an important role in the evaluation of its initial placement and in the assessment during its follow-up. For this reason, it is necessary to know not only the different existing devices and its components but also the reasons of malfunction or possible complications. The purpose of this article is to do a systematic review of the different types of pacemakers and ICD. We review their usual radiological appearances, the possible complications which might take place and its causes of malfunctioning.

  3. Genome-wide association of implantable cardioverter-defibrillator activation with life-threatening arrhythmias.

    Directory of Open Access Journals (Sweden)

    Sarah S Murray

    Full Text Available OBJECTIVES: To identify genetic factors that would be predictive of individuals who require an implantable cardioverter-defibrillator (ICD, we conducted a genome-wide association study among individuals with an ICD who experienced a life-threatening arrhythmia (LTA; cases vs. those who did not over at least a 3-year period (controls. BACKGROUND: Most individuals that receive implantable cardioverter-defibrillators never experience a life-threatening arrhythmia. Genetic factors may help identify who is most at risk. METHODS: Patients with an ICD and extended follow-up were recruited from 34 clinical sites with the goal of oversampling those who had experienced LTA, with a cumulative 607 cases and 297 controls included in the analysis. A total of 1,006 Caucasian patients were enrolled during a time period of 13 months. Arrhythmia status of 904 patients could be confirmed and their genomic data were included in the analysis. In this cohort, there were 704 males, 200 females, and the average age was 73.3 years. We genotyped DNA samples using the Illumina Human660 W Genotyping BeadChip and tested for association between genotype at common variants and the phenotype of having an LTA. RESULTS AND CONCLUSIONS: We did not find any associations reaching genome-wide significance, with the strongest association at chromosome 13, rs11856574 at P = 5×10⁻⁶. Loci previously implicated in phenotypes such as QT interval (measure of the time between the start of the Q wave and the end of the T wave as measured by electrocardiogram were not found to be significantly associated with having an LTA. Although powered to detect such associations, we did not find common genetic variants of large effect associated with having a LTA in those of European descent. This indicates that common gene variants cannot be used at this time to guide ICD risk-stratification. TRIAL REGISTRATION: ClinicalTrials.gov NCT00664807.

  4. Type D personality is associated with increased anxiety and depressive symptoms in patients with an implantable cardioverter defibrillator and their partners

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; van Domburg, Ron T; Theuns, Dominic A M J;

    2014-01-01

    We investigated the prevalence of anxiety and depressive symptoms in patients with an implantable cardioverter defibrillator (ICD) and their partners, and the role of personality factors and social support as determinants of distress.......We investigated the prevalence of anxiety and depressive symptoms in patients with an implantable cardioverter defibrillator (ICD) and their partners, and the role of personality factors and social support as determinants of distress....

  5. Implantable cardioverter defibrillator endocarditis caused by Klebsiella pneumoniae complicated by liver abscess and septic pulmonary embolism

    Directory of Open Access Journals (Sweden)

    Ilaria Izzo

    2013-11-01

    Full Text Available A 63-year old diabetic male patient carrying an implantable cardioverter defibrillator (ICD was hospitalized with a 7- day history of fever, notwithstanding an antibiotic therapy. The white-blood cell count was 11,000/mm3, the platelet count was 135,000/mm3 and C-reactive protein (CRP 13 mg/dL. Chest X-rays showed right infiltrates. Ceftriaxone was started. Defervescence was rapid, but CRP was still 12 mg/dL after 6 days. A trans-thoracic ecochacardiogram (TTE incidentally showed a liver hypoechoic lesion. A computed tomography scan revealed bilateral cavitated lung nodules and a large liver abscess. Klebsiella pneumoniae was isolated in blood cultures and TTE showed ICD endocarditis and a patent foramen ovalis. Levofloxacin and imipenem/cilastatin were started. The liver abscess was drained. After 30 days, the ICD was removed and re-implanted. At discharge, blood tests were within the normal range and the patient was asymptomatic. Follow up showed improvement of lung and hepatic lesions. To our knowledge, this is the second reported case of K. pneumoniae infective endocarditis with multiple septic emboli. Endocarditis should be suspected in presence of fever after the device implantation, in particular if risk factors are present.

  6. Radiation therapy in patients with cardiac pacemakers or implantable cardioverter defibrillators. Interdisciplinary safety recommendations

    International Nuclear Information System (INIS)

    Background: With increasing numbers of implanted pacemakers and implantable cardioverter defibrillators (ICD) and a rising incidence of malignant tumors, there is a growing probability of radiation-mediated device dysfunction. The only guidelines for the management of patients with cardiac pacemakers in the case of radiation therapy were published in 1994 and have not been updated since then. Based on the current evidence and modern device technology, the present paper aims to develop contemporary and interdisciplinary safety recommendations for the minimization of patient risk. Methods and results: A systematic literature research was carried out including the most relevant medical electronic databases. The search yielded 147 articles published between 1994 and 2012 of which 45 met the selection criteria and of these studies 34 presented primary data (9 in vitro and 25 in vivo studies). The impact of ionizing radiation varied significantly between implanted devices and ranged from no functional changes to complete loss of function. Important device dysfunctions included changes in sensing capability, altered pacing pulses or rate, changed or disabled tachyarrhythmia ICD therapies, early battery depletion and loss of telemetry. Modern pacemakers and ICDs are more sensitive to radiation than older models. Potentially life-threatening complications were observed after exposure of the pulse generator to comparatively low radiation doses (0.11 Gy). Conclusions: Practical recommendations for patient management and safety are presented that can be readily adopted by any institution carrying out radiation therapy. (orig.)

  7. Cost-Effectiveness of Adding Cardiac Resynchronization Therapy to an Implantable Cardioverter-Defibrillator Among Patients With Mild Heart Failure

    DEFF Research Database (Denmark)

    Woo, Christopher Y; Strandberg, Erika J; Schmiegelow, Michelle D;

    2015-01-01

    -defibrillator (ICD) alone among patients with left ventricular systolic dysfunction, prolonged intraventricular conduction, and mild heart failure. DESIGN: Markov decision model. DATA SOURCES: Clinical trials, clinical registries, claims data from Centers for Medicare & Medicaid Services, and Centers for Disease......BACKGROUND: Cardiac resynchronization therapy (CRT) reduces mortality and heart failure hospitalizations in patients with mild heart failure. OBJECTIVE: To estimate the cost-effectiveness of adding CRT to an implantable cardioverter-defibrillator (CRT-D) compared with implantable cardioverter...... Control and Prevention life tables. TARGET POPULATION: Patients aged 65 years or older with a left ventricular ejection fraction (LVEF) of 30% or less, QRS duration of 120 milliseconds or more, and New York Heart Association (NYHA) class I or II symptoms. TIME HORIZON: Lifetime. PERSPECTIVE: Societal...

  8. Cost Effectiveness of Implantable Cardioverter Defibrillator Therapy versus Drug Therapy for Patients at High Risk of Sudden Cardiac Death

    OpenAIRE

    Spath, Marian A.; Bernie J. O'Brien

    2002-01-01

    The implantable cardioverter defibrillator (ICD) is a therapy for patients at risk of sudden cardiac death due to ventricular tachycardia (VT) or ventricular fibrillation (VF). But the apparent high cost of ICD therapy relative to antiarrhythmic drugs such as amiodarone has raised questions about the cost effectiveness of ICD therapy versus drug therapy. To inform this debate we reviewed the literature on ICD cost effectiveness. An electronic and manual search was conducted for articles publi...

  9. Remote monitoring of implantable cardioverter-defibrillators. Problems and implications using a telemonitoring system.

    Science.gov (United States)

    Siebermair, J; Clauss, S; Martens, E; Schuessler, F; Oversohl, N; Haserueck, N; Estner, H L; Kääb, S; Wakili, R

    2015-04-01

    The rising number of implantable devices has led to an increase in device-related workload, e.g., regular interrogation follow-up visits. Telemonitoring systems for implantable cardioverter-defibrillators (ICDs) seem to be a promising tool for reducing workload and costs, and they have the potential of optimizing patient care. However, issues such as practical functionality of ICD telemonitoring in daily routine may affect its broad implementation. The objective of this study was to evaluate potential problems during the implementation of a telemonitoring system, Medtronic CareLink™ (CL™) with respect to the installation and data transmission process. A total of 159 patients with ICDs who were equipped with the CL™ system were evaluated and followed up for 16 months regarding the success rate of the first data transmission via the telemonitoring system. In this cohort, a high rate of nontransmission of 23.9 % was observed after the 16-month follow-up. A detailed interview of these patients (no transmission) revealed that the main reasons for failed transmissions were due to the patients' loss of interest in the concept (approximately 50 %) as well as technical problems (approximately 25 %) with setting up the system. These results indicate that telemonitoring systems bear potential problems and that the evaluation of patient motivation and technical support options seems to play an important role in establishing the functionality of these systems. PMID:24848864

  10. Radiotherapy in patients with pacemakers and implantable cardioverter defibrillators: a literature review.

    Science.gov (United States)

    Zaremba, Tomas; Jakobsen, Annette Ross; Søgaard, Mette; Thøgersen, Anna Margrethe; Riahi, Sam

    2016-04-01

    An increasing number of patients with implantable cardiac rhythm devices undergo radiotherapy (RT) for cancer and are thereby exposed to the risk of device failure. Current safety recommendations seem to have limitations by not accounting for the risk of pacemakers and implantable cardioverter defibrillators malfunctioning at low radiation doses. Besides scant knowledge about optimal safety measures, only little is known about the exact prevalence of patients with devices undergoing RT. In this review, we provide a short overview of the principles of RT and present the current evidence on the predictors and mechanisms of device malfunctions during RT. We also summarize practical recommendations from recent publications and from the industry. Strongly associated with beam energy of photon RT, device malfunctions occur at ∼3% of RT courses, posing a substantial issue in clinical practice. Malfunctions described in the literature typically consist of transient software disturbances and only seldom manifest as a permanent damage of the device. Through close cooperation between cardiologists and oncologists, a tailored individualized approach might be necessary in this patient group in waiting time for updated international guidelines in the field. PMID:26041870

  11. The implantable defibrillator and antiarrhythmic drugs--competitive and complementary treatment for severe ventricular arrhythmia.

    Science.gov (United States)

    Dorian, P; Newman, D

    1993-11-01

    Most patients with a history of sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) are at high risk of recurrence. Implanted defibrillators (ICDs) are highly effective in sensing and converting VT or VF to a perfusing rhythm. "Conventional" antiarrhythmic agents, which primarily block cardiac sodium channels, are relatively ineffective in preventing arrhythmia recurrence; amiodarone and sotalol appear to be effective in reducing recurrence and mortality rates, although the extent of benefit is not well understood. Despite the apparent advantage of ICDs, they have short- and long-term complications, are costly, and their benefit in prolonging the quantity or quality of life remains unproven. Randomized clinical trials which compare the effect of ICDs with that of antiarrhythmic drugs on mortality, cost, and quality of life will be necessary to understand how patients with malignant arrhythmias ought to be treated. If an ICD is implanted, adjunctive therapies need to be considered to treat the underlying heart disease and to derive optimum benefit from the device. Drugs may have beneficial or adverse interactions with devices, and the full understanding of these interactions requires further study. PMID:8269662

  12. Longitudinal changes in intracardiac repolarization lability in patients with implantable cardioverter-defibrillator

    Directory of Open Access Journals (Sweden)

    Abhilash eGuduru

    2013-08-01

    Full Text Available Background─While it is known that elevated baseline intracardiac repolarization lability is associated with the risk of fast ventricular tachycardia (FVT /ventricular fibrillation (VF, the effect of its longitudinal changes on the risk of FVT/VF is unknown. Methods and Results─Near-field (NF right ventricular (RV intracardiac electrograms (EGMs were recorded every 3-6 months at rest in 248 patients with structural heart disease (mean age 61.2±13.3; 185[75%] male; 162[65.3%] ischemic cardiomyopathy and implanted cardioverter-defibrillator (ICD or cardiac resynchronization therapy defibrillator (CRT-D [201 (81% primary prevention]. Intracardiac beat-to-beat QT variability index (QTVINF was measured on NF RV EGM. During the first study phase (median 18 months, participants made on average 2.4 visits. Then remote follow-up was continued for an additional median period of 3 years. Average QTVINF did not change during the first year after ICD implantation (-0.342±0.603 at baseline vs. -0.262±0.552 at 6 months vs. -0.334±0.603 at 12 months; however, it decreased thereafter (-0.510±0.603 at 18 months; P=0.042. Adjusted population-averaged GEE model showed that the odds of developing FVT/VF increased by 75% for each 1 unit increase in QTVINF. (OR 1.75 [95%CI 1.05-2.92]; P=0.031. However, individual patient–specific QTVINF trends (increasing, decreasing, flat varied from patient to patient. For a given patient, the odds of developing FVT/VF were not associated with increasing or decreasing QTVINF over time (OR 1.27; [95%CI 0.05–30.10]; P = 0.881.Conclusion─While on average the odds of FVT/VF increased with an increase in QTVINF, patient-specific longitudinal trends in QTVINF did not affect the odds of FVT/VF.

  13. 基于DSP的体外自动除颤仪研究%Research on Automatic External Defibrillator Based on DSP

    Institute of Scientific and Technical Information of China (English)

    景军; 丁景艳; 张玮; 洪文学

    2012-01-01

    Electrical defibrillation is the most effective way to treat the ventricular tachycardia (VT) and ventricular fibrillation (VF). An automatic external defibrillator based on DSP is introduced in this paper. The whole design consists of the signal collection module, the microprocessor controlingl module, the display module, the defibrillation module and the automatic recognition algorithm for VF and non VF, etc. This automatic external defibrillator has a-chieved goals such as ECG signal real-time acquisition, ECG wave synchronous display, data deliivering to U disk and automatic defibrillate when shockable rhythm appears, etc.%电击除颤是治疗室速(VT)和室颤(VF)的最有效的方法.本文提出了一种基于DSP的体外自动除颤仪设计方案,整个设计包括了信号采集模块、微处理器控制模块、显示模块、除颤模块及R波检测和VF与非VF自动识别算法等.本文设计的自动除颤仪实现了心电(ECG)数据实时采集、ECG波形同步显示、数据U盘导出、出现可电击复律心率时自动进行除颤等功能.

  14. A new transvenous internal cardioverter-defibrillator: implantation technique, complications, and short-term follow-up.

    Science.gov (United States)

    Jordaens, L; Vertongen, P; Provenier, F; Trouerbach, J W; Poelaert, J; Herregods, L

    1995-02-01

    Twenty-four patients with ventricular fibrillation or sustained ventricular tachycardia underwent implantation of a new transvenous defibrillator. All patients had a device implanted without thoracotomy. High placement of a shock lead in the anonymous vein and inversion of the shock-wave polarity allowed avoidance of placement of subcutaneous patches. Implantation time decreased from 138 minutes for the first 12 patients to 82 minutes for the last 12 patients, with 4 and 11 subpectoral pockets, respectively. Three patients required a minor reintervention. No bleeding or infection occurred. One episode of pulmonary edema and one pulmonary embolism were seen in the postoperative course. No postoperative deaths were observed. During a mean follow-up period of 4.12 months, 58% of the 24 patients had symptomatic arrhythmic episodes, with shocks in 50% of the 24. Inappropriate shocks were delivered in three cases (atrial fibrillation and T-wave sensing). One episode was not terminated even with four internal shocks. One patient had ventricular fibrillation because of a sensing problem. By reprogramming of sensitivity, back-up pacing, and adjustment of drug therapy these arrhythmic complications could be prevented. Pectoral implantation of a cardioverter-defibrillator is easy and can be performed by cardiologists experienced in pacemaker implantation. Careful postoperative observation, reprogramming after the first spontaneous event, and prehospital discharge induction of ventricular fibrillation will prevent arrhythmic complications. PMID:7832096

  15. No Electromagnetic Interference Occurred in a Patient with a HeartMate II Left Ventricular Assist System and a Subcutaneous Implantable Cardioverter-Defibrillator

    OpenAIRE

    Raman, Ajay Sundara; Shabari, Farshad Raissi; Kar, Biswajit; Loyalka, Pranav; Hariharan, Ramesh

    2016-01-01

    The use of subcutaneous implantable cardioverter-defibrillators is a novel option for preventing arrhythmia-mediated cardiac death in patients who are at risk of endovascular-device infection or in whom venous access is difficult. However, the potential for electromagnetic interference between subcutaneous defibrillators and left ventricular assist devices is largely unknown. We report the case of a 24-year-old man in whom we observed no electromagnetic interference between a subcutaneous imp...

  16. Sleep, Psychosocial Functioning, and Device-Specific Adjustment in Patients with Implantable Cardioverter Defibrillators (ICDs).

    Science.gov (United States)

    McCrae, Christina S; Roth, Alicia J; Ford, Jessica; Crew, Earl C; Conti, Jamie B; Berry, Richard B; Sears, Samuel F

    2016-01-01

    Rates of sleep disorders and associated adjustment were examined in patients with implantable cardioverter defibrillators (ICDs; n = 42; Mage = 61.57, SD = 12.60). One night of ambulatory polysomnography, 14 days of sleep diaries, and questionnaires (mood, sleepiness, fatigue, device acceptance) were administered. Controlling for ischemia, MANCOVA examined adjustment by sleep diagnosis. Apnea was most common (28.6%), followed by Insomnia (16.7%) and Comorbid Insomnia/Apnea (11.9%). Patients with insomnia reported poorer mood, greater sleepiness, and lower device acceptance than good sleepers; they also demonstrated poorer mood and less ICD device acceptance than patients with sleep apnea. Patients with comorbid insomnia/apnea also exhibited poorer mood and less ICD device acceptance than good sleepers; however, comorbid patients did not significantly differ from insomnia or apnea patients on any measure. Those with disordered sleep (regardless of type) reported greater fatigue than good sleepers. Assessment (and treatment) of difficulties with sleep, mood, fatigue, and device acceptance may be important for the comprehensive clinical management of ICD patients. Further research appears warranted. PMID:25174823

  17. A trial design for evaluation of empiric programming of implantable cardioverter defibrillators to improve patient management

    Directory of Open Access Journals (Sweden)

    Morgan John M

    2004-11-01

    Full Text Available Abstract The delivery of implantable cardioverter defibrillator (ICD therapy is sophisticated and requires the programming of over 100 settings. Physicians tailor these settings with the intention of optimizing ICD therapeutic efficacy, but the usefulness of this approach has not been studied and is unknown. Empiric programming of settings such as anti-tachycardia pacing (ATP has been demonstrated to be effective, but an empiric approach to programming all VT/VF detection and therapy settings has not been studied. A single standardized empiric programming regimen was developed based on key strategies with the intention of restricting shock delivery to circumstances when it is the only effective and appropriate therapy. The EMPIRIC trial is a worldwide, multi-center, prospective, one-to-one randomized comparison of empiric to physician tailored programming for VT/VF detection and therapy in a broad group of about 900 dual chamber ICD patients. The trial will provide a better understanding of how particular programming strategies impact the quantity of shocks delivered and facilitate optimization of complex ICD programming.

  18. Arrhythmia Management in the Elderly-Implanted Cardioverter Defibrillators and Prevention of Sudden Death.

    Science.gov (United States)

    Manian, Usha; Gula, Lorne J

    2016-09-01

    We present an overview of arrhythmia management in elderly patients as it pertains to implantable cardioverter defibrillator (ICD) therapy and prevention of sudden death. Treatment of arrhythmia in elderly patients is fraught with challenges pertaining to goals of care and patient frailty. With an ever increasing amount of technology available, realistic expectations of therapy need to balance quality and quantity of life. The ICD is an important treatment option for selected patients at risk of ventricular arrhythmia and sudden cardiac death. However, the incidence of sudden death as a percentage of all-cause mortality decreases with age. Studies have reported that 20% of elderly patients might die within 1 year of an episode of life-threatening ventricular arrhythmia, but most because of nonarrhythmic causes. This illustrates the 'sudden cardiac death paradox,' with a great proportion of death in elderly patients, even those at risk for ventricular arrhythmias, attributable to medical conditions that cannot be addressed by an ICD. We discuss current practices in ICD therapy in elderly patients, existing evidence from registries and clinical trials, approaches to risk stratification, and important ethical considerations. Although the decision on whether ICD insertion is appropriate in the elderly population remains an area of uncertainty from an evidence-based and ethical perspective, we offer insight on potential clinical and research strategies for this growing population. PMID:27568872

  19. Lithium-manganese dioxide cells for implantable defibrillator devices-Discharge voltage models

    Science.gov (United States)

    Root, Michael J.

    The discharge potential behavior of lithium-manganese dioxide cells designed for implantable cardiac defibrillators was characterized as a function of extent of cell depletion for tests designed to discharge the cells for times between 1 and 7 years. The discharge potential curves may be separated into two segments from 0 ≤ x ≤ ∼0.51 and ∼0.51 ≤ x ≤ 1.00, where x is the dimensionless extent of discharge referenced to the rated cell capacity. The discharge potentials conform to Tafel kinetics in each segment. This behavior allows the discharge potential curves to be predicted for an arbitrary discharge load and long term discharge performance may be predicted from short term test results. The discharge potentials may subsequently be modeled by fitting the discharge curves to empirical functions like polynomials and Padé approximants. A function based on the Nernst equation that includes a term accounting for nonideal interactions between lithium ions and the cathode host material, such as the Redlich-Kister relationship, also may be used to predict discharge behavior.

  20. Lithium-manganese dioxide cells for implantable defibrillator devices - Discharge voltage models

    Energy Technology Data Exchange (ETDEWEB)

    Root, Michael J. [Cardiac Rhythm Management Research and Development, Boston Scientific Corp., 4100 Hamline Ave. N., St. Paul, MN 55112 (United States)

    2010-08-01

    The discharge potential behavior of lithium-manganese dioxide cells designed for implantable cardiac defibrillators was characterized as a function of extent of cell depletion for tests designed to discharge the cells for times between 1 and 7 years. The discharge potential curves may be separated into two segments from 0 {<=} x {<=} {proportional_to}0.51 and {proportional_to}0.51 {<=} x {<=} 1.00, where x is the dimensionless extent of discharge referenced to the rated cell capacity. The discharge potentials conform to Tafel kinetics in each segment. This behavior allows the discharge potential curves to be predicted for an arbitrary discharge load and long term discharge performance may be predicted from short term test results. The discharge potentials may subsequently be modeled by fitting the discharge curves to empirical functions like polynomials and Pade approximants. A function based on the Nernst equation that includes a term accounting for nonideal interactions between lithium ions and the cathode host material, such as the Redlich-Kister relationship, also may be used to predict discharge behavior. (author)

  1. Pacemaker, implanted cardiac defibrillator and irradiation: Management proposal in 2010 depending on the type of cardiac stimulator and prognosis and location of cancer

    International Nuclear Information System (INIS)

    Ionizing radiation may interfere with electric components of pacemakers or implantable cardioverter defibrillators. The type, severity and extent of radiation damage to pacemakers, have previously been shown to depend on the total dose and dose rate. Over 300,000 new cancer cases are treated yearly in France, among which 60% are irradiated in the course of their disease. One among 400 of these patients has an implanted pacemaker or defibrillator. The incidence of pacemaker and implanted cardioverter defibrillator increases in an ageing population. The oncologic prognosis must be weighted against the cardiologic prognosis in a multidisciplinary and transversal setting. Innovative irradiation techniques and technological sophistications of pacemakers and implantable cardioverter-defibrillators (with the introduction of more radiosensitive complementary metal-oxide-semiconductors since 1970) have potentially changed the tolerance profiles. This review of the literature studied the geometric, dosimetric and radiobiological characteristics of the radiation beams for high energy photons, stereotactic irradiation, proton-therapy. Standardized protocols and radiotherapy optimization (particle, treatment fields, energy) are advisable in order to improve patient management during radiotherapy and prolonged monitoring is necessary following radiation therapy. The dose received at the pacemaker/heart should be calculated. The threshold for the cumulated dose to the pacemaker/implantable cardioverter-defibrillator (2 to 5 Gy depending on the brand), the necessity to remove/displace the device based on the dose-volume histogram on dosimetry, as well as the use of lead shielding and magnet are discussed. (authors)

  2. 埋藏式心脏转复除颤器植入术中除颤阈值测试的管理%Management of defibrillation threshold test in the implantation of implantable cardioverter defibrillator

    Institute of Scientific and Technical Information of China (English)

    周燕; 王玉如; 翟大玲; 徐金凤; 胡玉芳; 陈桂花; 何英; 殷雪梅

    2013-01-01

    目的 探讨埋藏式心脏转复除颤器(ICD)植入术中除颤阈值(DFT)测试过程中的监护与管理要点,降低测试过程中的并发症发生率.方法 回顾性分析50例植入ICD患者术中DFT测试与管理的过程,观察在规范化监护和管理下并发症的发生率.结果 50例患者植入手术过程顺利.1例患者在测试中首次除颤未成功,第2次予最大能量除颤成功;1例在行DFT测试后出现持续低血压和低血氧状态,通过及时应用升压药和增大给氧流量后恢复;1例患者诱发室颤未成功,放弃DFT测试,给予经验性能量设置.术后所有患者生命体征平稳,无手术相关重大并发症发生.结论 ICD除颤阈值测试的过程中,有出现持续低血压、低血氧和除颤阈值偏高等情况的可能,全面、有效的监护管理能显著降低DFT测试中的风险.%Objective To explore the guardianship and management points of defibrillation threshold test(DFT) in the implantation of implantable cardioverter defibrillator (ICD). Methods Test and management procedures of DFT in 50 patients with ICD implantation were analyzed retrospectively. Incidence rate of complications was observed under the standardized guardianship and management. Results All the patients had successful operations. One patient failed in the first defibrillation, and then had successful defibrillation with a maximum energy in second time. One patient had persistent hypotension and hypoxemia after DFT, which were corrected after application of pressor agent and increasing of oxygen flow. One patient received empirical energy setting instead of DFT because of ventricular fibrillation. After the operation, all the patients'vital signs were stable, and no one had severe operation- related complications. Conclusion Persistent hypotension, hypoxemia and high defibrillation threshold may occur in process of DFT, and comprehensive and effective management and guardianship can significantly reduce the

  3. Long-Term Performance of the Riata/ST Implantable Cardioverter-Defibrillator Lead.

    Science.gov (United States)

    Ströker, Erwin; de Asmundis, Carlo; Vanduynhoven, Philippe; De Vadder, Katrien; De Vusser, Philip; Mullens, Wilfried; Chierchia, Gian-Battista; Brugada, Pedro; Czapla, Jens; La Meir, Mark; Wellens, Francis; Van Herendael, Hugo; Rivero-Ayerza, Maximo

    2016-03-01

    Riata and Riata ST implantable cardioverter-defibrillator leads are prone to structural and electrical failure (EF). Our objective was to evaluate Riata/ST lead performance over a long-term follow-up. Of 184 patients having undergone Riata/ST and Riata ST Optim lead implantation from September 2003 to June 2008, 154 patients were evaluated for EF and radiographic conductor externalization (CE). Survival analysis for EF was performed for Riata/ST leads, both for failure-free lead survival and cumulative hazard. Subanalysis on 7Fr leads was performed to evaluate EF and CE rates both for different Riata ST lead management (monitoring vs proactive) and between Riata ST and Riata ST Optim leads. During a mean follow-up of 7 years, Riata/ST lead EF rate was 13% overall. Similar failure-free survival rate was noted for 7Fr as for 8Fr leads (log-rank, p = 0.63). Of all failed leads, 64% failed only after 5 years of follow-up. Compared with the absolute failure rate of 1.84% per device year, cumulative hazard analysis for leads surviving past 5 years revealed an estimated failure rate of 7% per year. No clinical or procedural predictors for EF were found. The subanalysis on 7Fr leads showed an excellent outcome both for a proactive lead management approach as for Optim leads. In conclusion, long-term survival of the Riata/ST lead is impaired with an accelerating EF risk over time. An initial exponential trend was followed by a linear lead failure pattern for leads surviving past 5 years, corresponding to an estimated 7% annual EF rate. These findings may have repercussions on the lead management strategy in patients currently surviving with a Riata/ST lead to prevent significant clinical events like inappropriate shocks or failed device interventions. PMID:26762730

  4. Pearls and perils of an implantable defibrillator trial using a common control: implications for the design of future studies

    Directory of Open Access Journals (Sweden)

    Hallstrom Alfred P

    2008-05-01

    Full Text Available Abstract Aims Implantable defibrillators are considered life-saving therapy in heart failure (CHF patients. Surprisingly, the recent Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT reached an opposing conclusion from that of numerous other trials about their survival benefit in patients with advanced CHF. A critical analysis of common control trial design may explain this paradoxical finding, with important implications for future studies. Methods and Results Common control trials compare several intervention groups to a single rather than separate control groups. Though potentially requiring fewer patients than trials using separate controls, variation in the common control group will influence all comparisons and creates correlations between findings. During subgroup analyses, this dependency of outcomes may increase belief in the presence of a real subgroup effect when, in fact, it should increase skepticism. For example, a high (r = 0.92, statistically unlikely (p = 0.052 correlation between comparisons was observed across the subgroups reported in SCD-HeFT. Such concordance between amiodarone and a defibrillator across subgroups was unexpected, given how much the effects of these treatments significantly differed from one another in the main study. This suggests the study's subgroup findings (specifically the absence of benefit from defibrillators in advanced CHF were not necessarily a consequence of treatment; more likely, they resulted from variation in what the treatments were compared against, the common control. Conclusion Common control trials can be more efficient than other designs, but induce dependence between treatment comparisons and require cautious interpretation.

  5. Implantable Defibrillators Improve Survival in Patients With Mildly Symptomatic Heart Failure Receiving Cardiac Resynchronization Therapy

    DEFF Research Database (Denmark)

    Gold, Michael R; Daubert, Jean-Claude; Abraham, William T;

    2013-01-01

    Cardiac resynchronization therapy (CRT) decreases mortality, improves functional status, and induces reverse left ventricular remodeling in selected populations with heart failure. These benefits have been noted with both CRT-pacemakers as well as those devices with defibrillator backup (CRT...

  6. In vitro assessment of the immunity of implantable cardioverter-defibrillators to magnetic fields of 50/60 Hz

    International Nuclear Information System (INIS)

    Public concern for the compatibility of electromagnetic (EM) sources with active implantable medical devices (AIMD) has prompted the development of new systems that can perform accurate exposure studies. EM field interference with active cardiac implants (e.g. implantable cardioverter-defibrillators (ICDs)) can be critical. This paper describes a magnetic field (MF) exposure system and the method developed for testing the immunity of ICD to continuous-wave MFs. The MFs were created by Helmholtz coils, housed in a Faraday cage. The coils were able to produce highly uniform MFs up to 4000 µT at 50 Hz and 3900 µT at 60 Hz, within the test space. Four ICDs were tested. No dysfunctions were found in the generated MFs. These results confirm that the tested ICDs were immune to low frequency MFs. (paper)

  7. 12. Physicians’ knowledge and attitudes in Saudi Arabia regarding implantable cardioverter-defibrillators and cardiac resynchronization therapy

    Directory of Open Access Journals (Sweden)

    A. Aljasser

    2016-07-01

    Full Text Available Information is limited regarding the knowledge and attitudes of physicians in Saudi Arabia involved in the referral of patients for implantable cardioverter-defibrillator (ICD and cardiac resynchronization and defibrillation therapy (CRT-D devices implantation. As such knowledge is the key to provide the patient with an important treatment, we aimed for its assessment. We conducted personal interviews with physicians involved in treating patients with heart failure. We included all hospitals in Riyadh region that has no cardiac electrophysiology service. Every participant was met in person and received an oral questionnaire that aims to assess basic knowledge about ICD and CRT.63 physicians were met from 13 hospitals (14 consultants and 49 specialist. 41% of participants use ⩽35% as the LVEF criterion for ICD referral in patients with cardiomyopathy. 30% of participants use ⩽35% as the LVEF criterion for CRT referral. 24% of participants were not aware about CRT as a therapy for patients with heart failure. 50% of the consultants use ⩽35% for ICD and CRT referral. 70% of the participants think that ICD may improve heart failure symptoms. 45% of participants who were about CRT do not think that CRT-D may prevent sudden death due to arrhythmia.There is a lack of knowledge with current clinical guidelines regarding ICD and CRT implantation. This finding highlights the need to improve the dissemination of guidelines to practitioners involved in managing patients with heart failure in an effort to improve ICD and CRT utilization.

  8. Cognitive behavioral therapy (CBT in a Patient with Implantable Cardioverter Defibrillator (ICD and Posttraumatic stress disorder(PTSD.

    Directory of Open Access Journals (Sweden)

    Sahar Ansari

    2014-09-01

    Full Text Available The implantable cardioverter defibrillator (ICD has currently become the standard treatment for preventing sudden cardiac death. There are some psychological consequences in patients with ICD such as posttraumatic stress disorder (PTSD after the shocks induced by ICD. This report aimed to present the case of a 54-year-old man with ICD who had developed PTSD; his PTSD was treated, using cognitive-behavioral psychotherapy consisting of relaxation, mindfulness and problem solving techniques. In patients with ICD who are experiencing PTSD using cognitive behavioral interventions may be helpful to reduce their psychological sufferings.

  9. Implante de cardio-desfibrilador em gestantes com cardiomiopatia hipertrófica Implantable cardioverter-defibrillator in pregnant women with hypertrophic cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Leonardo Jorge Cordeiro de Paula

    2010-09-01

    Full Text Available Descrevemos os casos de duas gestantes portadoras de cardiomiopatia hipertrófica com alto risco de morte súbita arrítmica, que foram submetidas a implante de cardioversor-desfibrilador automático (CDI no intercurso da gestação. O momento para a realização do procedimento e os cuidados necessários para o implante do CDI durante a gestação são discutidos e foram os principais objetivos deste relato.We describe the successful implantation of a cardioverter-defibrillator (ICD in two pregnant women with hypertrophic cardiomyopathy at high risk. The indication of ICD and the necessary care for ICD implantation during pregnancy are discussed and were the main objectives of this case report.

  10. New insights into defibrillation of the heart from realistic simulation studies

    OpenAIRE

    Trayanova, Natalia A.; Rantner, Lukas J.

    2014-01-01

    Cardiac defibrillation, as accomplished nowadays by automatic, implantable devices, constitutes the most important means of combating sudden cardiac death. Advancing our understanding towards a full appreciation of the mechanisms by which a shock interacts with the heart, particularly under diseased conditions, is a promising approach to achieve an optimal therapy. The aim of this article is to assess the current state-of-the-art in whole-heart defibrillation modelling, focusing on major insi...

  11. Implantable Cardioverter-Defibrillators at End of Battery Life: Opportunities for Risk (Re)-Stratification in ICD Recipients.

    Science.gov (United States)

    Merchant, Faisal M; Quest, Tammie; Leon, Angel R; El-Chami, Mikhael F

    2016-02-01

    Although implantable cardioverter-defibrillators (ICDs) are frequently viewed as a lifelong commitment in that patients are routinely scheduled for generator exchange (GE) at end of battery life, several considerations should prompt a reevaluation of risks and benefits before GE. Compared with initial ICD implant, patients receiving replacement devices are older, and have more comorbidities and shorter life expectancy, all of which may limit the benefit of ICD therapy following GE. Additionally, GE is associated with significant complications, including infection, which may increase the risk of mortality. In this paper, we review recent data regarding opportunities for risk stratification before GE, with a particular focus on those with improved left ventricular function and those who have not experienced ICD therapies during the first battery life. We also provide a broader perspective on ICD therapy, focusing on how decisions regarding GE may affect goals of care at the end of life. PMID:26821633

  12. Echokardiographie aktuell: Gelungene Implantation eines Defibrillators mit Resynchronisationsfunktion, aber dem Patienten geht es schlechter ...

    Directory of Open Access Journals (Sweden)

    Neuhold U

    2008-01-01

    Full Text Available bVorgeschichte/bbr Vor 4 Jahren fand bei dem 73-jährigen Patienten ein Vorderwandinfarkt infolge Plaqueruptur statt, damals wurde koronarangiographisch der Ausschluss einer signifikant stenosierenden KHK getroffen. Seither ist eine reduzierte Linksventrikelfunktion (LVF bekannt. Im letzten Jahr mehrfach stationäre Aufnahmen wegen kardialer Dekompensation, in diesem Zeitraum wurde die medikamentöse Herzinsuffizienztherapie, bestehend aus ACE-Hemmer und Betablocker in Maximaldosis, Spironolacton und Torasemid, optimiert. Auch Levosimendan wurde verabreicht. Der Pat. präsentiert sich jetzt überwiegend in NYHA-Stadium II–III, sodass die Indikation zur Implantation eines prophylaktischen Defibrillators (ICD gestellt wird. Bei inkomplettem Linksschenkelblock mit einer QRS-Breite von 130 msec (Abb. 1 wird echokardiographisch auch in Richtung Resynchronisation (CRT evaluiert.br bEchokardiographie präoperativ/bbr Es zeigt sich eine stark reduzierte LVF mit einer geschätzten EF von 35 % mit optisch gering vorhandener Asynchronie, sowie zusätzlicher Hypokinesie apikal und distal lateral (Abb. 2–4. Von den gemessenen Dyssynchronieparametern fand sich lediglich auf AV-Ebene ein signifikanter Wert mit einer "diastolic filling time" (dft von 38 % (Cut-off: 40 % (Abb. 5. Auf interventrikulärer Ebene war das interventrikulär- elektromechanische Delay (IVEMD mit 20 und das intraventrikuläre Delay (gemessen mittels M-Mode in der parasternalen kurzen Achse und PW-TDI in den apikalen Schnitten außerhalb des signifikanten Bereiches. Es wird somit die Indikation zur Implantation eines ICD-CRT gestellt, da nach geltender Expertenmeinung auch die Dyssynchronie auf AV-Ebene alleine ausreichend ist, um einen Benefit durch zusätzliche Resynchronisation mit höherer Wahrscheinlichkeit voraussagen zu können. In einer 2-stündigen Operation in Vollnarkose wird eine ICD-Elektrode in den Apex des rechten Ventrikels (RV geschraubt, eine steuerbare Elektrode

  13. Comorbidity burden is associated with poor psychological well-being and physical health status in patients with an implantable cardioverter-defibrillator

    DEFF Research Database (Denmark)

    Hoogwegt, Madelein T; Kupper, Nina; Jordaens, Luc;

    2013-01-01

    Comorbidity burden has been linked to survival in patients with an implantable cardioverter-defibrillator (ICD), but no study has examined the influence on psychological well-being and health status. We examined the relationship between comorbidity burden and anxiety, depression, and health status...

  14. The distressed (Type D) personality in both patients and partners enhances the risk of emotional distress in patients with an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    van den Broek, Krista C; Versteeg, Henneke; Erdman, Ruud A M;

    2011-01-01

    A subgroup of patients with an implantable cardioverter defibrillator (ICD) experiences emotional distress. This may be related to partner factors. We examined the impact of the personality of the partner (i.e., the distressed (Type D) personality) in combination with that of the patient on anxiety...

  15. Cost-effectiveness of implantable defibrillator as first-choice therapy versus electrophysiologically guided, tiered strategy in postinfarct sudden death survivors - A randomized study

    NARCIS (Netherlands)

    Hauer, RNW; Schrijvers, G; vanCapelle, FJL; Tijssen, JGP; Crijns, HJGM; Algra, A; Ramanna, H; Bakker, PFA; deMedina, EOR; Wever, Eric F. D.

    1996-01-01

    Background Rising costs of health care, partly as a result of costly therapeutic innovations, are of concern to both the medical profession and healthcare authorities. The implantable cardioverter-defibrillator or (ICD) is still not remunerated by Dutch healthcare insurers. The aim of this study was

  16. Serum-Based Oxylipins Are Associated with Outcomes in Primary Prevention Implantable Cardioverter Defibrillator Patients

    Science.gov (United States)

    Zhang, Yiyi; Guallar, Eliseo; Blasco-Colmenares, Elena; Harms, Amy C.; Vreeken, Rob J.; Hankemeier, Thomas; Tomaselli, Gordon F.; Cheng, Alan

    2016-01-01

    Introduction Individuals with systolic heart failure are at risk of ventricular arrhythmias and all-cause mortality. Little is known regarding the mechanisms underlying these events. We sought to better understand if oxylipins, a diverse class of lipid metabolites derived from the oxidation of polyunsaturated fatty acids, were associated with these outcomes in recipients of primary prevention implantable cardioverter defibrillators (ICDs). Methods Among 479 individuals from the PROSE-ICD study, baseline serum were analyzed and quantitatively profiled for 35 known biologically relevant oxylipin metabolites. Associations with ICD shocks for ventricular arrhythmias and all-cause mortality were evaluated using Cox proportional hazards models. Results Six oxylipins, 17,18-DiHETE (HR = 0.83, 95% CI 0.70 to 0.99 per SD change in oxylipin level), 19,20-DiHDPA (HR = 0.79, 95% CI 0.63 to 0.98), 5,6-DiHETrE (HR = 0.73, 95% CI 0.58 to 0.91), 8,9-DiHETrE (HR = 0.76, 95% CI 0.62 to 0.95), 9,10-DiHOME (HR = 0.81, 95% CI 0.65 to 1.00), and PGF1α (HR = 1.33, 95% CI 1.04 to 1.71) were associated with the risk of appropriate ICD shock after multivariate adjustment for clinical factors. Additionally, 4 oxylipin-to-precursor ratios, 15S-HEPE / FA (20:5-ω3), 17,18-DiHETE / FA (20:5-ω3), 19,20-DiHDPA / FA (20:5-ω3), and 5S-HEPE / FA (20:5-ω3) were positively associated with the risk of all-cause mortality. Conclusion In a prospective cohort of patients with primary prevention ICDs, we identified several novel oxylipin markers that were associated with appropriate shock and mortality using metabolic profiling techniques. These findings may provide new insight into the potential biologic pathways leading to adverse events in this patient population. PMID:27281224

  17. Implantable cardioverter defibrillator therapy in pediatric and congenital heart disease patients: a single tertiary center experience in Korea

    Directory of Open Access Journals (Sweden)

    Bo Kyung Jin

    2013-03-01

    Full Text Available Purpose: The use of implantable cardioverter defibrillators (ICDs to prevent sudden cardiac death is increasing in children and adolescents. This study investigated the use of ICDs in children with congenital heart disease. Methods: This retrospective study was conducted on the clinical characteristics and effectiveness of ICD implantation at the department of pediatrics of a single tertiary center between 2007 and 2011. Results: Fifteen patients underwent ICD implantation. Their mean age at the time of implantation was 14.5±5.4 years (range, 2 to 22 years. The follow-up duration was 28.9±20.4 months. The cause of ICD implantation was cardiac arrest in 7, sustained ventricular tachycardia in 6, and syncope in 2 patients. The underlying disorders were as follows: ionic channelopathy in 6 patients (long QT type 3 in 4, catecholaminergic polymorphic ventricular tachycardia [CPVT] in 1, and J wave syndrome in 1, cardiomyopathy in 5 patients, and postoperative congenital heart disease in 4 patients. ICD coils were implanted in the pericardial space in 2 children (ages 2 and 6 years. Five patients received appropriate ICD shock therapy, and 2 patients received inappropriate shocks due to supraventricular tachycardia.During follow-up, 2 patients required lead dysfunction-related revision. One patient with CPVT suffered from an ICD storm that was resolved using sympathetic denervation surgery. Conclusion: The overall ICD outcome was acceptable in most pediatric patients. Early diagnosis and timely ICD implantation are recommended for preventing sudden death in high-risk children and patients with congenital heart disease.

  18. Embodied Revelation: A Classic Grounded Theory of Heart Failure Patient Decision Making Surrounding Primary Prevention Implantable Cardioverter Defibrillator Therapy

    Directory of Open Access Journals (Sweden)

    Vera Barton-Caro Ph.D.,

    2015-12-01

    Full Text Available The purpose of this classic grounded theory study was to explain the complex decision making process of heart failure (HF patients considering primary prevention implantable cardioverter defibrillator (ICD therapy. Sudden cardiac death (SCD is the leading cause of death for people with HF as well as the primary cause of death in the United States (US. ICDs represent the standard of care as the only effective therapy for primary prevention of SCD. However, a significant proportion of qualifying HF patients declines this invasive, yet life-saving device. The grounded theory is of Embodied revelation. The threat of SCD for ICD candidates consists of four stages: living in conscious denial, heightening of awareness, sanctioning ICD therapy, and living in new assurance. The first stage ends abruptly with the critical juncture of grasping the threat of SCD. This grounded theory has implications for research, nursing and medical practice, as well as bioethical considerations.

  19. Behandling med implanterbar defibrillator

    DEFF Research Database (Denmark)

    Roseva-Nielsen, Natasha G; Svendsen, Jesper Hastrup

    2003-01-01

    About 20 years ago the first patient received an implantable cardioverter defibrillator (ICD), and since then the number of implants have increased dramatically. The ICD can terminate ventricular fibrillation and ventricular tachycardia. Studies of secondary prophylaxis show that ICD treatment can...

  20. A meta-analysis of mortality in end-stage renal disease patients receiving implantable cardioverter defibrillators (ICDs.

    Directory of Open Access Journals (Sweden)

    Tien-Hsing Chen

    Full Text Available Data on the effectiveness of implantable implantable cardioverter defibrillators (ICDs with respect to reducing mortality in patients with chronic kidney disease (CKD and end-stage renal disease (ESRD are lacking. The purpose of this meta-analysis was to compare the mortality of patients with ESRD who have received and not received an ICD. A search was conducted on January 31, 2013 of Medline, Cochrane, EMBASE, and Google Scholar. Studies were selected for inclusion based on the following criteria. 1 Randomized controlled trial. 2 ESRD patients with heart failure. 3 Device therapy (ICD, CRT-defibrillator [CRT-D] used to treat heart failure. 4 Primary outcome is survival analysis. 5 Retrospective study if survival analysis was performed. The primary outcome was overall survival (OS, and the secondary outcome was 2-year survival. Odds ratios (ORs with 95% confidence intervals (CI were calculated, and a χ2-based test of homogeneity was performed. Three studies were included in the analysis. The combined OR for OS was 2.245 (95% CI 1.871 to 2.685, P<0.001, indicating that patients with an ICD had a significantly higher OS than those without an ICD. The combined OR for 2-year survival was 2.312 (95% CI 1.921 to 2.784, P<0.001, indicating that patients with an ICD had a significantly higher 2-year survival rate than those without an ICD. The use of ICD in patients with ESRD is associated with an increase in the OS and the 2-year survival rate.

  1. Incidence and causes of inappropriate detection and therapy by implantable defibrillators of cardioversion in patients with ventricular tachyarrhythmia

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Background Implantable cardioverter defibrillator (ICD) is the only effective therapy in patients with life threatening ventricular arrhythmias. Inappropriate detection and therapy by ICDs are the most common causes of side effects that affect the quality of life in ICD recipients. This study evaluated the incidence and causes of inappropriate detection and therapy by ICDs in patients in our hospital.Methods From January 2000 to December 2005, fifty patients who received ICD implantation for ventricular arrhythmias for prevention of sudden cardiac death were evaluated in this study. Each ICD was programmed using clinical arrhythmic and cardiac data of the patient before discharge. Patients were followed up by standard schedule after implantation and all data retrieved from each device were collected and saved for further analysis. Results No arrhythmic event was detected in 12/50 (24%) patients during the period of follow-up. Among the remaining patients, 11 (22%) experienced inappropriate detections and therapies during follow-up in this study. ICD detected 383 ventricular tachyarrhythmia (VT) and 108 ventricular fibrillation (VF) episodes and delivered 678 therapies. In VT group, ICD delivered 413 antitachycardiac pacings (ATPs) and 118 shocks, among which 78 ATPs and 9 shocks were initiated by 55/383 (14.3%) inappropriate detections. In VF group ICD delivered 147 shocks, among which 56 shocks were initiated by 28/108 (26.9%) inappropriate detections. Overall, more than 50% of these episodes were caused by atrial fibrillation (AF) with rapid ventricular response, followed by electromagnetic or myopotential interference. In addition, most inappropriate therapies occurred within one year after ICD implantation.Conclusions About one fifth of patients experienced ICD inappropriate detection and therapy after implantation. The main cause was AF with rapid ventricular response, followed by electromagnetic or myopotential interference.

  2. Impact of shocks on mortality in patients with ischemic or dilated cardiomyopathy and defibrillators implanted for primary prevention.

    Directory of Open Access Journals (Sweden)

    Florian Streitner

    Full Text Available BACKGROUND: Emerging interest is seen in the paradox of defibrillator shocks for ventricular tachyarrhythmia and increased mortality risk. Particularly in patients with dilated cardiomyopathy (DCM, the prognostic importance of shocks is unclear. The purpose of this study was to compare the outcome after shocks in patients with ischemic cardiomyopathy (ICM or DCM and defibrillators (ICD implanted for primary prevention. METHODS AND RESULTS: Data of 561 patients were analyzed (mean age 68.6±10.6 years, mean left ventricular ejection fraction 28.6±7.3%. During a median follow-up of 49.3 months, occurrence of device therapies and all-cause mortality were recorded. 74 out of 561 patients (13.2% experienced ≥1 appropriate and 51 out of 561 patients (9.1% ≥1 inappropriate shock. All-cause mortality was 24.2% (136 out of 561 subjects. Appropriate shock was associated with a trend to higher mortality in the overall patient population (HR 1.48, 95% CI 0.96-2.28, log rank p = 0.072. The effect was significant in ICM patients (HR 1.61, 95% CI 1.00-2.59, log rank p = 0.049 but not in DCM patients (HR 1.03, 95% CI 0.36-2.96, log rank p = 0.96. Appropriate shocks occurring before the median follow-up revealed a much stronger impact on mortality (HR for the overall patient population 2.12, 95% CI 1.24-3.63, p = 0.005. The effect was driven by ICM patients (HR 2.48, 95% CI 1.41-4.37, p = 0.001, as appropriate shocks again did not influence survival of DCM patients (HR 0.63, 95% CI 0.083-4.75, p = 0.65. Appropriate shocks occurring after the median follow-up and inappropriate shocks occurring at any time revealed no impact on survival in any of the groups (p = ns. CONCLUSION: Appropriate shocks are associated with reduced survival in patients with ICM but not in patients with DCM and ICDs implanted for primary prevention. Furthermore, the negative effect of appropriate shocks on survival in ICM patients is only evident within the

  3. Beta-blocker therapy is not associated with symptoms of depression and anxiety in patients receiving an implantable cardioverter-defibrillator

    DEFF Research Database (Denmark)

    Hoogwegt, Madelein T; Kupper, Nina; Theuns, Dominic A M J;

    2012-01-01

    Beta-blockers are frequently prescribed to implantable cardioverter-defibrillator (ICD) patients. Beta-blocker therapy has been proposed to induce emotional distress such as depression and anxiety, but a paucity of studies has examined the relationship between beta-blockers and distress. We...... investigated the association between beta-blocker therapy, including type and dosage, and symptoms of anxiety and depression in a consecutive cohort of patients receiving an ICD....

  4. Cost-Utility Analysis of the EVOLVO Study on Remote Monitoring for Heart Failure Patients With Implantable Defibrillators: Randomized Controlled Trial

    OpenAIRE

    Zanaboni, Paolo; Landolina, Maurizio; Marzegalli, Maurizio; Lunati, Maurizio; Perego, Giovanni B; Guenzati, Giuseppe; CURNIS, ANTONIO; Valsecchi, Sergio; Borghetti, Francesca; Borghi, Gabriella; Masella, Cristina

    2013-01-01

    Background Heart failure patients with implantable defibrillators place a significant burden on health care systems. Remote monitoring allows assessment of device function and heart failure parameters, and may represent a safe, effective, and cost-saving method compared to conventional in-office follow-up. Objective We hypothesized that remote device monitoring represents a cost-effective approach. This paper summarizes the economic evaluation of the Evolution of Management Strategies of Hear...

  5. 可嵌入心电震发生器的电击系统方案%A Shocking System Solution for Implantable Cardioverter Defibrillators

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@ 可嵌入心电震发生器(Implantable Cardioverter Defibrillators-ICD)已通用几年了.ICD在连接到心脏的两个电极之间施加高压脉冲,它随时检测心脏纤维性颤动.此脉冲可高达800V,在几毫秒期间电流达几十安培.

  6. Predictors of appropriate therapy in patients with implantable cardioverter-defibrillator for primary prevention of sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Dennis W. Zhu

    2010-02-01

    Full Text Available The purpose of this study was to evaluate predictors of appropriate therapy in patients with implantable cardioverter-defibrillators (ICD for primary prevention of sudden cardiac death. A retrospective cohort of 321 patients with systolic heart failure undergoing ICD placement for primary prevention of sudden cardiac death was queried with a mean follow-up period of 2.6 years. Appropriate ICD therapy was defined as therapy delivered for termination of a ventricular tachyarrhythmia. Appropriate ICD therapy was delivered in 142 (44% of the patients. In a multivariate model, body mass index ≥28.8 kg/m2 , chronic kidney disease, left ventricular ejection fraction ≤20% and metabolic syndrome were found to be independent predictors of appropriate ICD therapy. Appropriate ICD therapy was associated with higher cardiovascular mortality. These findings show the importance of identification of risk factors, especially metabolic syndrome, in patients following ICD implantation as aggressive treatment of these co-morbidities may decrease appropriate ICD therapy and cardiovascular mortality.

  7. Analysis of implantable cardioverter-defibrillator lead failures%植入型心律转复除颤器导线故障分析

    Institute of Scientific and Technical Information of China (English)

    陈太波; 程康安; 程中伟; 范静波; 姜秀春; 方全

    2011-01-01

    目的 总结分析我院植入型心律转复除颤器( ICD)起搏除颤导线故障病例特点。方法 对2005年10月至2009年12月62例在我院新植入ICD导线患者进行随访分析,所有导线植入均以锁骨下静脉作为入路。随访中出现以下1项或多项异常考虑导线故障:(1)起搏阻抗永久性或间歇性>2000 Ω或<250 Ω;(2)除颤高压阻抗>200 Ω;(3)心内电图证实除颤导线感知非生理性高频噪声导致误放电。结果 中位数随访时间28(10 ~46)个月,4例患者(6.5%)诊断ICD导线故障,导线寿命18~38个月;临床均以ICD误放电至医院就诊,同时程控发现ICD导线起搏阻抗异常。其中l例患者放电前闻及ICD导线阻抗报警,4例患者均重新植入新的起搏感知导线。结论 ICD导线故障是一个值得重视的临床问题。ICD导线阻抗报警功能可能有助于早期发现导线故障。如程控发现仅仅除颤导线起搏阻抗异常,植入新的起搏感知导线可以作为首选的故障处理方法。%Objective The aim of the present study was to analyze the characteristics of patients with defibrillation lead failures after implantable cardioverter-defibrillator( ICD)implantation. Methods From Oct. 2005 to Dec 2009 we implanted a new defibrillation lead for 62 consecutive cases, among which all leads were implanted by puncture of the subclavian vein. A lead failure was diagnosed if one or more of the following criteria were met: ( 1 ) permanent or temporary pacing impedance increased to more than 2000 ohms or decreased to less than 200 to 250 ohms; ( 2 ) permanent or temporary high voltage impedance increased to more than 200ohms ; (3) inappropriate shock due to oversensing non-physiologic high frequence noises was documented by intracardiac electrogram. Results During the median follow-up of 28 months ( between 10 and 46 months after implantation) 4 (6. 5% )defibrillation leads failed and the leads survival time ranged

  8. Contemporary strategies for risk stratification and prevention of sudden death with the implantable defibrillator in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Maron, Barry J; Maron, Martin S

    2016-05-01

    Hypertrophic cardiomyopathy (HCM) is regarded as the most common nontraumatic cause of sudden death (SD) in young people (including trained athletes). Introduction of implantable cardioverter-defibrillators (ICD) to HCM 15 years ago represented a new paradigm for clinical practice and probably the most significant advance in management of this disease. ICDs offer protection against SD by terminating potentially lethal ventricular tachyarrhythmias (11%/year secondary and 4%/year primary prevention), although implant decisions are weighed against the possibility of device-related complications (5%/year). ICDs have altered the natural history of HCM, creating the opportunity for extended or normal longevity for many patients. However, assessing SD risk and targeting appropriate candidates for prophylactic device therapy can be compounded by unpredictability of the underlying arrhythmogenic substrate, evident by delays ≥10 years between implant and first ICD intervention. Multiple or a single strong risk marker within the clinical profile of an individual HCM patient can justify consideration for a primary-prevention ICD when combined with physician judgment and shared decision making. The role of the mathematical SD risk score proposed by the European Society of Cardiology to identify patients who benefit from ICD therapy is incompletely resolved. Contemporary treatment interventions and advanced risk stratification using ≥1 conventional markers have served the HCM patient population well, with reduced disease-related mortality rates across all age groups to <1%/year, due largely to the penetration of ICDs into HCM practice. Prevention of SD has now become an integral, albeit challenging, component of HCM management, contributing importantly to its emergence as a contemporary treatable cardiac disease. PMID:26749314

  9. The role of defibrillation testing.

    Science.gov (United States)

    Amit, Guy; Healey, Jeff S

    2015-09-01

    The induction and termination of ventricular fibrillation at the time of defibrillator insertion (defibrillation testing [DT]) has traditionally been an integral component of implantable cardioverter-defibrillator (ICD) implantation. However, over the last 10 years, published series suggested a high rate of first-shock efficacy for clinical ventricular arrhythmias, even if no DT was done. Over the same time, several published reports and series have shown uncommon but serious complications related to DT. Throughout the world, there has been a steady decline in the proportion of patients receiving an ICD who undergo DT, which, in many regions, is less than 50%. PMID:26304533

  10. Characteristics associated with low treatment satisfaction in patients with implanted cardioverter defibrillators: results from the LICAD study.

    Science.gov (United States)

    Ladwig, Karl-Heinz; Deisenhofer, Isabelle; Simon, Heidi; Schmitt, Claus; Baumert, Jens J

    2005-06-01

    The evaluation of low treatment satisfaction (LTS) with an implanted cardioverter defibrillator (ICD) remains a neglected area of clinical research. However, a trustful attitude toward an ICD is crucial. Within the scope of ICD health technology assessment, we searched for predictors of LTS. Of 195 ICD patients enrolled (mean 59.8 years, standard deviation 12.6), 163 (83.6%) were men and 26 (16.4%) were women. We measured anxiety, helplessness, and depression with standardized instruments and LTS with 11 dichotomous items concerning a mistrustful attitude, a negative body image, and low appraisal. A total of 47 (24.1%) patients were considered as LTS patients. Multivariate logistic regression was used for assessment of LTS. Adjusted for age and survey, LTS was significantly more prevalent in depressed, anxious, and phobic patients. Multivariate logistic regression including medical and psychological covariates revealed the experience of > or =5 shocks with an odds ratio (OR) of 10.17 (95% CI 3.57-29.00, P effect on LTS. Age, educational status, and depression were not significant. LTS patients required more support for living with the ICD (P < or = 0.001). Thus, LTS serves as surrogate measure for deteriorated psychic health. Clinicians should be advised to identify LTS patients and to consider psychotherapeutic counseling for them. PMID:15955182

  11. A pilot study of a mindfulness based stress reduction program in adolescents with implantable cardioverter defibrillators or pacemakers.

    Science.gov (United States)

    Freedenberg, Vicki A; Thomas, Sue A; Friedmann, Erika

    2015-04-01

    Adolescents with implantable cardioverter defibrillators (ICDs) or pacemakers (PMs) face unique challenges that can cause psychosocial distress. Psychosocial interventions are effective for adults with cardiac devices and could potentially impact adolescents' adjustment to these devices. Mindfulness Based Stress Reduction (MBSR) is a structured psycho-educational program that includes meditation, yoga, and group support and has been studied extensively among adults. This study examined the feasibility of the MBSR program for adolescents with ICDs/PMs, a population previously unexamined in the research literature. The participants completed measures of anxiety and depression (Hospital Anxiety and Depression Scale) and coping (Responses to Stress Questionnaire) at baseline and after the six-session MBSR intervention. Mean age of the cohort (n = 10) was 15 ± 3 years, 6 were male, 6 had a PM, and 4 had an ICD. Feasibility was demonstrated by successful recruitment of 10 participants, 100 % participation and completion. Anxiety decreased significantly following the intervention, with a large effect size, t[9] = 3.67, p depression (r = -.88, p = .001). Post-intervention, the group independently formed their own Facebook group and requested to continue meeting monthly. Although generalizability is limited due to the small sample size, this successful pilot study paves the way for larger studies to examine the efficacy of MBSR interventions in adolescents with high-risk cardiac diagnoses. PMID:25519914

  12. Investigation of Pt, Ti, TiN, and nano-porous carbon electrodes for implantable cardioverter-defibrillator applications

    Energy Technology Data Exchange (ETDEWEB)

    Norlin, A.; Pan, J.; Leygraf, C

    2004-09-15

    The electrochemical behavior and stability of Pt, Ti, TiN, and nano-porous carbon for implantable cardioverter-defibrillator (ICD) electrode application were investigated in a phosphate buffered saline solution. The electrochemical interfacial properties were examined by electrochemical impedance spectroscopy, and the potential and current response during ICD shock pulses were recorded by a digital oscilloscope. Changes in surface composition and structure were investigated using X-ray photoelectron spectroscopy and environmental scanning electron microscopy. When exposed to anodic 700 V shock pulses with duration of 10 ms, only Pt was stable, nano-porous carbon electrode was slightly attacked, whereas Ti and TiN electrodes suffered severe degradation. Upon cathodic shock pulsing, all the materials were stable, but Ti and TiN electrodes with a smooth surface showed evidence of hydrogen adsorption. Porous and rough electrodes produced less gas evolution compared to a smooth surfaces, due to a higher amount of charge transferred through non-Faradaic processes. The reason for this could be higher interfacial capacity due to the large surface area.

  13. Symbolic Dynamics Analysis of Short Data Sets: an Application to Heart Rate Variability from Implantable Defibrillator Devices

    Science.gov (United States)

    Zebrowski, Jan J.; Baranowski, Rafal; Przybylski, Andrzej

    2003-07-01

    A method is described for the assessment of the complexity of short data sets by nonlinear dynamics. The method was devised for and tested on human heart rate recordings approximately 2000 to 9000 RR intervals long which were extracted from the memory of implantable defibrillator devices (ICD). It is, however, applicable in a more general context. The ICDs are meant to control life-threatening episodes of ventricular tachycardia and/or ventricular fibrillation by applying a electric shock to the heart through intracardiac electrodes. It is well known that conventional ICD algorithms yield approximately 20--30 % of spurious interventions. The main aim of this work is to look for nonlinear dynamics methods to enhance the appropriateness of the ICD intervention. We first showed that nonlinear dynamics methods first applied to 24-hour heart rate variability analysis were able to detect the need for the ICD intervention. To be applicable to future ICD use, the methods must also be low in computational requirements. Methods to analyse the complexity of the short and non-stationary sets were devised. We calculated the Shannon entropy of symbolic words obtained in a sliding 50 beat window and analysed the dependence of this complexity measure on the time. Precursors were found extending much earlier time than the time the standard ICD algorithms span.

  14. The Power of Exercise-Induced T-wave Alternans to Predict Ventricular Arrhythmias in Patients with Implanted Cardiac Defibrillator

    Directory of Open Access Journals (Sweden)

    Laura Burattini

    2013-01-01

    Full Text Available The power of exercise-induced T-wave alternans (TWA to predict the occurrence of ventricular arrhythmias was evaluated in 67 patients with an implanted cardiac defibrillator (ICD. During the 4-year follow-up, electrocardiographic (ECG tracings were recorded in a bicycle ergometer test with increasing workload ranging from zero (NoWL to the patient's maximal capacity (MaxWL. After the follow-up, patients were classified as either ICD_Cases (n = 29, if developed ventricular tachycardia/fibrillation, or ICD_Controls (n = 38. TWA was quantified using our heart-rate adaptive match filter. Compared to NoWL, MaxWL was characterized by faster heart rates and higher TWA in both ICD_Cases (12-18 μ V vs. 20-39 μ V; P < 0.05 and ICD_Controls (9-15 μ V vs. 20-32 μ V; P < 0.05. Still, TWA was able to discriminate the two ICD groups during NoWL (sensitivity = 59-83%, specificity = 53-84% but not MaxWL (sensitivity = 55-69%, specificity = 39-74%. Thus, this retrospective observational case-control study suggests that TWA's predictive power for the occurrence of ventricular arrhythmias could increase at low heart rates.

  15. Cognitive-Behavioral Treatment of Posttraumatic Stress in Patients With Implantable Cardioverter Defibrillators: Results From a Randomized Controlled Trial.

    Science.gov (United States)

    Ford, Jessica; Rosman, Lindsey; Wuensch, Karl; Irvine, Jane; Sears, Samuel F

    2016-08-01

    Approximately 20% of patients with implantable cardioverter defibrillators (ICDs) suffer from posttraumatic stress disorder (PTSD) due to a history of cardiac arrest, device implantation, and ICD shock. There has been very little examination of treatment of PTSD symptoms in these patients. This study evaluated the effect of a specific cognitive-behavioral therapy (CBT) intervention for ICD patients with high levels of PTSD symptoms: a manualized program consisting of 8 telephone sessions with a trained counselor, a patient education book, and a stress management procedure on compact disc. Participants were 193 ICD patients, who were randomized to CBT or usual cardiac care (UCC) who completed self-report surveys at the time of recruitment and 6 and 12 months after initial measurement. Previous publication on the primary research evaluation questions reported that the CBT condition resulted in greater improvement on PTSD and depression symptoms than the UCC for the general population of ICD patients, but did not evaluate the effect on those with elevated symptoms of PTSD. The authors conducted secondary analyses of the effect of treatment on high and low PTSD symptom groups based on a cutoff for the Impact of Event Scale-Revised (Weiss & Marmar, 1997). Participants in the CBT group who had high symptoms experienced significantly greater symptom reduction from baseline to 12 months (d = 2.44, p = .021) than the UCC group (d = 1.12). Participants with low symptoms had small reductions regardless of group assignment (d = 0.16, p = .031). ICD-focused CBT was sufficient to produce a large, statistically significant reduction in PTSD symptoms in ICD patients with indications for treatment. PMID:27415850

  16. Interest of PET/CT with {sup 18}F-F.D.G. in the diagnosis of endocarditis on pacemaker or defibrillator to be implanted; Interet de la TEP-TDM au 18FDG dans le diagnostic d'endocardite sur pacemaker ou defibrillateur implantable

    Energy Technology Data Exchange (ETDEWEB)

    Bensimhon, L.; Hugonnet, F.; Maunoury, C.; Faraggi, M. [Hopital europeen Georges-Pompidou, Service de medecine nucleaire, 75 - Paris (France); Lavergne, T.; Leheuzey, J.Y. [Hopital europeen Georges-Pompidou, Service de cardiologie, 75 - Paris (France); Mainardi, J.L. [Hopital europeen Georges-Pompidou, Service de microbiologie, 75 - Paris (France); Latremouille, C. [Hopital europeen Georges-Pompidou, Service de chirurgie cardiovasculaire, 75 - Paris (France)

    2010-07-01

    Purpose: Infection of pacemaker device or implantable defibrillators are rare (<5%) but serious and sometimes difficult, we evaluated the interest of PET / CT with {sup 18}F-F.D.G. in the diagnosis. conclusion: PET can be useful to diagnose infection on pacemaker and implantable defibrillators. A prolonged antibiotic therapy may cause false negatives. In our series, the management could have been altered by the examination in 6 out of 21. (N.C.)

  17. Methodological limitations of psychosocial interventions in patients with an implantable cardioverter-defibrillator (ICD A systematic review

    Directory of Open Access Journals (Sweden)

    Ockene Ira S

    2009-12-01

    Full Text Available Abstract Background Despite the potentially life-saving benefits of the implantable cardioverter-defibrillator (ICD, a significant group of patients experiences emotional distress after ICD implantation. Different psychosocial interventions have been employed to improve this condition, but previous reviews have suggested that methodological issues may limit the validity of such interventions. Aim: To review the methodology of previously published studies of psychosocial interventions in ICD patients, according to CONSORT statement guidelines for non-pharmacological interventions, and provide recommendations for future research. Methods We electronically searched the PubMed, PsycInfo and Cochrane databases. To be included, studies needed to be published in a peer-reviewed journal between 1980 and 2008, to involve a human population aged 18+ years and to have an experimental design. Results Twelve studies met the eligibility criteria. Samples were generally small. Interventions were very heterogeneous; most studies used cognitive behavioural therapy (CBT and exercise programs either as unique interventions or as part of a multi-component program. Overall, studies showed a favourable effect on anxiety (6/9 and depression (4/8. CBT appeared to be the most effective intervention. There was no effect on the number of shocks and arrhythmic events, probably because studies were not powered to detect such an effect. Physical functioning improved in the three studies evaluating this outcome. Lack of information about the indication for ICD implantation (primary vs. secondary prevention, limited or no information regarding use of anti-arrhythmic (9/12 and psychotropic (10/12 treatment, lack of assessments of providers' treatment fidelity (12/12 and patients' adherence to the intervention (11/12 were the most common methodological limitations. Conclusions Overall, this review supports preliminary evidence of a positive effect of psychosocial interventions

  18. Complications after cardiac implantable electronic device implantations

    DEFF Research Database (Denmark)

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nohr, Ellen Aagaard;

    2013-01-01

    Complications after cardiac implantable electronic device (CIED) treatment, including permanent pacemakers (PMs), cardiac resynchronization therapy devices with defibrillators (CRT-Ds) or without (CRT-Ps), and implantable cardioverter defibrillators (ICDs), are associated with increased patient...

  19. Successful delivery by a cesarean section in a parturient with severe dilated cardiomyopathy, an implantable cardioverter defibrillator, and a repaired tetralogy of fallot

    Directory of Open Access Journals (Sweden)

    Rafid Fayadh Al-Aqeedi

    2011-01-01

    Full Text Available Repaired congenital heart disease has become more prevalent in women of childbearing age. We report an unusual case of a 24-year-old multigravida with a repaired tetralogy of Fallot, severe dilated cardiomyopathy, and implantable cardioverter defibrillator placement who was managed successfully by a cesarean section three times. This case underscores the impact of such events on maternal and fetal safety and the importance of a multidisciplinary approach in the management of pregnant patients with complex congenital and medical problems.

  20. Radiography of Cardiac Conduction Devices: A Pictorial Review of Pacemakers and Implantable Cardioverter Defibrillators

    Science.gov (United States)

    Torres-Ayala, Stephanie C; Santacana-Laffitte, Guido; Maldonado, José

    2014-01-01

    Cardiac conduction devices (CCDs) depend on correct anatomic positioning to function properly. Chest radiography is the preferred imaging modality to evaluate CCD's anatomic location, lead wire integrity, and help in identifying several complications. In this pictorial review, our goal is to familiarize radiologists with CCD implantation techniques, appropriate positioning of the device, common causes of malfunction, methods to improve report accuracy, and assure maximal therapeutic benefit. PMID:25806132

  1. Clinical and psychological impact of prophylactic implantable cardioverter-defibrillators in a community heart failure population.

    LENUS (Irish Health Repository)

    Arnous, S

    2012-02-01

    AIMS: ICD implantation for primary prevention of sudden cardiac death in patients with left ventricular systolic dysfunction (ejection fraction <\\/= 35%) has increased since the publication of the SCD-HEFT and MADIT-II data. The aim of this study is to examine the effectiveness and safety of prophylactic ICD use in a community heart failure population and to assess the impact on patient\\'s quality of life. METHODS AND RESULTS: Seventy-one ICDs were inserted between the years 2002 and 2006. The mean follow-up from time of insertion was 24 +\\/- 11 months. Eighteen patients (25%) had potentially life-saving therapy. Seven (10%) patients received inappropriate shocks. Complications were encountered in five patients (7%). CONCLUSION: In a community heart failure population, prophylactic ICD implantation is associated with a high incidence of life-saving therapy, a low complication rate and a high level of tolerability. These data indicate translation of clinical trial benefits to the general heart failure population.

  2. Results of ENHANCED Implantable Cardioverter Defibrillator Programming to Reduce Therapies and Improve Quality of Life (from the ENHANCED-ICD Study)

    DEFF Research Database (Denmark)

    Mastenbroek, Mirjam H.; Pedersen, Susanne S.; van der Tweel, Ingeborg;

    2016-01-01

    . We examined whether programming a number of intervals to detect (NID) of 60/80 for ventricular tachyarrhythmia (VT)/ventricular fibrillation (VF) detection was safe and the impact of this strategy on (1) adverse events related to ICD shocks and syncopal events; (2) ATPs/shocks; and (3) patient...... programming strategy, unnecessary ICD therapy was prevented in 10% of ENHANCED-ICD patients during a median follow-up period of 1.3 years. With respect to patient-reported outcomes, levels of distress were highest and perceived health status lowest at the time of implantation, which both gradually improved......Novel implantable cardioverter defibrillator (ICD) discrimination algorithms and programming strategies have significantly reduced the incidence of inappropriate shocks, but there are still gains to be made with respect to reducing appropriate but unnecessary antitachycardia pacing (ATP) and shocks...

  3. 置入型心律转复除颤器52例术中除颤阈值的测定及术后随访%Safety and efficacy of intraoperative defibrillation threshold measured by defibrillation safety margin n 52 patients with implantable cardioverter defibrillator

    Institute of Scientific and Technical Information of China (English)

    张宇; 袁宽道; 汤宝鹏; 马依彤; 张燕一; 王疆; 李晋新; 张疆华; 许国军

    2010-01-01

    Objective To observe the safety and efficacy of implantable cardioverter defibrillator (ICD) intraoperative defibrillation threshold (DFT) measured by defibrillation safety margin (DSM).Methods Fifty-two patients underwent ICD implantation were enrolled in this study (25 single chamber ICD, 23 double chamber ICD, 4 three chamber ICD). DFT was measured by DSM method. All patients were followuped regularly. Results DFT was ( 13.27 ± 2. 95 ) J and DSM was ( 17. 40 ± 2. 89 ) J in this patient cohort. There were no serious intraoperative complications. Malignant ventricular arrhythmia occurred in 38 patients post ICD, 469 episodes of nonsustained ventricular tachycardia (VT) were spontaneously terminated, 265 episodes were sustained VT and 245 (92. 5% ) episodes were successfully terminated by 1 antitachycardia pace treatment (ATP), 13(4. 89% ) episodes successfully terminated by 2 ATP, and ATP failed to terminate VT in 7 (2. 64% ) episodes and VTs were terminated by low energy cardioversion. All 141 episodes of ventricular fibrillation (VF) were successfully identified, and 14 episodes spontaneously terminated before discharging, 127 VF episodes (91.34%) were terminated by 1 energy shock,defibrillation energy was ( 12. 84 ±3. 18)J, 11 ( 12.2% ) VF episodes were terminated by 2 energy shocks,defibrillation energy was ( 16. 36 ± 2. 34)J. Conclusion It is safe and feasible to use defibrillation threshold measured by DSM for patients receiving ICD implantation.%目的 探讨置入型心律转复除颤器(ICD)置入术中除颤阈值(DFT)的测定方法并观察术后随访结果.方法 52例置入ICD患者,其中单腔ICD 25例(48.08%),双腔ICD 23例(44.23%),三腔ICD 4例(7.69%).置入术中用测定除颤安全范围(DSM)方法进行DFT测定,并对患者进行定期随访.结果 52例ICD置入术中,测得DFT为(13.27±2.95)J,DSM为(17.40±2.89)J,手术中无严重并发症发生.52例中,38例出现恶性室性心律失常,其中469次为非持续性(可自行终

  4. Nurse- and peer-led self-management programme for patients with an implantable cardioverter defibrillator; a feasibility study

    Directory of Open Access Journals (Sweden)

    van Eijk Jacques

    2007-09-01

    Full Text Available Abstract Background The prevalence of cardiovascular disease is increasing. Improved treatment options increase survival after an acute myocardial infarction or sudden cardiac arrest, although patients often have difficulty adjusting and regaining control in daily life. In particular, patients who received an implantable cardioverter defibrillator (ICD experience physical and psychological problems. Interventions to enhance perceived control and acceptance of the device are therefore necessary. This paper describes a small-scale study to explore the feasibility and the possible benefits of a structured nurse- and peer-led self-management programme ('Chronic Disease Self-Management Program' – CDSMP among ICD patients. Methods Ten male ICD patients (mean age = 65.5 years participated in a group programme, consisting of six sessions, led by a team consisting of a nurse specialist and a patient with cardiovascular disease. Programme feasibility was evaluated among patients and leaders by measuring performance of the intervention according to protocol, attendance and adherence of the participating ICD patients, and patients' and leaders' opinions about the programme. In addition, before and directly after attending the intervention, programme benefits (e.g. perceived control, symptoms of anxiety and depression, and quality of life were assessed. Results The programme was conducted largely according to protocol. Eight patients attended at least four sessions, and adherence ranged from good to very good. On average, the patients reported to have benefited very much from the programme, which they gave an overall report mark of 8.4. The leaders considered the programme feasible as well. Furthermore, improvements were identified for general self-efficacy expectancies, symptoms of anxiety, physical functioning, social functioning, role limitations due to physical problems, and pain. Conclusion This study suggests that a self-management programme led by a

  5. Subclavian Vein Stenosis/Occlusion Following Transvenous Cardiac Pacemaker and Defibrillator Implantation: Incidence, Pathophysiology and Current Management

    Directory of Open Access Journals (Sweden)

    Brian O'Leary

    2015-08-01

    Full Text Available Subclavian vein stenosis is a common, but usually asymptomatic, complication following cardiac device placement. In addition to reviewing the literature on incidence, pathogenesis and management options for this important clinical problem, we describe two cases of symptomatic subclavian vein occlusion following pacemaker/defibrillator placement and successful treatment with venoplasty and stenting.

  6. Electrical Storm after Implantation of Implantable Cardioverter Defibrillator and Its treatment%植入型心律转复除颤器植入术后电风暴发生及其治疗进展

    Institute of Scientific and Technical Information of China (English)

    茅魁; 蔡鑫

    2013-01-01

    近年来,植入型心律转复除颤器治疗恶性心律失常的疗效明确,但术后电风暴诱发因素的治疗进展和预后愈来愈受到临床重视,现就近年的研究进展进行综述.%In recent years, the efficacy of implantable cardioverter defibrillator has been proved definite in treatment of nausea arrhythmia, and the treatment of postoperative electrical storm and its prognosis have been attached more and more importance to. This paper reviews its recent research progress.

  7. 植入除颤器患者的双腔起搏或心室后备起搏双腔和VVI植入型除颤器(DAVID)试验%Dual-Chamber Pacing or Ventricular Backup Pacing in Patients With an Implantable Defibrillator The Dual Chamber and VVI Implantable Defibrillator (DAVID) Trial

    Institute of Scientific and Technical Information of China (English)

    The DAVID Trial Investigators

    2003-01-01

    @@ 背景:有后备心室起搏的植入型心律转复除颤器(implant-able cardioverter defibrillator,ICD)可使有危及生命的室性心律失常患者的生存率提高.最新的植入型ICD绝大多数具有双腔起搏治疗功能.在该人群,死亡率的最常见原因是充血性心力衰竭.

  8. Defibrillator-Induced Tricuspid Abscess Presenting as Diabetic Ketoacidosis and Wound Ulceration

    OpenAIRE

    Khan, Rafay; Arshed, Sabrina; Ahmed, Amar; Sen, Shuvendu; Yousif, Abdalla

    2015-01-01

    Right-sided endocarditis is predominantly seen in patients with a history of intravenous drug abuse. However, it is well shown in the literature to be associated with patients containing foreign bodies such as pacemakers, central venous lines, and in those with congenital heart disease. In patients with pacemaker leads and in those with automatic implantable cardioverter defibrillators (AICDs), it is important to suspect foreign body infection when there are signs and indications of bacteremi...

  9. Implantable cardioverter-defibrillator therapy in a 34-year-old patient with eating disorders and after the third sudden cardiac arrest.

    Science.gov (United States)

    Piotrowicz, Ewa; Orzechowski, Piotr; Bilinska, Maria; Przybylski, Andrzej; Szumowski, Lukasz; Piotrowicz, Ryszard

    2015-03-01

    Eating disorders (ED) such as anorexia nervosa and bulimia are psychiatric diseases associated with the highest mortality rate of any other psychiatric disorders. More recently, long-term outcome studies with follow-up of over 20 years report a mortality of between 15% and 18% (Casiero and Frishman, Cardiol Rev 14(5), 227, 2006). The sudden death secondary to arrhythmias is often the cause of death in these patients (Casiero and Frishman, Cardiol Rev 14(5), 227, 2006). A case of life-threatening ventricular arrhythmia (VA) in a patient with ED is presented. Clinical records (cardiologic, psychiatric), electrocardiograms, echocardiogram, coronary angiogram, cardiac magnetic resonance, and endocrine diagnostics were performed. Finally a cardioverter-defibrillator (ICD) was implanted in the patient after her third cardiac arrest. An optimal approach to antiarrhythmic therapy in such patients is a real challenge for a cardiologist. PMID:24535846

  10. Implantable cardioverter defibrillator - discharge

    Science.gov (United States)

    ... electrodes, were placed in your heart and were connected to your ICD. The ICD can quickly detect ... lean over the open hood of a running car. Also stay away from: Radio transmitters and high- ...

  11. Estudo clínico de um sistema cardioversor-desfibrilador implantável que apresenta limiares de desfibrilação baixos usando eletrodos de estrutura fractal Clinical studies of an implantable cardioversor - defibrillators system providing low defibrillation thresholds as well as high signal amplitudes due to fractal coated electrodes

    Directory of Open Access Journals (Sweden)

    Fernando A. LUCCHESE

    1999-01-01

    Full Text Available Em função do contínuo desenvolvimento tecnológico, a geração atual de cardioversores-desfibriladores implantáveis (CDI garante um alto grau de segurança e eficiência na detecção e reversão de taquiarritmias ventriculares. O presente trabalho sumariza os resultados clínicos obtidos com 1058 CDI de câmara única (Phylax 6, Phylax XM, Biotronik utilizando eletrodo único e tecnologia de carcaça ativa, SPS e Kainox RV (com uma mola intracavitária de choque, SL-ICD e Kainox SL (com duas molas intracavitárias de choque, Biotronik. Na quase totalidade dos pacientes, com exceção de 3 (> 99%, foram obtidos limiares de desfibrilação com baixa energia usando apenas um eletrodo transvenoso. Isto tem permitido substituir o teste de limiar de desfibrilação usual por um teste simples durante o implante, afim de minimizar os riscos associados com repetidas induções de fibrilação e conseqüente extensão do período de anestesia.Due to continuously improved technologies, the present generation of implantable cardioverter-defibrillators (ICD guarantees a high degree of safety and efficacy for detecting and terminating ventricular tachyarrhythmias. This paper summarizes the clinical results obtained with 1058 single-chamber ICD (Phylax 6, Phylax XM, Biotronik employing single-lead and active housing technology (SPS and Kainox RV (single coil, SL-ICD and Kainox SL (double coil, Biotronik. In all but 3 patients (> 99%, reliable low-energy defibrillation was achieved using transvenous leads only. This has led to the trend to replace DFT testing by a short function test during implantation in order to minimize the risks associated with repeated induction of fibrillation and extended anesthesia.

  12. Causes and management of implantable cardiac defibrillator lead failure%植入型心律转复除颤器除颤电极导线功能故障的原因及处理

    Institute of Scientific and Technical Information of China (English)

    汤益民; 沈法荣; 孙国建; 陈建明; 何浪; 金红峰

    2011-01-01

    Objective To examine the incidence, causes, and management of defibrillation leads failure of implanted cardiac defibrillators (ICD) and cardiac resynchronization therapy plus defibrillator (CRT- D) devices.Methods One hundred and sixty- six patients with implanted ICD or CRT- D were followed up.Results Five out of 166 patients presented defibrillation lead failure with a incidence rate of 3.01%.Among 5 cases 1 had insulation defects, 1 had lead functional failure and 3 had T- wave suppression feature.New defibrillation lead was implanted in 2 patients and active- fixation pacing lead was implanted in another 2 patients.Conclusion Defibrillator lead failure can cause inappropriate shocks.It can be prevented by implantation of new defibrillatior lead.%目的 探讨植入型心律转复除颤器(ICD)及心脏再同步化心律转复除颤器(CRT-D)除颤电极导线功能故障的发生率、可能原因及处理方法.方法 对166例植入ICD或CRT-D的患者进行长期跟踪随访,统计除颤电极导线功能故障发生率,分析其可能原因及处理方法.结果 166例患者中出现除颤电极导线功能故障5例,发生率为3.01%.其中电极导线绝缘层破裂1例,ICD导线功能障碍1例,R波感知逐渐降低3例.其中2例予以更换除颤电极导线,2例予以植入普通主动固定电极导线,余1例随访中待择期处理.结论 植入ICD或CRT-D的患者,除颤电极导线功能障碍可引起ICD不适当放电,随访中若发现除颤电极导线功能障碍,应及时更换导线.

  13. 起搏器和植入性心律转复除颤器的召回和安全警示%Recalls and Safety Alerts Involving Pacemakers and Implantable Cardioverter-Defibrillator Generators

    Institute of Scientific and Technical Information of China (English)

    William H.Maisel; Maisel O. Sweeney; William G.Stevenson; Kristin E.Ellison; Laurence M. Epstein

    2002-01-01

    @@ 背景:起搏器和植入性心律转复除颤器(implantable cardioverter-defibrillator,ICD)常常发生出乎预料的故障,需由美国食品与药物管理局(FDA)召回(recall).尽管起搏器和ICD植入日益增多,但对它们的召回和安全警示(报告)知之甚少.

  14. Appropriate evaluation and treatment of heart failure patients after implantable cardioverter-defibrillator discharge: time to go beyond the initial shock.

    Science.gov (United States)

    Mishkin, Joseph D; Saxonhouse, Sherry J; Woo, Gregory W; Burkart, Thomas A; Miles, William M; Conti, Jamie B; Schofield, Richard S; Sears, Samuel F; Aranda, Juan M

    2009-11-24

    Multiple clinical trials support the use of implantable cardioverter-defibrillators (ICDs) for prevention of sudden cardiac death in patients with heart failure (HF). Unfortunately, several complicating issues have arisen from the universal use of ICDs in HF patients. An estimated 20% to 35% of HF patients who receive an ICD for primary prevention will experience an appropriate shock within 1 to 3 years of implant, and one-third of patients will experience an inappropriate shock. An ICD shock is associated with a 2- to 5-fold increase in mortality, with the most common cause being progressive HF. The median time from initial ICD shock to death ranges from 168 to 294 days depending on HF etiology and the appropriateness of the ICD therapy. Despite this prognosis, current guidelines do not provide a clear stepwise approach to managing these high-risk patients. An ICD shock increases HF event risk and should trigger a thorough evaluation to determine the etiology of the shock and guide subsequent therapeutic interventions. Several combinations of pharmacologic and device-based interventions such as adding amiodarone to baseline beta-blocker therapy, adjusting ICD sensitivity, and employing antitachycardia pacing may reduce future appropriate and inappropriate shocks. Aggressive HF surveillance and management is required after an ICD shock, as the risk of sudden cardiac death is transformed to an increased HF event risk. PMID:19926003

  15. Verification of the dose from an Iridium-192 (192Ir) sealed source absorbed by an implantable cardioverter defibrillator (ICD) during uterine intracavitary brachytherapy

    International Nuclear Information System (INIS)

    The purpose of this study was to verify the dose absorbed by an implantable cardioverter defibrillator (ICD) from an 192Ir sealed source during uterine intracavitary brachytherapy, and to confirm its immunity to radiation effects. First, prior to treatment, the doses around the ICD position of an anthromorphic phantom were evaluated. Next, we also measured the dose at the ICD position using a fluorescent glass dosimeter and silicon diode dosimeter during the treatment of intracavitary brachytherapy of a patient implanted with an ICD. The results of the phantom study showed the dose percentage at the ICD location, 2 cm deep, to be 0.074% of the prescribed dose. The results of a treatment study similarly showed the dose, measured using a fluorescent glass dosimeter in the ICD position, to be 0.071% of the prescribed dose. During the application of the total prescribed dose, 30 Gy/5 fraction, the dose at the surface of the ICD position was estimated to be 21.2 mGy, well below the 1 Gy maximum recommended in the JASTRO guidelines. We regard dose verification and monitoring during treatment to be both necessary and useful in the treatment of individual cases. (author)

  16. Automatic frequency controller for power amplifiers used in bio-implanted applications: issues and challenges.

    Science.gov (United States)

    Hannan, Mahammad A; Hussein, Hussein A; Mutashar, Saad; Samad, Salina A; Hussain, Aini

    2014-01-01

    With the development of communication technologies, the use of wireless systems in biomedical implanted devices has become very useful. Bio-implantable devices are electronic devices which are used for treatment and monitoring brain implants, pacemakers, cochlear implants, retinal implants and so on. The inductive coupling link is used to transmit power and data between the primary and secondary sides of the biomedical implanted system, in which efficient power amplifier is very much needed to ensure the best data transmission rates and low power losses. However, the efficiency of the implanted devices depends on the circuit design, controller, load variation, changes of radio frequency coil's mutual displacement and coupling coefficients. This paper provides a comprehensive survey on various power amplifier classes and their characteristics, efficiency and controller techniques that have been used in bio-implants. The automatic frequency controller used in biomedical implants such as gate drive switching control, closed loop power control, voltage controlled oscillator, capacitor control and microcontroller frequency control have been explained. Most of these techniques keep the resonance frequency stable in transcutaneous power transfer between the external coil and the coil implanted inside the body. Detailed information including carrier frequency, power efficiency, coils displacement, power consumption, supplied voltage and CMOS chip for the controllers techniques are investigated and summarized in the provided tables. From the rigorous review, it is observed that the existing automatic frequency controller technologies are more or less can capable of performing well in the implant devices; however, the systems are still not up to the mark. Accordingly, current challenges and problems of the typical automatic frequency controller techniques for power amplifiers are illustrated, with a brief suggestions and discussion section concerning the progress of

  17. Automatic Frequency Controller for Power Amplifiers Used in Bio-Implanted Applications: Issues and Challenges

    Directory of Open Access Journals (Sweden)

    Mahammad A. Hannan

    2014-12-01

    Full Text Available With the development of communication technologies, the use of wireless systems in biomedical implanted devices has become very useful. Bio-implantable devices are electronic devices which are used for treatment and monitoring brain implants, pacemakers, cochlear implants, retinal implants and so on. The inductive coupling link is used to transmit power and data between the primary and secondary sides of the biomedical implanted system, in which efficient power amplifier is very much needed to ensure the best data transmission rates and low power losses. However, the efficiency of the implanted devices depends on the circuit design, controller, load variation, changes of radio frequency coil’s mutual displacement and coupling coefficients. This paper provides a comprehensive survey on various power amplifier classes and their characteristics, efficiency and controller techniques that have been used in bio-implants. The automatic frequency controller used in biomedical implants such as gate drive switching control, closed loop power control, voltage controlled oscillator, capacitor control and microcontroller frequency control have been explained. Most of these techniques keep the resonance frequency stable in transcutaneous power transfer between the external coil and the coil implanted inside the body. Detailed information including carrier frequency, power efficiency, coils displacement, power consumption, supplied voltage and CMOS chip for the controllers techniques are investigated and summarized in the provided tables. From the rigorous review, it is observed that the existing automatic frequency controller technologies are more or less can capable of performing well in the implant devices; however, the systems are still not up to the mark. Accordingly, current challenges and problems of the typical automatic frequency controller techniques for power amplifiers are illustrated, with a brief suggestions and discussion section concerning

  18. Determining fitness to work after implantation of a cardiac defibrillator in a worker exposed to magnetic fields; Quelle conduite tenir apres l'implantation d'un defibrillateur cardiaque chez un travailleur expose aux champs magnetiques?

    Energy Technology Data Exchange (ETDEWEB)

    Magne, I. [Electricite de France, R and D, Lab. des Materiels Electriques, 77 - Moret sur Loing (France); Souques, M. [Electricite de France, EDF-Gaz de France, Service des Etudes Medicales, 75 - Paris (France); Hero, M. [MEDTRONIC France, 92 - Boulogne-Billancourt (France)

    2007-04-15

    An EDF worker potentially exposed to high-intensity 50 Hz magnetic fields had a cardiac defibrillator implanted. Theoretically its operation could be disturbed by magnetic field exposure at work. We use this case study to present an approach to evaluating work safety and the worker's fitness in such situations. The protocol consisted of measuring the magnetic field at the different places where the worker performed his job duties, in his presence, and simultaneously monitoring the operation of the device. The Medtronic device was programmed in bipolar mode. Throughout the workplace, the maximal magnetic field intensity measured at the device level was 650 {mu}T. No dysfunction was recorded in bipolar mode. Following these measurements and device controls, the worker was declared fit and resumed his previous job. Two years later, no incident has been reported. (authors)

  19. Pacemaker, implanted cardiac defibrillator and irradiation: Management proposal in 2010 depending on the type of cardiac stimulator and prognosis and location of cancer; Pacemaker, defibrillateur et radiotherapie: propositions de conduite a tenir en 2010 en fonction du type de stimulateur cardiaque, du pronostic et du site du cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lambert, P. [Service d' anesthesie reanimation, hopital Nord, centre hospitalier universitaire de Saint-etienne, 42055 Saint-etienne cedex 2 (France); Da Costa, A. [Service de cardiologie, hopital Nord, centre hospitalier universitaire de Saint-etienne, 42055 Saint-etienne cedex 2 (France); Marcy, P.Y. [Departement de radiologie, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 2 (France); Universite Nice Sophia-Antipolis, 33, avenue de Valombrose, 06189 Nice cedex 2 (France); Kreps, S. [Service de radiotherapie Corad, centre regional universitaire de cancerologie Henry-S.-Kaplan, hopital Bretonneau-2, CHU de Tours, boulevard Tonnelle, 37000 Tours (France); Angellier, G.; Marcie, S.; Bondiau, P.Y. [Universite Nice Sophia-Antipolis, 33, avenue de Valombrose, 06189 Nice cedex 2 (France); Departement de radiotherapie oncologie, centre CyberKnife, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 2 (France); Briand-Amoros, C. [Service de radiotherapie, hopital europeen Georges-Pompidou, 20, rue Leblanc, 75015 Paris (France); Thariat, J. [Universite Nice Sophia-Antipolis, 33, avenue de Valombrose, 06189 Nice cedex 2 (France); Departement de radiotherapie oncologie, centre CyberKnife, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 2 (France); IBDC CNRS UMR 6543, centre Antoine-Lacassagne, universite Sophia-Antipolis, 33, avenue de Valombrose, 06189 Nice cedex 2 (France)

    2011-06-15

    Ionizing radiation may interfere with electric components of pacemakers or implantable cardioverter defibrillators. The type, severity and extent of radiation damage to pacemakers, have previously been shown to depend on the total dose and dose rate. Over 300,000 new cancer cases are treated yearly in France, among which 60% are irradiated in the course of their disease. One among 400 of these patients has an implanted pacemaker or defibrillator. The incidence of pacemaker and implanted cardioverter defibrillator increases in an ageing population. The oncologic prognosis must be weighted against the cardiologic prognosis in a multidisciplinary and transversal setting. Innovative irradiation techniques and technological sophistications of pacemakers and implantable cardioverter-defibrillators (with the introduction of more radiosensitive complementary metal-oxide-semiconductors since 1970) have potentially changed the tolerance profiles. This review of the literature studied the geometric, dosimetric and radiobiological characteristics of the radiation beams for high energy photons, stereotactic irradiation, proton-therapy. Standardized protocols and radiotherapy optimization (particle, treatment fields, energy) are advisable in order to improve patient management during radiotherapy and prolonged monitoring is necessary following radiation therapy. The dose received at the pacemaker/heart should be calculated. The threshold for the cumulated dose to the pacemaker/implantable cardioverter-defibrillator (2 to 5 Gy depending on the brand), the necessity to remove/displace the device based on the dose-volume histogram on dosimetry, as well as the use of lead shielding and magnet are discussed. (authors)

  20. Relation of symptomatic heart failure and psychological status to persistent depression in patients with implantable cardioverter-defibrillator

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Hoogwegt, Madelein T; Jordaens, Luc;

    2011-01-01

    Association class III-IV (OR 2.95; 95% CI 1.47 to 5.89), Type D personality (OR 7.98; 95% CI 3.98 to 16.04), and the use of psychotropic medication (OR 2.73; 95% CI 1.27 to 5.84) were independent correlates of persistent depression. In conclusion, symptomatic heart failure, psychological status....... We examined the prevalence and correlates of persistent depression using an intraindividual approach. Consecutive patients who had undergone ICD implantation (n = 386; 79.3% men) completed a set of validated questionnaires, including the Hospital Anxiety and Depression Scale (HADS), at baseline and 3...... months after implantation. Information on ICD therapies was obtained by device interrogation. At 3 months after implantation, 52 (14%) of the 386 patients had persistent depression (HADS cutoff ≥8 before and 3 months after implantation). Heart failure (odds ratio [OR] 2.29; 95% confidence interval [CI] 1...

  1. Gender differences in anxiety and concerns about the cardioverter defibrillator

    DEFF Research Database (Denmark)

    Spindler, Helle; Johansen, Jens B; Andersen, Kirsten Krogh;

    2009-01-01

    Little is known about gender differences in the response to implantable cardioverter defibrillator (ICD) therapy. We compared female and male ICD patients on anxiety, depression, health-related quality of life (HRQL), ICD concerns, and ICD acceptance.......Little is known about gender differences in the response to implantable cardioverter defibrillator (ICD) therapy. We compared female and male ICD patients on anxiety, depression, health-related quality of life (HRQL), ICD concerns, and ICD acceptance....

  2. Is metal artefact reduction mandatory in cardiac PET/CT imaging in the presence of pacemaker and implantable cardioverter defibrillator leads?

    International Nuclear Information System (INIS)

    Cardiac PET/CT imaging is often performed in patients with pacemakers and implantable cardioverter defibrillator (ICD) leads. However, metallic implants usually produce artefacts on CT images which might propagate to CT-based attenuation-corrected (CTAC) PET images. The impact of metal artefact reduction (MAR) for CTAC of cardiac PET/CT images in the presence of pacemaker, ICD and ECG leads was investigated using both qualitative and quantitative analysis in phantom and clinical studies. The study included 14 patients with various leads undergoing perfusion and viability examinations using dedicated cardiac PET/CT protocols. The PET data were corrected for attenuation using both artefactual CT images and CT images corrected using the MAR algorithm. The severity and magnitude of metallic artefacts arising from these leads were assessed on both linear attenuation coefficient maps (μ-maps) and attenuation-corrected PET images. CT and PET emission data were obtained using an anthropomorphic thorax phantom and a dedicated heart phantom made in-house incorporating pacemaker and ICD leads attached at the right ventricle of the heart. Volume of interest-based analysis and regression plots were performed for regions related to the lead locations. Bull's eye view analysis was also performed on PET images corrected for attenuation with and without the MAR algorithm. In clinical studies, the visual assessment of PET images by experienced physicians and quantitative analysis did not reveal erroneous interpretation of the tracer distribution or significant differences when PET images were corrected for attenuation with and without MAR. In phantom studies, the mean differences between tracer uptake obtained without and with MAR were 10.16±2.1% and 6.86±2.1% in the segments of the heart in the vicinity of metallic ICD or pacemaker leads, and were 4.43±0.5% and 2.98±0.5% in segments far from the leads. Although the MAR algorithm was able to effectively improve the quality of

  3. Is metal artefact reduction mandatory in cardiac PET/CT imaging in the presence of pacemaker and implantable cardioverter defibrillator leads?

    Energy Technology Data Exchange (ETDEWEB)

    Ghafarian, Pardis [Shahid Beheshti University, Department of Radiation Medicine, Tehran (Iran, Islamic Republic of); Geneva University Hospital, Division of Nuclear Medicine, Geneva 4 (Switzerland); Tehran University of Medical Sciences, Research Center for Science and Technology in Medicine, Tehran (Iran, Islamic Republic of); Aghamiri, S.M.R. [Shahid Beheshti University, Department of Radiation Medicine, Tehran (Iran, Islamic Republic of); Ay, Mohammad R. [Tehran University of Medical Sciences, Research Center for Science and Technology in Medicine, Tehran (Iran, Islamic Republic of); Tehran University of Medical Sciences, Department of Medical Physics and Biomedical Engineering, Tehran (Iran, Islamic Republic of); Tehran University of Medical Sciences, Research Institute for Nuclear Medicine, Tehran (Iran, Islamic Republic of); Rahmim, Arman [Johns Hopkins University, Department of Radiology, Baltimore, MD (United States); Schindler, Thomas H. [Geneva University, Cardiovascular Center, Nuclear Cardiology, Geneva (Switzerland); Ratib, Osman [Geneva University Hospital, Division of Nuclear Medicine, Geneva 4 (Switzerland); Zaidi, Habib [Geneva University Hospital, Division of Nuclear Medicine, Geneva 4 (Switzerland); Geneva University, Geneva Neuroscience Center, Geneva (Switzerland)

    2011-02-15

    Cardiac PET/CT imaging is often performed in patients with pacemakers and implantable cardioverter defibrillator (ICD) leads. However, metallic implants usually produce artefacts on CT images which might propagate to CT-based attenuation-corrected (CTAC) PET images. The impact of metal artefact reduction (MAR) for CTAC of cardiac PET/CT images in the presence of pacemaker, ICD and ECG leads was investigated using both qualitative and quantitative analysis in phantom and clinical studies. The study included 14 patients with various leads undergoing perfusion and viability examinations using dedicated cardiac PET/CT protocols. The PET data were corrected for attenuation using both artefactual CT images and CT images corrected using the MAR algorithm. The severity and magnitude of metallic artefacts arising from these leads were assessed on both linear attenuation coefficient maps ({mu}-maps) and attenuation-corrected PET images. CT and PET emission data were obtained using an anthropomorphic thorax phantom and a dedicated heart phantom made in-house incorporating pacemaker and ICD leads attached at the right ventricle of the heart. Volume of interest-based analysis and regression plots were performed for regions related to the lead locations. Bull's eye view analysis was also performed on PET images corrected for attenuation with and without the MAR algorithm. In clinical studies, the visual assessment of PET images by experienced physicians and quantitative analysis did not reveal erroneous interpretation of the tracer distribution or significant differences when PET images were corrected for attenuation with and without MAR. In phantom studies, the mean differences between tracer uptake obtained without and with MAR were 10.16{+-}2.1% and 6.86{+-}2.1% in the segments of the heart in the vicinity of metallic ICD or pacemaker leads, and were 4.43{+-}0.5% and 2.98{+-}0.5% in segments far from the leads. Although the MAR algorithm was able to effectively improve

  4. Mid-term follow-up of patients with Brugada syndrome following a cardioverter defibrillator implantation: A single center experience

    OpenAIRE

    Kharazi, A; Emkanjoo, Z; A. Alizadeh; Nikoo, MH; Jorat, MV; Sadr-Ameli, MA

    2007-01-01

    Background Brugada syndrome is an arrhythmogenic disease characterized by an ECG pattern of ST-segment elevation in the right precordial leads and an increase risk of sudden cardiac death. Risk stratification for the life-threatening arrhythmic events in Brugada syndrome is not yet established. In the present study, we report our experience in patients with Brugada syndrome, following an ICD implantation. Methods and Results A total of 12 patients (11 men, 1 woman) with a mean age of 46.5±11....

  5. Use of the Wearable Cardioverter Defibrillator in High-Risk Populations.

    Science.gov (United States)

    Lamichhane, Madhab; Safadi, Abdul; Surapaneni, Phani; Salehi, Negar; Thakur, Ranjan K

    2016-08-01

    The United States Food and Drug Administration has approved the wearable cardioverter defibrillator (WCD) for use in patients who are at high risk for sudden cardiac arrest (SCA) and who do not yet have an established indication for an implantation cardioverter defibrillator (ICD) or have contraindications for device implantation for various reasons. The WCD is typically used for primary prevention in (1) high-risk patients with reduced left ventricular ejection fraction (LVEF) ≤35 % after recent acute myocardial infarction (MI) during the 40-day ICD waiting period, (2) before and after coronary artery bypass graft or percutaneous coronary intervention during the 90-day ICD waiting period, (3) after recently diagnosed nonischemic dilated cardiomyopathy (NICM) during the 3- to 9-month medical therapy optimization period, or (4) for those with inherited proarrhythmic conditions such as long QT syndrome or hypertrophic cardiomyopathy. Unlike the automatic external defibrillator, the WCD does not require assistance from bystanders for therapy and conscious patients can delay or avert therapy with the use of response buttons. The WCD exhibits a small risk of inappropriate shock, mostly due to supraventricular tachycardia and/or electrical noise. Multiple non-randomized observational studies have shown high efficacy in detection and appropriate shock therapy for sustained ventricular tachyarrhythmias. This paper discusses the use of the WCD for prevention of SCA in patients with various cardiac substrates. PMID:27319008

  6. Matching Automatic Gain Control Across Devices in Bimodal Cochlear Implant Users

    NARCIS (Netherlands)

    Veugen, L.C.E.; Chalupper, J.; Snik, A.F.M; Opstal, A.J. van; Mens, L.H.M

    2016-01-01

    OBJECTIVES: The purpose of this study was to improve bimodal benefit in listeners using a cochlear implant (CI) and a hearing aid (HA) in contralateral ears, by matching the time constants and the number of compression channels of the automatic gain control (AGC) of the HA to the CI. Equivalent AGC

  7. Automatic segmentation of intra-cochlear anatomy in post-implantation CT

    Science.gov (United States)

    Reda, Fitsum A.; Dawant, Benoit M.; McRackan, Theodore R.; Labadie, Robert F.; Noble, Jack H.

    2013-03-01

    A cochlear implant (CI) is a neural prosthetic device that restores hearing by directly stimulating the auditory nerve with an electrode array. In CI surgery, the surgeon threads the electrode array into the cochlea, blind to internal structures. We have recently developed algorithms for determining the position of CI electrodes relative to intra-cochlear anatomy using pre- and post-implantation CT. We are currently using this approach to develop a CI programming assistance system that uses knowledge of electrode position to determine a patient-customized CI sound processing strategy. However, this approach cannot be used for the majority of CI users because the cochlea is obscured by image artifacts produced by CI electrodes and acquisition of pre-implantation CT is not universal. In this study we propose an approach that extends our techniques so that intra-cochlear anatomy can be segmented for CI users for which pre-implantation CT was not acquired. The approach achieves automatic segmentation of intra-cochlear anatomy in post-implantation CT by exploiting intra-subject symmetry in cochlear anatomy across ears. We validated our approach on a dataset of 10 ears in which both pre- and post-implantation CTs were available. Our approach results in mean and maximum segmentation errors of 0.27 and 0.62 mm, respectively. This result suggests that our automatic segmentation approach is accurate enough for developing customized CI sound processing strategies for unilateral CI patients based solely on postimplantation CT scans.

  8. Estimating dose to implantable cardioverter-defibrillator outside the treatment fields using a skin QED diode, optically stimulated luminescent dosimeters, and LiF thermoluminescent dosimeters

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Maria F., E-mail: chanm@mskcc.org [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Song, Yulin; Dauer, Lawrence T.; Li Jingdong; Huang, David; Burman, Chandra [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

    2012-10-01

    The purpose of this work was to determine the relative sensitivity of skin QED diodes, optically stimulated luminescent dosimeters (OSLDs) (microStar Trade-Mark-Sign DOT, Landauer), and LiF thermoluminescent dosimeters (TLDs) as a function of distance from a photon beam field edge when applied to measure dose at out-of-field points. These detectors have been used to estimate radiation dose to patients' implantable cardioverter-defibrillators (ICDs) located outside the treatment field. The ICDs have a thin outer case made of 0.4- to 0.6-mm-thick titanium ({approx}2.4-mm tissue equivalent). A 5-mm bolus, being the equivalent depth of the devices under the patient's skin, was placed over the ICDs. Response per unit absorbed dose-to-water was measured for each of the dosimeters with and without bolus on the beam central axis (CAX) and at a distance up to 20 cm from the CAX. Doses were measured with an ionization chamber at various depths for 6- and 15-MV x-rays on a Varian Clinac-iX linear accelerator. Relative sensitivity of the detectors was determined as the ratio of the sensitivity at each off-axis distance to that at the CAX. The detector sensitivity as a function of the distance from the field edge changed by {+-} 3% (1-11%) for LiF TLD-700, decreased by 10% (5-21%) for OSLD, and increased by 16% (11-19%) for the skin QED diode (Sun Nuclear Corp.) at the equivalent depth of 5 mm for 6- or 15-MV photon energies. Our results showed that the use of bolus with proper thickness (i.e., {approx}d{sub max} of the photon energy) on the top of the ICD would reduce the scattered dose to a lower level. Dosimeters should be calibrated out-of-field and preferably with bolus equal in thickness to the depth of interest. This can be readily performed in clinic.

  9. Mechanisms of Defibrillation

    OpenAIRE

    Dosdall, Derek J.; Fast, Vladimir G.; Ideker, Raymond E.

    2010-01-01

    Electrical shock has been the one effective treatment for ventricular fibrillation for several decades. With the advancement of electrical and optical mapping techniques, histology, and computer modeling, the mechanisms responsible for defibrillation are now coming to light. In this review, we discuss recent work that demonstrates the various mechanisms responsible for defibrillation. On the cellular level, membrane depolarization and electroporation affect defibrillation outcome. Cell bundle...

  10. Towards Low Energy Atrial Defibrillation.

    Science.gov (United States)

    Walsh, Philip; Kodoth, Vivek; McEneaney, David; Rodrigues, Paola; Velasquez, Jose; Waterman, Niall; Escalona, Omar

    2015-01-01

    A wireless powered implantable atrial defibrillator consisting of a battery driven hand-held radio frequency (RF) power transmitter (ex vivo) and a passive (battery free) implantable power receiver (in vivo) that enables measurement of the intracardiac impedance (ICI) during internal atrial defibrillation is reported. The architecture is designed to operate in two modes: Cardiac sense mode (power-up, measure the impedance of the cardiac substrate and communicate data to the ex vivo power transmitter) and cardiac shock mode (delivery of a synchronised very low tilt rectilinear electrical shock waveform). An initial prototype was implemented and tested. In low-power (sense) mode, >5 W was delivered across a 2.5 cm air-skin gap to facilitate measurement of the impedance of the cardiac substrate. In high-power (shock) mode, >180 W (delivered as a 12 ms monophasic very-low-tilt-rectilinear (M-VLTR) or as a 12 ms biphasic very-low-tilt-rectilinear (B-VLTR) chronosymmetric (6ms/6ms) amplitude asymmetric (negative phase at 50% magnitude) shock was reliably and repeatedly delivered across the same interface; with >47% DC-to-DC (direct current to direct current) power transfer efficiency at a switching frequency of 185 kHz achieved. In an initial trial of the RF architecture developed, 30 patients with AF were randomised to therapy with an RF generated M-VLTR or B-VLTR shock using a step-up voltage protocol (50-300 V). Mean energy for successful cardioversion was 8.51 J ± 3.16 J. Subsequent analysis revealed that all patients who cardioverted exhibited a significant decrease in ICI between the first and third shocks (5.00 Ω (SD(σ) = 1.62 Ω), p power transfer and sensing of ICI during cardioversion are evidenced as key to the advancement of low-energy atrial defibrillation. PMID:26404298

  11. Differential effects of defibrillation on systemic and cardiac sympathetic activity

    OpenAIRE

    Bode, F; U. Wiegand; Raasch, W; Richardt, G.; Potratz, J

    1998-01-01

    Objective—To assess the effect of defibrillation shocks on cardiac and circulating catecholamines.
Design—Prospective examination of myocardial catecholamine balance during dc shock by simultaneous determination of arterial and coronary sinus plasma concentrations. Internal countershocks (10-34 J) were applied in 30 patients after initiation of ventricular fibrillation for a routine implantable cardioverter defibrillator test. Another 10 patients were externally cardioverted (50-360 J) for at...

  12. Nursing Experience on Electrical Storm of Implantable Cardioverter Defibrillator%植入型心脏转复除颤器患者发生电风暴的护理体会

    Institute of Scientific and Technical Information of China (English)

    丁恒

    2010-01-01

    心脏性猝死(sudden cardiac death,SCD)通常是致命性室性心律失常的最终结局.预防室性心律失常所致心源性猝死惟一有效的方法是植入植入型心脏转复除颤器(implantable cardioverter defibrillator,ICD)以减少心脏性猝死的发生[1].ICD已经从对室性心动过速(简称室速)、心室颤动(简称室颤)进行二级预防,扩展到对低射血分数的一级预防.

  13. Subcutaneous Implantable Cardioverter-Defibrillator

    Science.gov (United States)

    ... LIBRARY Hello, Guest! My alerts Sign In Join Facebook Twitter Home About this Journal Editorial Board General Statistics Circulation Cover Doodle → Blip the Doodle Go Red For Women's Issue Information for Advertisers Author Reprints Commercial Reprints Customer Service and Ordering ...

  14. Defibrillator/monitor/pacemakers.

    Science.gov (United States)

    2003-05-01

    Defibrillator/monitors allow operators to assess and monitor a patient's ECG and, when necessary, deliver a defibrillating shock to the heart. When integral noninvasive pacing is added, the device is called a defibrillator/monitor/pacemaker. In this Evaluation, we present our findings for two newly evaluated models, the Welch Allyn PIC 50 and the Zoll M Series CCT, and we summarize our findings for the previously evaluated models that are still on the market. We rate the models for the following applications: general crash-cart use, in-hospital transport use, and emergency medical service (EMS) use. PMID:12827940

  15. Design of the evolution of management strategies of heart failure patients with implantable defibrillators (EVOLVO study to assess the ability of remote monitoring to treat and triage patients more effectively

    Directory of Open Access Journals (Sweden)

    Campana Carlo

    2009-06-01

    Full Text Available Abstract Background Heart failure patients with implantable defibrillators (ICD frequently visit the clinic for routine device monitoring. Moreover, in the case of clinical events, such as ICD shocks or alert notifications for changes in cardiac status or safety issues, they often visit the emergency department or the clinic for an unscheduled visit. These planned and unplanned visits place a great burden on healthcare providers. Internet-based remote device interrogation systems, which give physicians remote access to patients' data, are being proposed in order to reduce routine and interim visits and to detect and notify alert conditions earlier. Methods The EVOLVO study is a prospective, randomized, parallel, unblinded, multicenter clinical trial designed to compare remote ICD management with the current standard of care, in order to assess its ability to treat and triage patients more effectively. Two-hundred patients implanted with wireless-transmission-enabled ICD will be enrolled and randomized to receive either the Medtronic CareLink® monitor for remote transmission or the conventional method of in-person evaluations. The purpose of this manuscript is to describe the design of the trial. The results, which are to be presented separately, will characterize healthcare utilizations as a result of ICD follow-up by means of remote monitoring instead of conventional in-person evaluations. Trial registration ClinicalTrials.gov: NCT00873899

  16. Automatic tracking of arbitrarily shaped implanted markers in kilovoltage projection images: A feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Regmi, Rajesh; Lovelock, D. Michael; Hunt, Margie; Zhang, Pengpeng; Pham, Hai; Xiong, Jianping; Yorke, Ellen D.; Mageras, Gig S., E-mail: magerasg@mskcc.org [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York 10065 (United States); Goodman, Karyn A.; Rimner, Andreas [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York 10065 (United States); Mostafavi, Hassan [Ginzton Technology Center, Varian Medical Systems, Palo Alto, California 94304 (United States)

    2014-07-15

    Purpose: Certain types of commonly used fiducial markers take on irregular shapes upon implantation in soft tissue. This poses a challenge for methods that assume a predefined shape of markers when automatically tracking such markers in kilovoltage (kV) radiographs. The authors have developed a method of automatically tracking regularly and irregularly shaped markers using kV projection images and assessed its potential for detecting intrafractional target motion during rotational treatment. Methods: Template-based matching used a normalized cross-correlation with simplex minimization. Templates were created from computed tomography (CT) images for phantom studies and from end-expiration breath-hold planning CT for patient studies. The kV images were processed using a Sobel filter to enhance marker visibility. To correct for changes in intermarker relative positions between simulation and treatment that can introduce errors in automatic matching, marker offsets in three dimensions were manually determined from an approximately orthogonal pair of kV images. Two studies in anthropomorphic phantom were carried out, one using a gold cylindrical marker representing regular shape, another using a Visicoil marker representing irregular shape. Automatic matching of templates to cone beam CT (CBCT) projection images was performed to known marker positions in phantom. In patient data, automatic matching was compared to manual matching as an approximate ground truth. Positional discrepancy between automatic and manual matching of less than 2 mm was assumed as the criterion for successful tracking. Tracking success rates were examined in kV projection images from 22 CBCT scans of four pancreas, six gastroesophageal junction, and one lung cancer patients. Each patient had at least one irregularly shaped radiopaque marker implanted in or near the tumor. In addition, automatic tracking was tested in intrafraction kV images of three lung cancer patients with irregularly shaped

  17. Somatosensory amplification mediates sex differences in psychological distress among cardioverter-defibrillator patients

    DEFF Research Database (Denmark)

    Versteeg, Henneke; Baumert, Jens; Kolb, Christof;

    2010-01-01

    The present study examined whether female patients with an implantable cardioverter defibrillator (ICD) report more psychological distress than male patients, and whether somatosensory amplification mediates this relationship. Design: Consecutive ICD patients (N = 241; 33% women) participating in...

  18. Towards Low Energy Atrial Defibrillation

    Directory of Open Access Journals (Sweden)

    Philip Walsh

    2015-09-01

    Full Text Available A wireless powered implantable atrial defibrillator consisting of a battery driven hand-held radio frequency (RF power transmitter (ex vivo and a passive (battery free implantable power receiver (in vivo that enables measurement of the intracardiac impedance (ICI during internal atrial defibrillation is reported. The architecture is designed to operate in two modes: Cardiac sense mode (power-up, measure the impedance of the cardiac substrate and communicate data to the ex vivo power transmitter and cardiac shock mode (delivery of a synchronised very low tilt rectilinear electrical shock waveform. An initial prototype was implemented and tested. In low-power (sense mode, >5 W was delivered across a 2.5 cm air-skin gap to facilitate measurement of the impedance of the cardiac substrate. In high-power (shock mode, >180 W (delivered as a 12 ms monophasic very-low-tilt-rectilinear (M-VLTR or as a 12 ms biphasic very-low-tilt-rectilinear (B-VLTR chronosymmetric (6ms/6ms amplitude asymmetric (negative phase at 50% magnitude shock was reliably and repeatedly delivered across the same interface; with >47% DC-to-DC (direct current to direct current power transfer efficiency at a switching frequency of 185 kHz achieved. In an initial trial of the RF architecture developed, 30 patients with AF were randomised to therapy with an RF generated M-VLTR or B-VLTR shock using a step-up voltage protocol (50–300 V. Mean energy for successful cardioversion was 8.51 J ± 3.16 J. Subsequent analysis revealed that all patients who cardioverted exhibited a significant decrease in ICI between the first and third shocks (5.00 Ω (SD(σ = 1.62 Ω, p < 0.01 while spectral analysis across frequency also revealed a significant variation in the impedance-amplitude-spectrum-area (IAMSA within the same patient group (|∆(IAMSAS1-IAMSAS3[1 Hz − 20 kHz] = 20.82 Ω-Hz (SD(σ = 10.77 Ω-Hz, p < 0.01; both trends being absent in all patients that failed to cardiovert

  19. Nursing care to the patient with implantable automatic fibre-removing machine

    Directory of Open Access Journals (Sweden)

    Sandra Isabel García Mora

    2011-03-01

    Full Text Available The primary prevention of the cardiac sudden death constitutes one of the main challenges of the present cardiology. The main reason for this interest comes dice by the little possibilities of surviving an extra-hospital cardiac shutdown, smaller of 20%.El implantable automatic fibre-removing machine (DAI is the most effective therapy to prevent the cardiac sudden death related to ventricular tachyarrhythmias. From the beginnings of the therapy by means of the DAI, besides the survival and the quality of life of the patients it has constituted an important reason for attention. The carrying patients present/display agreements that can have an excellent impact in their quality of life. The infirmary personnel must know the therapy the DAI, to be able to provide to the patients and their familiar surroundings the optimal cares to confront its daily life, a level of confidence and comfort derived from the positioning of a permanent electronics.

  20. An algorithm for automatic, computed-tomography-based source localization after prostate implant

    International Nuclear Information System (INIS)

    Permanent implant of the prostate using I-125 and Pd-103 seeds is a popular choice of treatment for early-stage prostate cancer in the United States. Evaluation of the quality of the implant is best based on the calculated dose distribution from postimplant computed tomography (CT) images. This task, however, has been time-consuming and inaccurate. We have developed an algorithm for automatic source localization from postimplant CT images. The only requirement of this algorithm is knowledge of the number of seeds present in the prostate, thus minimizing the need for human intervention. The algorithm processes volumetric CT data from the patient, and pixels of higher CT numbers are categorized into classes of definite and potential source pixels. A multithresholding technique is used to further determine the number of seeds and their precise locations in the CT volume data. A graphic user interface was developed to facilitate operator review of and intervention in the calculation and the results of the algorithm. This algorithm was tested on two phantoms containing nonradioactive seeds, one with 20 seeds in discrete locations and another with 100 seeds with small distances between seeds. The tests showed that the algorithm was able to identify the seed locations to within 1 mm of their physical locations for discrete seed locations. It was further able to separate seeds at close proximity to each other while maintaining an average seed localization error of less than 2 mm, with no operator intervention required

  1. The effect of automatic gain control structure and release time on cochlear implant speech intelligibility.

    Directory of Open Access Journals (Sweden)

    Phyu P Khing

    Full Text Available Nucleus cochlear implant systems incorporate a fast-acting front-end automatic gain control (AGC, sometimes called a compression limiter. The objective of the present study was to determine the effect of replacing the front-end compression limiter with a newly proposed envelope profile limiter. A secondary objective was to investigate the effect of AGC speed on cochlear implant speech intelligibility. The envelope profile limiter was located after the filter bank and reduced the gain when the largest of the filter bank envelopes exceeded the compression threshold. The compression threshold was set equal to the saturation level of the loudness growth function (i.e. the envelope level that mapped to the maximum comfortable current level, ensuring that no envelope clipping occurred. To preserve the spectral profile, the same gain was applied to all channels. Experiment 1 compared sentence recognition with the front-end limiter and with the envelope profile limiter, each with two release times (75 and 625 ms. Six implant recipients were tested in quiet and in four-talker babble noise, at a high presentation level of 89 dB SPL. Overall, release time had a larger effect than the AGC type. With both AGC types, speech intelligibility was lower for the 75 ms release time than for the 625 ms release time. With the shorter release time, the envelope profile limiter provided higher group mean scores than the front-end limiter in quiet, but there was no significant difference in noise. Experiment 2 measured sentence recognition in noise as a function of presentation level, from 55 to 89 dB SPL. The envelope profile limiter with 625 ms release time yielded better scores than the front-end limiter with 75 ms release time. A take-home study showed no clear pattern of preferences. It is concluded that the envelope profile limiter is a feasible alternative to a front-end compression limiter.

  2. Custo-efetividade de cardiodesfibriladores implantáveis no Brasil nos setores público e privado Cost-effectiveness of implantable cardioverter defibrillators in Brazil in the public and private sectors

    Directory of Open Access Journals (Sweden)

    Rodrigo Antonini Ribeiro

    2010-10-01

    Full Text Available FUNDAMENTO: Vários ensaios clínicos randomizados demonstraram a efetividade do cardiodesfibrilador implantável (CDI na redução de morte de pacientes com insuficiência cardíaca congestiva (ICC. Estudos de países desenvolvidos já avaliaram a custo-efetividade do CDI, porém as informações não são transferíveis para o Brasil. OBJETIVO: Avaliar a custo-efetividade do CDI em pacientes com ICC sob duas perspectivas: pública e saúde suplementar. MÉTODOS: Um modelo de Markov foi criado para analisar a relação de custo-efetividade incremental (RCEI do CDI, comparado à terapia convencional, em pacientes com ICC. Efetividade foi medida em anos de vida ajustados para qualidade (QALY. Na literatura, buscaram-se dados de efetividade e complicações. Custos foram extraídos das tabelas do SUS e de valores praticados pelos convênios, assim como médias de internações hospitalares. Análises de sensibilidade univariadas foram feitas em todas as variáveis do modelo. RESULTADOS: A RCEI foi de R$ 68.318/QALY no cenário público e R$ 90.942/QALY no privado. Esses valores são superiores aos sugeridos como pontos de corte pela Organização Mundial da Saúde, de três vezes o PIB per capita (R$ 40.545 no Brasil. Variáveis mais influentes na análise de sensibilidade foram: custo do CDI, intervalo de troca do gerador e efetividade do CDI. Em simulação de cenário semelhante ao MADIT-I, as relações foram de R$ 23.739/QALY no cenário público e R$ 33.592/QALY no privado. CONCLUSÃO: Para a população em geral com ICC, a relação de RCEI do CDI, tanto na perspectiva pública como na privada, é elevada. Resultados mais favoráveis ocorrem em pacientes com alto risco de morte súbita.BACKGROUND: Many randomized clinical trials have demonstrated the effectiveness of the implantable cardioverter-defibrillator (ICDs in death reduction of chronic heart failure (CHF patients. Some developed countries studies have evaluated its cost

  3. 除颤电极导线故障判断与植入起搏感知电极的处理效果%Efficacy Analysis of Pace/Sense Lead Implantation in Management of Cardioverter-Defibrillator Lead Malfunction

    Institute of Scientific and Technical Information of China (English)

    于海波; 王冬梅; 梁延春; 许国卿; 刘荣; 王祖禄; 韩雅玲

    2015-01-01

    目的:评价植入起搏感知电极处理埋藏式心律转复除颤器( implantable cardioverter defibrillator, ICD)电极导线功能故障的效果。方法回顾性分析4例植入ICD患者发生除颤电极导线功能故障的原因及处理方法。结果4例均因右心室除颤电极导线功能故障出现ICD误感知及误电击,高压阻抗均在正常范围,其中3例有术侧不适当用力情况。分析故障原因,3例为起搏感知电极断裂,1例为除颤电极早期磨损。4例均经腋静脉入路重新植入一根起搏感知电极,其中电池耗竭1例术中更换ICD。随访观察7~70个月,均未再出现ICD误感知及误电击事件,导线参数变化均在正常范围。结论术侧过度用力可能是除颤电极导线功能故障发生的主要原因,在除颤功能正常的情况下,植入起搏感知电极可解决该故障。%Objective To evaluate the efficacy and safety of pace/sense lead implantation in management of implant-able cardioverter defibrillator ( ICD) lead failure. Methods 4 patients were implanted with pace/sense lead to manage defib-rillation lead malfunction. Cause of the lead failure was analyzed, and the efficacy and safety of pace/sense lead replacement were evaluated. Results 4 patients with defibrillation lead malfunction in the right ventricle underwent inappropriate detec-tion and shocks. Among them, the high voltage impedance of defibrillation leads of all the patients were in the normal range. 3 cases experienced inappropriate force on the operation side. The cause of lead malfunction might be fraction of pace/sense lead in 3 patients and early abrasion of pace/sense in 1 patient. An additional pace/sense lead was implanted through trans-axillary venous for 4 patients, and the patients were then followed up for 7-70 months and no more inappropriate sense and shocks recurred, and all the changes of lead parameters were within the normal range. Conclusion A possible main cause for lead malfunction

  4. Unusual Cause of Inappropriate Implantable Cardioverter Defibrillators’ Shock: Tremor

    Directory of Open Access Journals (Sweden)

    Mustafa Oylumlu

    2013-08-01

    Full Text Available Implantable cardioverter defibrillators are widely used for primary and secondary prevention from sudden death. These devices terminate attacks of ventricular tachycardia and ventricular fibrillation by applying direct current shock, if it necessary. Despite these benefical effects, inappropriate shocks are important side effects of implantable cardioverter defibrillators. Inappropriate implantable cardioverter defibrillator shocks impair life quality by causing pain and psychological side-effects, and even induce new arrhytmias. In this paper we present a case of inappropriate implantable cardioverter defibrillator shock due to tremor.

  5. 采用植入式除颤器预防非缺血性心肌病患者发生死亡随机对照试验汇总分析%Implantable Defibrillators for the Prevention of Mortality in Patients With Nonischemic Cardiomyopathy A Meta-analysis of Randomized Controlled Trials

    Institute of Scientific and Technical Information of China (English)

    Akshay S. Desai; James C. Fang; William H. Maisel; 顾佳

    2005-01-01

    @@ 背景:植入式心脏复律除颤器(implantable cardioverter defibrillator,ICD)能有效预防(包括一级预防和二级预防)心脏射血分数(ejection fraction)下降的陈旧性心肌梗死患者发生心源性猝死.但是,目前仍缺乏证据肯定该疗法能提高非缺血性心肌病(nonischemic cardiomyopathy,NICM)患者的生存率.

  6. Automatic calibration of the inlet pressure sensor for the implantable continuous-flow ventricular assist device.

    Science.gov (United States)

    Shi, Wei; Saito, Itsuro; Isoyama, Takashi; Nakagawa, Hidemoto; Inoue, Yusuke; Ono, Toshiya; Kouno, Akimasa; Imachi, Kou; Abe, Yusuke

    2011-06-01

    Significant progress in the development of implantable ventricular assist devices using continuous-flow blood pumps has been made recently. However, a control method has not been established. The blood pressure in the inflow cannula (inlet pressure) is one of the candidates for performing an adequate control. This could also provide important information about ventricle sucking. However, no calibration method for an inlet pressure sensor exists. In this study, an automatic calibration algorithm of the inlet pressure sensor from the pressure waveform at the condition of ventricle sucking was proposed. The calibration algorithm was constructed based on the consideration that intrathoracic pressure could be substituted for atmospheric pressure because the lung is open to air. We assumed that the inlet pressure at the releasing point of the sucking would represent the intrathoracic pressure, because the atrial pressure would be low owing to the sucking condition. A special mock circulation system that can reproduce ventricle sucking was developed to validate the calibration algorithm. The calibration algorithm worked well with a maximum SD of 2.1 mmHg for 3-min measurement in the mock circulation system. While the deviation was slightly large for an elaborate calibration, it would still be useful as a primitive calibration. The influence of the respiratory change and other factors as well as the reliability of the calibration value should be investigated with an animal experiment as a next step. PMID:21373781

  7. Painless Implanted Cardioverter Defibrillator Therapy: Have We Taken It Seriously?%植入式心脏复律除颤器的无痛性治疗:我们重视了吗?

    Institute of Scientific and Technical Information of China (English)

    宿燕岗

    2011-01-01

    Shocking therapy of implanted cardioverter defibrillator (ICD) has been criticized for its causing myocardium damage and inducing electrical storm. Instead the anti-tachycardia pacing (ATP) function has been introduced as the main pain-free therapy of ICD, which could terminate about 3/4 ventricular tachycardia ( VT) events, without raising the risk of syncope or accelerated VT. The main concerns of ATP include differential identification of supraventricular tachycardia, re-confirmation of charging, settings of fast VT zone, strategies for optimization, and ATP while or before charging etc. , and the parameters should be adjusted individually during follow up. More concern should be paid to pain-free ICD therapy in clinical practice.%电击治疗可导致包括心肌损伤及诱发植入式心脏复律除颤器电风暴等弊端.植入式心脏复律除颤器的无痛性治疗主要是指其抗心动过速起搏功能.抗心动过速起搏能成功终止约3/4的室性心动过速事件,不增加晕厥或加速室性心动过速.无痛性治疗的主要策略包括室上性心动过速的鉴别程序、充电时的再确认、设定快速室性心动过速区、抗心动过速起搏策略优化、充电中和充电前抗心动过速起搏等.这些参数设置应个体化并在随访中进行调整.应重视植入式心脏复律除颤器无痛性治疗在临床上的应用.

  8. Percutaneous Extraction of Transvenous Permanent Pacemaker/Defibrillator Leads

    Directory of Open Access Journals (Sweden)

    Stylianos Paraskevaidis

    2014-01-01

    Full Text Available Background. Widespread use of cardiovascular implantable electronic devices has inevitably increased the need for lead revision/replacement. We report our experience in percutaneous extraction of transvenous permanent pacemaker/defibrillator leads. Methods. Thirty-six patients admitted to our centre from September 2005 through October 2012 for percutaneous lead extraction were included. Lead removal was attempted using Spectranetics traction-type system (Spectranetics Corp., Colorado, CO, USA and VascoExtor countertraction-type system (Vascomed GmbH, Weil am Rhein, Germany. Results. Lead extraction was attempted in 59 leads from 36 patients (27 men, mean ± SD age 61±5 years, with permanent pacemaker (n=25, defibrillator (n=8, or cardiac resynchronisation therapy (n=3 with a mean ± SD implant duration of 50±23 months. The indications for lead removal included pocket infection (n=23, endocarditis (n=2, and ventricular (n=10 and atrial lead dysfunction (n=1. Traction device was used for 33 leads and countertraction device for 26 leads. Mean ± SD fluoroscopy time was 4±2 minutes/lead for leads implanted 48 months (n=21, P=0.03. Complete procedural success rate was 91.7% and clinical procedural success rate was 100%, while lead procedural success rate was 95%. Conclusions. In conclusion, percutaneous extraction of transvenous permanent pacemaker/defibrillator leads using dedicated removal tools is both feasible and safe.

  9. Basal genoplivning af voksne og automatisk ekstern defibrillering

    DEFF Research Database (Denmark)

    Berlac, P.A.; Lippert, F.K.; Torp-Pedersen, Christian Tobias

    2008-01-01

    The new ERC guidelines on resuscitation emphasize the importance of quality CPR. BLS should be started as early as possible. Lay rescuers should not check for a pulse, they should call for help and start chest compressions immediately. Compression depth should be 4-5 cm at a rate of 100 compressi...... ventilations followed by a compression-ventilation ratio of 15:2. Automatic External Defibrillation should be used as early as possible Udgivelsesdato: 2008/11/17...

  10. Use of automated external defibrillators in a Brazilian airline. A 1-year experience

    Directory of Open Access Journals (Sweden)

    Alves Paulo Magalhães

    2001-01-01

    Full Text Available After the incorporation of automated external defibrilators by other airlines and the support of the Brazilian Society of cardiology, Varig Airlines Began the onboard defibrilation program with the initial purpose of equiping wide-body aircrafts frequently used in international flights and that airplanes use in the Rio - São Paulo route. With all fight attendants trained, the automated. External defibrilation devides were incorporated to 34 airplanes of a total pleet of 80 aircrats. The devices were intalled in the bagage compartments secured with velero straps and 2 pairs of electrods, one or which pre-conected to the device to minimize application time. Later, a portable monitor was addres to the ressocitation kit in the long flights. The expansion of the knowledge of the basic life support fundamentors and the correted implantation of the survival chain and of the automated external defibrilators will increase the extense of recovery of cardiorespiratory arrest victins in aircrafts.

  11. Electrostriction Effects During Defibrillation

    CERN Document Server

    Fritz, Michelle M; Roth, Bradley J

    2011-01-01

    Background-The electric field applied to the heart during defibrillation causes mechanical forces (electrostriction), and as a result the heart deforms. This paper analyses the physical origin of the deformation, and how significant it is. Methods-We represent the heart as an anisotropic cylinder. This simple geometry allows us to obtain analytical solutions for the potential, current density, charge, stress, and strain. Results-Charge induced on the heart surface in the presence of the electric field results in forces that deform the heart. In addition, the anisotropy of cardiac tissue creates a charge density throughout the tissue volume, leading to body forces. These two forces cause the tissue to deform in a complicated manner, with the anisotropy suppressing radial displacements in favor of tangential ones. Quantitatively, the deformation of the tissue is small, although it may be significant when using some imaging techniques that require the measurement of small displacements. Conclusions-The anisotrop...

  12. Automatic pre- to intra-operative CT registration for image-guided cochlear implant surgery

    OpenAIRE

    Reda, Fitsum A.; Noble, Jack H; Labadie, Robert F.; Dawant, Benoit M.

    2012-01-01

    Percutaneous cochlear implantation (PCI) is a minimally invasive image-guided cochlear implant approach, where access to the cochlea is achieved by drilling a linear channel from the skull surface to the cochlea. The PCI approach requires pre- and intra-operative planning. Computation of a safe linear drilling trajectory is performed in a pre-operative CT. This trajectory is mapped to intra-operative space using the transformation matrix that registers the pre- and intra-operative CTs. Howeve...

  13. Prevención primaria y secundaria de muerte súbita en un hospital de la Seguridad Social de Costa Rica: reporte del registro de pacientes con desfibrilador automático implantable, 2007-2011 Primary and secondary prevention of sudden cardiac death in a hospital of the social security system in Costa Rica: report from the registry of patients with implantable cardioverter-defibrillators, 2007-2011

    Directory of Open Access Journals (Sweden)

    Hugo Arguedas-Jiménez

    2013-03-01

    Full Text Available Justificación y objetivo: diversos estudios han demostrado la eficacia de los desfibriladores automáticos implantables en la prevención de la muerte súbita cardiaca. La aplicación de dicha evidencia debe ser evaluada mediante registros. El objetivo de este estudio fue describir las principales características epidemiológicas y clínicas y las complicaciones de los pacientes a quienes se les implanta un desfibrilador automático implantable en un hospital de tercer nivel en Costa Rica. Métodos: estudio observacional de cohorte, retrospectivo, que incluyó la totalidad de pacientes a quienes se les implantó un desfibrilador automático implantable en el hospital “Dr. Rafael Ángel Calderón Guardia” entre 2007 y 2011. Resultados: se incluyó 23 pacientes. La edad media fue de 55 ± 18 años. La cardiopatía isquémica fue la etiología más frecuente (10 pacientes. Veinte pacientes estaban en clase funcional I o II; la fracción de eyección media fue 0,38 ± 0,17. En los 18 pacientes el desfibrilador automático se implantó por prevención secundaria. Cinco pacientes presentaron una complicación temprana, todos ellos con dispositivos bicamerales: 2 hematomas menores, una disección del seno coronario, un desplazamiento del electrodo atrial derecho y un ictus cardioembólico. Hubo un total de 101 terapias (en 8 pacientes, de las cuales 94 fueron apropiadas (en 5 pacientes y 7 inapropiadas (en 3 pacientes; dos de estos últimos habían tenido episodios previos de fibrilación atrial. Conclusión: este registro muestra que la mayoría de los implantes de desfibriladores automáticos se realizan por prevención secundaria, con una alta tasa de terapias adecuadas y una baja tasa de terapias inadecuadas y de complicaciones; además, permite evaluar las indicaciones y las complicaciones asociadas con esta terapia.Aim: Several studies have demonstrated the efficacy of implantable cardioverter-defibrillators in the prevention of sudden

  14. 21 CFR 870.5325 - Defibrillator tester.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Defibrillator tester. 870.5325 Section 870.5325...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Therapeutic Devices § 870.5325 Defibrillator tester. (a) Identification. A defibrillator tester is a device that is connected to the output of...

  15. Mass transport limitation in implantable defibrillator batteries

    Science.gov (United States)

    Schmidt, C.; Tam, G.; Scott, E.; Norton, J.; Chen, K.

    Using cells with lithium reference electrodes, the power-limiting behavior in the lithium-SVO cell was shown to be due to a rapid voltage transition at the anode. A novel test cell was developed to explore the influence of current density, bulk LiAsF 6 concentration, separator type and separator proximity to the anode on the time to onset ( τ) of the anode polarization. The results were found to follow a relationship, iτ1/2∝ Cbulk, consistent with the Sand equation. This relationship also predicts that the critical concentration of LiAsF 6, at which onset of the anode polarization occurs, is near the solubility limit of LiAsF 6 in our system (around 3.5-4.0 M). This general phenomenon was found to be quantitatively similar for two dissimilar separator types, and the anode polarization could also be induced in the absence of separator at high concentration and current density. However, it appears that τ decreases with closer proximity of the separator to the anode surface (i.e. cell stack pressure), suggesting that the effect of separator is to inhibit convective transport to and from the Li surface.

  16. Association of psychiatric history and type D personality with symptoms of anxiety, depression, and health status prior to ICD implantation

    DEFF Research Database (Denmark)

    Starrenburg, Annemieke H; Kraaier, Karin; Pedersen, Susanne S.;

    2013-01-01

    Personality factors and psychiatric history may help explain individual differences in risk of psychological morbidity and poor health outcomes in patients with an implantable cardioverter defibrillator (ICD)....

  17. Implantation of dual chamber pacemaker defibrillator and placement of endocardial leads via the axillary vein%置入双腔起搏心脏复律除颤器及经腋静脉送入心内电极的初步临床体会

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    目的初步评价新型双腔起搏心脏复律除颤器抗室性心动过速/室颤(VT/VF)及心动过缓起搏的临床效果,了解经腋静脉送入心房及心室电极的安全性及有效性。 方法 7例室性心动过速及或室颤同时伴有心动过缓患者接受了双腔起搏心脏复律除颤器治疗,其中冠心病5例、扩张性心肌病2例。心房及心室电极均在X光线透视、静脉注入造影剂指导下,直接穿刺腋静脉,从该静脉送入。 结果脉冲发生器埋在左上胸皮下5例,胸大肌与胸小肌之间2例。仪器对所有VT/VF均能及时识别并成功治疗,同时提供有效的房室顺序起搏功能。所有心内电极均成功地经腋静脉送入,无并发症。 结论双腔起搏心脏复律除颤器不但能有效地治疗严重室性心律失常,而且能提供可靠的房室顺序性起搏功能,且经腋静脉送入电极安全,可靠。%Objectives To assess the preliminary clinical results of implantation of dual chamber pacemaker defibrillator and to evaluate the safety and effectiveness of placement of endocardial leads in the axillary vein. Methods Seven patients with ventricular tachycardia and/or ventricular fibrillation (VT/VF), associated with bradyarrhythmia received implantation of a dual chamber pacemaker defibrillator, including 5 patients with coronary artery disease and 2 patients with dilated cardiomyopathy.The atrial and ventricular leads were introduced via the axillary vein under venographic guidance. Results Dual chamber pacemaker defibrillators were successfully implanted in the left chest subcutaneous pocket in 5 patients and the left pectoral muscular pocket in 2 patients. All the VT/VF occurring either inducibly during the procedure or spontanuously during follow-up were detected promptly and treated successfully. Both the pacing and sensing functions were satisfactory. The endocardial leads required were successfully introduced via the axillary vein

  18. Increased anxiety in partners of patients with a cardioverter-defibrillator

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; VAN DEN Berg, Martha; Erdman, Ruud A M;

    2009-01-01

    The partner of the implantable cardioverter-defibrillator (ICD) patient serves as an important source of support for the patient, which may be hampered if the partner experiences increased distress. We examined (1) potential differences in anxiety and depressive symptoms in ICD patients compared to...

  19. AED (Automated External Defibrillator) Programs: Questions and Answers

    Science.gov (United States)

    ... live. What is an AED ? The automated external defibrillator ( AED ) is a computerized medical device. An AED ... AED or another defibrillation device (semiautomatic or manual defibrillator). The AHA also supports placing AEDs in targeted ...

  20. Estimation of current density distribution under electrodes for external defibrillation

    Directory of Open Access Journals (Sweden)

    Papazov Sava P

    2002-12-01

    Full Text Available Abstract Background Transthoracic defibrillation is the most common life-saving technique for the restoration of the heart rhythm of cardiac arrest victims. The procedure requires adequate application of large electrodes on the patient chest, to ensure low-resistance electrical contact. The current density distribution under the electrodes is non-uniform, leading to muscle contraction and pain, or risks of burning. The recent introduction of automatic external defibrillators and even wearable defibrillators, presents new demanding requirements for the structure of electrodes. Method and Results Using the pseudo-elliptic differential equation of Laplace type with appropriate boundary conditions and applying finite element method modeling, electrodes of various shapes and structure were studied. The non-uniformity of the current density distribution was shown to be moderately improved by adding a low resistivity layer between the metal and tissue and by a ring around the electrode perimeter. The inclusion of openings in long-term wearable electrodes additionally disturbs the current density profile. However, a number of small-size perforations may result in acceptable current density distribution. Conclusion The current density distribution non-uniformity of circular electrodes is about 30% less than that of square-shaped electrodes. The use of an interface layer of intermediate resistivity, comparable to that of the underlying tissues, and a high-resistivity perimeter ring, can further improve the distribution. The inclusion of skin aeration openings disturbs the current paths, but an appropriate selection of number and size provides a reasonable compromise.

  1. Use of Automated External Defibrillators

    Energy Technology Data Exchange (ETDEWEB)

    Gregory K Christensen

    2009-02-01

    In an effort to improve survival from cardiac arrest, the American Heart Association (AHA) has promoted the Chain of Survival concept, describing a sequence of prehospital steps that result in improved survival after sudden cardiac arrest. These interventions include immediate deployment of emergency medical services, prompt cardiopulmonary resuscitation, early defibrillation when indicated, and early initiation of advanced medical care. Early defibrillation has emerged as the most important intervention with survival decreasing by 10% with each minute of delay in defibrillation. Ventricular Fibrillation (VF) is a condition in which there is uncoordinated contraction of the heart cardiac muscle of the ventricles in the heart, making them tremble rather than contract properly. VF is a medical emergency and if the arrhythmia continues for more than a few seconds, blood circulation will cease, and death can occur in a matter of minutes. During VF, contractions of the heart are not synchronized, blood flow ceases, organs begin to fail from oxygen deprivation and within 10 minutes, death will occur. When VF occurs, the victim must be defibrillated in order to establish the heart’s normal rhythm. On average, the wait for an ambulance in populated areas of the United States is about 11 minutes. In view of these facts, the EFCOG Electrical Safety Task Group initiated this review to evaluate the potential value of deployment and use of automated external defibrillators (AEDs) for treatment of SCA victims. This evaluation indicates the long term survival benefit to victims of SCA is high if treated with CPR plus defibrillation within the first 3-5 minutes after collapse. According to the American Heart Association (AHA), survival rates as high as 74% are possible if treatment and defibrillation is performed in the first 3 minutes. In contrast survival rates are only 5% where no AED programs have been established to provide prompt CPR and defibrillation. ["CPR statistics

  2. Defibrillation thresholds are lower with smaller storage capacitors.

    Science.gov (United States)

    Leonelli, F M; Kroll, M W; Brewer, J E

    1995-09-01

    Present implantable cardioverter defibrillators use a wide range of capacitance values for the storage capacitor. However, the optimal capacitance value is unknown. We hypothesized that a smaller capacitor, by delivering its charge in a time closer to the heart chronaxie, should lower the defibrillation threshold (DFT). We compared the energy required to defibrillate 10 open-chest dogs, after 15 seconds of ventricular fibrillation, with a monophasic, time-truncated waveform delivered from either a 85-microF or a 140-microF capacitor. Shocks were delivered through a pair of 14-cm2 epicardial patch electrodes: The two capacitors were randomly tested twice with each dog using a modified 3-reversal method for each DFT determination. The average stored and delivered DFT energies for the 85-microF capacitor were 6.0 +/- 1.7 joules and 5.2 +/- 1.5 joules, respectively, compared to 6.7 +/- 1.7 joules and 6.0 +/- 1.5 joules for the 140-microF capacitor (P = 0.01 and P = 0.004, respectively). The mean leading edge voltages were higher, the pulse duration shorter, and the mean impedance lower for the 85-microF capacitor. The impedance was inversely related to the pulse duration and the voltage decay suggesting that, at least in part, the mechanism of improved defibrillation could be accounted for by the waveform electrical characteristics. There was an equal number of episodes of postshock bradyarrhythmias and tachyarrhythmias following discharges from each capacitor. Moreover, there was no relationship between the likelihood of these arrhythmias and either the initial voltage or the delivered current nor there was a higher number of episodes of postshock hypotension following the smaller capacitor discharges.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7491309

  3. Defibrillator-Induced Tricuspid Abscess Presenting as Diabetic Ketoacidosis and Wound Ulceration.

    Science.gov (United States)

    Khan, Rafay; Arshed, Sabrina; Ahmed, Amar; Sen, Shuvendu; Yousif, Abdalla

    2016-01-01

    Right-sided endocarditis is predominantly seen in patients with a history of intravenous drug abuse. However, it is well shown in the literature to be associated with patients containing foreign bodies such as pacemakers, central venous lines, and in those with congenital heart disease. In patients with pacemaker leads and in those with automatic implantable cardioverter defibrillators (AICDs), it is important to suspect foreign body infection when there are signs and indications of bacteremia. When these leads become infected, they can spread the infection to the tricuspid valve resulting in vegetations. The proper management is removal of the infected lead and foreign body along with a prolonged course of antibiotics. However, it is unusual and a relatively rare entity to see foreign body infection resulting from a wound ulcer resulting in not only endocarditis but also abscess formation on the tricuspid valve. Here we report a case of a 60-year-old male with recent AICD placement presenting as diabetic ketoacidosis due to tricuspid abscess formation as a result of a foot ulcer. PMID:26668682

  4. Development of Automated External Defibrillator%体外自动除颤器的研制

    Institute of Scientific and Technical Information of China (English)

    惠杰; 朱宗成; 谷云飞; 邬小玫; 方祖祥; 蒋文平

    2013-01-01

    Automatic external defibrillator (AED) is independently designed and developed and evaluated ventricular tachycardia ( VT/VF ) recognition sensitivity, specificity and defibrillation effect through animal experiment. The result shows that this device has advantages of convenient carrying, fast operation and accuracy, and has higher recognition sensitivity, specificity and defibrillation effect.%  自主设计和研制体外自动除颤器(AED),并通过动物实验评价该AED对室速/室颤(VT/VF)识别的敏感性、特异性以及除颤效果。实验结果表明该设备具有较高的识别敏感性、特异性和除颤效果,且便于携带、操作快捷和工作精确的优点。

  5. Experimental new automatic tools for robotic stereotactic neurosurgery: towards "no hands" procedure of leads implantation into a brain target.

    Science.gov (United States)

    Mazzone, P; Arena, P; Cantelli, L; Spampinato, G; Sposato, S; Cozzolino, S; Demarinis, P; Muscato, G

    2016-07-01

    The use of robotics in neurosurgery and, particularly, in stereotactic neurosurgery, is becoming more and more adopted because of the great advantages that it offers. Robotic manipulators easily allow to achieve great precision, reliability, and rapidity in the positioning of surgical instruments or devices in the brain. The aim of this work was to experimentally verify a fully automatic "no hands" surgical procedure. The integration of neuroimaging to data for planning the surgery, followed by application of new specific surgical tools, permitted the realization of a fully automated robotic implantation of leads in brain targets. An anthropomorphic commercial manipulator was utilized. In a preliminary phase, a software to plan surgery was developed, and the surgical tools were tested first during a simulation and then on a skull mock-up. In such a way, several tools were developed and tested, and the basis for an innovative surgical procedure arose. The final experimentation was carried out on anesthetized "large white" pigs. The determination of stereotactic parameters for the correct planning to reach the intended target was performed with the same technique currently employed in human stereotactic neurosurgery, and the robotic system revealed to be reliable and precise in reaching the target. The results of this work strengthen the possibility that a neurosurgeon may be substituted by a machine, and may represent the beginning of a new approach in the current clinical practice. Moreover, this possibility may have a great impact not only on stereotactic functional procedures but also on the entire domain of neurosurgery. PMID:27194228

  6. Implantable cardioverter defibrillator clinic casualties: inadvertent reprogramming during routine implantable cardioverter defibrillator follow-up.

    Science.gov (United States)

    Ozahowski, T P; Greenberg, M L; Mock, P; Holzberger, P T; Gerling, B; Zalinger, C; Perry, C

    1996-10-01

    On one occasion during a busy ICD follow-up clinic, the preceding patient's parameters for rate, PDF, and delay were inadvertently programmed into the subsequent patient's generator using the CPI Programmer Model 2035. This occurred after capacitor reformation, without pressing the "Program" button. The source of this reprogramming error was failure to clear the programmer memory of the previous patient's data, usually achieved by turning the programmer off between patients (or selecting "New Patient" from the menu). At our next ICD follow-up clinic, we purposely did not turn off the programmer between two sets of patients. On both occasions the above finding was repeated and confirmed. These observations indicate the potential for serious reprogramming errors that can occur simply by not clearing the programmer's memory between clinic patients. PMID:8904549

  7. First clinical evaluation of an atrial haemodynamic sensor lead for automatic optimization of cardiac resynchronization therapy

    Science.gov (United States)

    Duncker, David; Delnoy, Peter Paul; Nägele, Herbert; Mansourati, Jacques; Mont, Lluís; Anselme, Frédéric; Stengel, Petra; Anselmi, Francesca; Oswald, Hanno; Leclercq, Christophe

    2016-01-01

    Aims One option to improve cardiac resynchronization therapy (CRT) responder rates lies in the optimization of pacing intervals. A haemodynamic sensor embedded in the SonRtip atrial lead measures cardiac contractility and provides a systematic automatic atrioventricular and interventricular delays optimization. This multi-centre study evaluated the safety and performance of the lead, up to 1 year. Methods and results A total of 99 patients were implanted with the system composed of the lead and a CRT-Defibrillator device. Patients were followed at 1, 3, 6, and 12 months post-implant. The primary safety objective was to demonstrate that the atrial lead complication free rate was superior to 90% at 3-months follow-up visit. A lead handling questionnaire was filled by implanting investigators. Lead electrical performances and the performance of the system to compute AV and VV delays were evaluated at each study visit over 1 year. The complication free rate at 3 months post-implant was 99.0% [95%CI 94.5–100.0%], P 75% of the weeks. Conclusion The atrial lead is safe to implant and shows stable electrical performance over time. It therefore offers a promising tool for automatic CRT optimization to further improve responder rates to CRT. PMID:25976907

  8. Implantable loop recorder for recurrent syncopes.

    Science.gov (United States)

    Babuty, D; Pierre, B; Grimard, C; Zannad, N; Marie, O; Fauchier, L

    2009-08-01

    Syncope is a common disorder which may recur and impair the survival and the quality of life of the patients. The objective of the investigation of syncope is to diagnose the cardiac etiology, as mortality rate is high. Implantable loop recorder or insertable cardiac monitor (ICM) is a useful tool to establish a correlation between syncope and heart rhythm. About half of implanted patients complain of a new syncope and about 50% of these patients had cardiac rhythm disturbances on ICM. The most frequent is a sinus bradycardia or sinus arrest, but these results depend on the age of patients, resting electrocardiography (ECG) abnormalities and structural cardiac disease. A classification of the mechanisms of recurrent syncopes has been defined with the results of the ISSUE study, separating the syncope due to primary cardiac arrhythmia from neurally-mediated syncope and from unknown syncope. The analysis of the presyncopal phase on the ICM restored ECG allows physicians to adapt the treatment (antiarrhytmic agents or pacemaker) and optimize the programming of the pacemaker when necessary. It is early recommended to implant the ICM in patients affected with syncope with normal physical examination, normal ECG and without structural heart disease and negative tilt testing. In the presence of cardiac disease, it is recommended to implant ICM after performing an electrophysiological study and tilt testing. In syncope patients with depressed left ventricular ejection fraction, the implantation of an automatic implantable cardiac defibrillator is preferable. The indications of the ICM tend to be extended to new syncope populations such as pediatric patients and epileptic population. Early application of ICM reduces the cost of the investigation of the patients suffering from syncope, especially when the electrophysiological study is avoided. In the future the implantation of the ICM should be early discussed in the Syncope Unit to shorten the duration and the cost of the

  9. Verification of a Defibrillation Simulation Using Internal Electric Fields in a Human Shaped Phantom

    OpenAIRE

    Tate, Jess; Pilcher, Thomas; Aras, Kedar; Burton, Brett; Macleod, Rob

    2014-01-01

    We have developed a computer simulation to evaluate the success of Implantable Cardioverter Defibrillators (ICDs) in a patient specific manner. Though we have verified the simulations by means of surface recordings of shock potentials in humans, recordings of potentials within the heart and torso are needed to further verify the model for use in a clinical setting. We suspended an ex-planted porcine heart in a torso shaped electrolytic tank and recorded potentials on the tank surface, the epi...

  10. Injury to the coronary arteries and related structures by implantation of cardiac implantable electronic devices.

    Science.gov (United States)

    Pang, Benjamin J; Barold, S Serge; Mond, Harry G

    2015-04-01

    Damage to the coronary arteries and related structures from pacemaker and implantable cardioverter-defibrillator lead implantation is a rarely reported complication that can lead to myocardial infarction and pericardial tamponade that may occur acutely or even years later. We summarize the reported cases of injury to coronary arteries and related structures and review the causes of troponin elevation in the setting of cardiac implantable electronic device implantation. PMID:25564549

  11. Implantable cardioverter defibrillator and application in cardiac rehabilitation%植入式自动心律转复除颤器及其在心脏康复中的应用

    Institute of Scientific and Technical Information of China (English)

    李之明; 张彩举; 于钦军

    2004-01-01

    植入式自动心律转复除颤器(implantable cardioverter defibrillator,ICD)作为一种治疗严重心律失常的设备,具有高效、安全、实用的特点,能显著降低室性心律失常患者猝死的风险和死亡率,在国际上受到广泛关注。

  12. 21 CFR 870.5310 - Automated external defibrillator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated external defibrillator. 870.5310 Section 870.5310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... external defibrillator. (a) Identification. An automated external defibrillator (AED) is a...

  13. Wearable defibrillator use in heart failure (WIF: results of a prospective registry

    Directory of Open Access Journals (Sweden)

    Kao Andrew C

    2012-12-01

    Full Text Available Abstract Background Heart failure (HF patients have a high risk of death, and implantable cardioverter defibrillators (ICDs are effective in preventing sudden cardiac death (SCD. However, a certain percentage of patients may not be immediate candidates for ICDs, particularly those having a short duration of risk or an uncertain amount of risk. This includes the newly diagnosed patients, as well as those on the cardiac transplant list or NYHA class IV heart failure patients who do not already have an ICD. In these patients, a wearable cardioverter defibrillator (WCD may be used until long term risk of SCD is defined. The purpose of this study was to determine the incidence of SCD in this population, and the efficacy of early defibrillation by a WCD. Methods Ten enrolling centers identified 89 eligible HF patients who were either listed for cardiac transplantation, diagnosed with dilated cardiomyopathy, or receiving inotropic medications. Data collected included medical history, device records, and outcomes (including 90 day mortality. Results Out of 89 patients, final data on 82 patients has been collected. Patients wore the device for 75±58 days. Mean age was 56.8±13.2, and 72% were male. Most patients (98.8% were diagnosed with dilated cardiomyopathy with a low ejection fraction ( Conclusions In conclusion, the WCD monitored HF patients until further assessment of risk. The leading reasons for end of WCD use were improvement in left ventricular ejection fraction (LVEF or ICD implantation if there was no significant improvement in LVEF.

  14. Effects of drugs on defibrillation threshold%药物对除颤阈值的影响

    Institute of Scientific and Technical Information of China (English)

    黄震华

    2009-01-01

    Implantable cardioverter-defibrillator possesses vital value for preventing sudden cardiac death. For patients with already implantable cardioverter-defibrillator, some cardiovascular drugs especially the anti-arrhythmic ones are still inevitably needed. Some evidences showed that sotalol, and β-adrenergic receptor antagonists may decrease defibrillation threshold, and amiodarone, lidocaine, mexiletine, moracizine, verapamil may increase defibrillation threshold.%埋藏式心脏复律除颤器对于预防心源性猝死具有重要价值.对于已安装埋藏式心脏复律除颤器的病人,不可避免地仍需使用一些心血管药物,特别是抗心律失常药物.一些证据表明,索他洛尔、肾上腺素β受体阻滞药可降低除颤阈值,而胺碘酮、利多卡因、美西律、莫雷西嗪、维拉帕米等可提高除颤阈值.

  15. Atrioverter: An implantable device for the treatment of atrial fibrillation

    OpenAIRE

    Wellens, HJJ; Lau, CP; Lüderitz, B; Akhtar, M.; Waldo, AL; Camm, AJ; C. Timmermans; Tse, HF; Jung, W.; Jordaens, L.; Ayers, G

    1998-01-01

    Background - During atrial fibrillation, electrophysiological changes occur in atrial tissue that favor the maintenance of the arrhythmia and facilitate recurrence after conversion to sinus rhythm. An implantable defibrillator connected to right atrial and coronary sinus defibrillation leads allows prompt restoration of sinus rhythm by a low-energy shock. The safety and efficacy of this system, called the Atrioverter, were evaluated in a prospective, multicenter study. Methods and Results - T...

  16. Automated external defibrillators, life vest defibrillator, or both%体外自动除颤器、救生衣除颤器的使用或两者同时使用?

    Institute of Scientific and Technical Information of China (English)

    C.RichardConti; 杨渊; 丁荣晶

    2012-01-01

    As most understand,survival of cardiac arrest victims falls significantly if cardioversion is not performed promptly.The standard of practice for out-of-hospital defibrilhtion is the implantable cardiac defibrillator; however, much has been written and discussed about the use of automated external defibrillators.Not as much has been written about life vest wearable defibrillators.How to use these devices will be reviewed in this article.%医院外除颤临床上推荐使用埋藏式心律转复除颤器(Implantable cardiac defibrillator,ICD),关于体外自动除颤器(automated external defibrillators,AED)的使用和讨论也比较多,救生衣除颤器的报道则较少.Winkle[1]在近期综述指出,美国每年有数十万的院外患者死于心脏骤停.众所周知,心脏骤停患者如果未及时得到心脏电复律,生存的机会非常低.电生理学家在给患者置入ICD后,常通过诱发心室颤动并立即除颤来检测ICD功能.这强调了早期除颤是提高生存率的关键.一般来说,除非ICD不能正常工作,置入ICD的患者不需要心肺复苏.

  17. Frequent Home Monitoring of ICD Is Effective to Prevent Inappropriate Defibrillator Shock Delivery

    Directory of Open Access Journals (Sweden)

    Paolo Bifulco

    2014-01-01

    Full Text Available Recently, in the context of telemedicine, telemonitoring services are gaining attention. They are offered, for example, to patients with implantable cardioverter defibrillators (ICDs. A major problem associated with ICD therapy is the occurrence of inappropriate shocks which impair patients’ quality of life and may also be arrhythmogenic. The telemonitoring can provide a valid support to intensify followup visits, in order to improve the prevention of inappropriate defibrillator shock, thus enhancing patient safety. Inappropriate shock generally depends on atrial fibrillation, supraventricular tachycardia, and abnormal sensing (such as those caused by electromagnetic interferences. As a practical example, an unusual case of an ICD patient who risked an inappropriate shock while taking a shower is reported. Continuous remote telemonitoring was able to timely warn cardiologist via GSM-SMS, who were able to detect improper sensing examining the intracardiac electrogram via Web. Patient was promptly contacted and warned to not further come in contact with the hydraulic system and any electrical appliance to prevent an inappropriate defibrillator shock. This demonstrates the effectiveness and usefulness of continuous remote telemonitoring in supporting ICD patients.

  18. Evaluation and automatic correction of metal-implant-induced artifacts in MR-based attenuation correction in whole-body PET/MR imaging

    International Nuclear Information System (INIS)

    The aim of this paper is to describe a new automatic method for compensation of metal-implant-induced segmentation errors in MR-based attenuation maps (MRMaps) and to evaluate the quantitative influence of those artifacts on the reconstructed PET activity concentration. The developed method uses a PET-based delineation of the patient contour to compensate metal-implant-caused signal voids in the MR scan that is segmented for PET attenuation correction. PET emission data of 13 patients with metal implants examined in a Philips Ingenuity PET/MR were reconstructed with the vendor-provided method for attenuation correction (MRMaporig, PETorig) and additionally with a method for attenuation correction (MRMapcor, PETcor) developed by our group. MRMaps produced by both methods were visually inspected for segmentation errors. The segmentation errors in MRMaporig were classified into four classes (L1 and L2 artifacts inside the lung and B1 and B2 artifacts inside the remaining body depending on the assigned attenuation coefficients). The average relative SUV differences (εrelav) between PETorig and PETcor of all regions showing wrong attenuation coefficients in MRMaporig were calculated. Additionally, relative SUVmean differences (εrel) of tracer accumulations in hot focal structures inside or in the vicinity of these regions were evaluated. MRMaporig showed erroneous attenuation coefficients inside the regions affected by metal artifacts and inside the patients' lung in all 13 cases. In MRMapcor, all regions with metal artifacts, except for the sternum, were filled with the soft-tissue attenuation coefficient and the lung was correctly segmented in all patients. MRMapcor only showed small residual segmentation errors in eight patients. εrelav (mean ± standard deviation) were: ( − 56 ± 3)% for B1, ( − 43 ± 4)% for B2, (21 ± 18)% for L1, (120 ± 47)% for L2 regions. εrel (mean ± standard deviation) of hot focal structures were: ( − 52 ± 12)% in B1, (

  19. Arrhythmogenic Right Ventricular Cardiomyopathy: Risk Stratification and Indications for Defibrillator Therapy.

    Science.gov (United States)

    Zorzi, Alessandro; Rigato, Ilaria; Bauce, Barbara; Pilichou, Kalliopi; Basso, Cristina; Thiene, Gaetano; Iliceto, Sabino; Corrado, Domenico

    2016-06-01

    Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a genetically determined disease which predisposes to life-threatening ventricular arrhythmias. The main goal of ARVC therapy is prevention of sudden cardiac death (SCD). Implantable cardioverter defibrillator (ICD) is the most effective therapy for interruption of potentially lethal ventricular tachyarrhythmias. Despite its life-saving potential, ICD implantation is associated with a high rate of complications and significant impact on quality of life. Accurate risk stratification is needed to identify individuals who most benefit from the therapy. While there is general agreement that patients with a history of cardiac arrest or hemodynamically unstable ventricular tachycardia are at high risk of SCD and needs an ICD, indications for primary prevention remain a matter of debate. The article reviews the available scientific evidence and guidelines that may help to stratify the arrhythmic risk of ARVC patients and guide ICD implantation. Other therapeutic strategies, either alternative or additional to ICD, will be also addressed. PMID:27147509

  20. The NO Regular Defibrillation testing In Cardioverter Defibrillator Implantation (NORDIC ICD) trial

    DEFF Research Database (Denmark)

    Bänsch, Dietmar; Bonnemeier, Hendrik; Brandt, Johan;

    2015-01-01

    was standardized across all participating centres. After inducing a fast ventricular tachycardia (VT) with a heart rate ≥240 b.p.m. or ventricular fibrillation (VF) with a low-energy T-wave shock, DF was attempted with an initial 15 J shock. If the shock reversed the VT or VF, DF testing was considered successful...

  1. Remote monitoring of cardiac implantable electronic devices

    OpenAIRE

    Lappegård, Knut Tore

    2015-01-01

    Seminario desarrollado en la Segunda Conferencia Internacional de Comunicación en Salud, celebrada el 23 de octubre de 2015 en la Universidad Carlos III de Madrid Cardiac implantable electronic devices (CIEDs) are used with increasing frequency for the diagnosis and treatment of cardiac arrhythmias. In Europe, a total number of 550,000 pacemakers and 180,000 defibrillators were implanted in 2014. Follow-up of these patients is a large challenge to the health system and requires a substanti...

  2. Insulation Failure of the Linox Defibrillator Lead: A Case Report and Retrospective Review of a Single Center Experience.

    Science.gov (United States)

    Howe, Andrew J; McKeag, Nicholas A; Wilson, Carol M; Ashfield, Kyle P; Roberts, Michael J

    2015-06-01

    Implantable cardioverter defibrillator (ICD) lead insulation failure and conductor externalization have been increasingly reported. The 7.8F silicon-insulated Linox SD and Linox S ICD leads (Biotronik, Berlin, Germany) were released in 2006 and 2007, respectively, with an estimated 85,000 implantations worldwide. A 39-year-old female suffered an out-of-hospital ventricular fibrillation (VF) arrest with successful resuscitation. An ICD was implanted utilizing a single coil active fixation Linox(Smart) S lead (Biotronik, Berlin, Germany). A device-triggered alert approximately 3 years after implantation confirmed nonphysiological high rate sensing leading to VF detection. A chest X-ray showed an abnormality of the ICD lead and fluoroscopic screening confirmed conductor externalization proximal to the defibrillator coil. In view of the combined electrical and fluoroscopic abnormalities, urgent lead extraction and replacement were performed. A review of Linox (Biotronik) and Vigila (Sorin Group, Milan, Italy) lead implantations within our center (n = 98) identified 3 additional patients presenting with premature lead failure, 2 associated with nonphysiological sensed events and one associated with a significant decrease in lead impedance. All leads were subsequently removed and replaced. This case provides a striking example of insulation failure affecting the Linox ICD lead and, we believe, is the first to demonstrate conductor externalization manifesting both electrical and fluoroscopic abnormalities. PMID:25711237

  3. Prevention of sudden cardiac death by the implantable cardioverter defibrilator

    OpenAIRE

    Kovačević Dragan V.; Stojišić-Milosavljević Anastazija; Topalov Vasilije; Mihajlović Bogoljub; Sakač Dejan; Kozlovački Živa

    2011-01-01

    Introduction. Sudden cardiac death or, as it is also called, a modern man’s killer occurs a few hours after the beginning of the disease. Sudden death is the one that happens within an hour from the onset of the subjective discomforts regardless of the existence of any previous disease. According to modern statistics, 450.000 people die suddenly in the USA and 150,000 in Germany. Causes of sudden death. The most frequent causes of sudden death are cardiologic or, in other words, a heart...

  4. Sexual Health for Patients with an Implantable Cardioverter Defibrillator

    Science.gov (United States)

    ... LIBRARY Hello, Guest! My alerts Sign In Join Facebook Twitter Home About this Journal Editorial Board General Statistics Circulation Cover Doodle → Blip the Doodle Go Red For Women's Issue Information for Advertisers Author Reprints Commercial Reprints Customer Service and Ordering ...

  5. How to Respond to an Implantable Cardioverter-Defibrillator Recall

    Science.gov (United States)

    ... LIBRARY Hello, Guest! My alerts Sign In Join Facebook Twitter Home About this Journal Editorial Board General Statistics Circulation Cover Doodle → Blip the Doodle Go Red For Women's Issue Information for Advertisers Author Reprints Commercial Reprints Customer Service and Ordering ...

  6. Nationwide Fluoroscopic Screening of Recalled Riata Defibrillator Leads in Denmark

    DEFF Research Database (Denmark)

    Larsen, Jacob Mosgaard; Riahi, Sam; Nielsen, Jens C.;

    2013-01-01

    The natural history of insulation defects with inside-out conductor externalization in recalled St Jude Medical Riata defibrillator leads is not well understood.......The natural history of insulation defects with inside-out conductor externalization in recalled St Jude Medical Riata defibrillator leads is not well understood....

  7. Wearable Automatic External Deifbrillators%穿戴式自动体外除颤仪

    Institute of Scientific and Technical Information of China (English)

    罗华杰; 罗章源; 金勋; 张蕾蕾; 王长金; 张文赞; 涂权

    2015-01-01

    Defibrillation is the most effective method of treating ventricular fibrillation(VF), this paper introduces wearable automatic external defibrillators based on embedded system which includes ECG measurements, bioelectrical impedance measurement, discharge defibrilation module, which can automatic identify VF signal, biphasic exponential waveform defibrilation discharge. After verified by animal tests, the device can realize ECG acquisition and automatic identification. After identifying the ventricular fibrilation signal, it can automatic defibrilate to abort ventricular fibrilation and to realize the cardiac electrical cardioversion.%电击除颤是最有效的治疗室颤(VF)的方法,该文介绍的是基于嵌入式系统的穿戴式自动体外除颤仪,包括心电信号测量,生物阻抗测量,放电除颤模块,能够自动识别室颤信号,以双相指数波型进行除颤放电。经动物实验验证,该设备可实现心电信号采集及自动识别,在识别出室颤信号后能自动进行电击除颤,可中止室颤,实现心脏电转复。

  8. Genoplivning med automatisk ekstern defibrillator på hospital

    DEFF Research Database (Denmark)

    Løfgren, Bo; Wahlgreen, Claus; Hoffmann, Anne Mette;

    2009-01-01

    Early defibrillation is a determinant of survival in cardiac arrest. We report a Danish case of successful in-hospital resuscitation using an automated external defibrillator (AED). This case illustrates important aspects of implementation of in-hospital use of an AED, i.e. location of the AED......, education of the staff, systematic registration and data collection and technical aspects of AED use. If in-hospital AED implementation is carefully executed, its use may provide a safe and effective way of obtaining early defibrillation. Udgivelsesdato: 2009-Jan-26...

  9. Experience With the Wearable Cardioverter-Defibrillator in Patients at High Risk for Sudden Cardiac Death

    Science.gov (United States)

    Günther, Michael; Quick, Silvio; Pfluecke, Christian; Rottstädt, Fabian; Szymkiewicz, Steven J.; Ringquist, Steven; Strasser, Ruth H.; Speiser, Uwe

    2016-01-01

    Background: This study evaluated the wearable cardioverter-defibrillator (WCD) for use and effectiveness in preventing sudden death caused by ventricular tachyarrhythmia or fibrillation. Methods: From April 2010 through October 2013, 6043 German WCD patients (median age, 57 years; male, 78.5%) were recruited from 404 German centers. Deidentified German patient data were used for a retrospective, nonrandomized analysis. Results: Ninety-four patients (1.6%) were treated by the WCD in response to ventricular tachyarrhythmia/fibrillation. The incidence rate was 8.4 (95% confidence interval, 6.8–10.2) per 100 patient-years. Patients with implantable cardioverter-defibrillator explantation had an incidence rate of 19.3 (95% confidence interval, 12.2–29.0) per 100 patient-years. In contrast, an incidence rate of 8.2 (95% confidence interval, 6.4–10.3) was observed in the remaining cardiac diagnosis groups, including dilated cardiomyopathy, myocarditis, and ischemic and nonischemic cardiomyopathies. Among 120 shocked patients, 112 (93%) survived 24 hours after treatment, whereas asystole was observed in 2 patients (0.03%) with 1 resulting death. ConclusionS: This large cohort represents the first nationwide evaluation of WCD use in patients outside the US healthcare system and confirms the overall value of the WCD in German treatment pathways. PMID:27458236

  10. Wearable 'Defibrillator-In-A-Vest' May Help Some Heart Patients

    Science.gov (United States)

    ... nlm.nih.gov/medlineplus/news/fullstory_158001.html Wearable 'Defibrillator-in-a-Vest' May Help Some Heart ... what the relative benefit is," he added. The wearable defibrillator is worn under clothes looks like a " ...

  11. Use a defibrillator, save a life

    CERN Multimedia

    Joannah Caborn Wengler

    2012-01-01

    With the work for Long Shutdown 1 looming on the horizon, the CERN Fire Brigade is anticipating a heavy workload: more people working at CERN means more call-outs. So the more trained first-aiders around to help out before the paramedics arrive, the better. Would you know what to do in a medical emergency?   It could happen at any time: two colleagues are having a coffee at work, when one suddenly clutches his or her chest and falls to the floor unconscious. What would you do? Run to find a first-aider? Call the ambulance and wait, finishing your coffee? Neither response is entirely correct. On Monday 11 June in Building 40 the CMS safety group, in collaboration with the Fire Brigade and the Medical Service, demonstrated the recommended, potentially life-saving response to cardiac arrest (see the video), including the correct use of a defibrillator, ten of which were recently installed in key CERN locations (the Bulletin reported).     “In countries where...

  12. A new approach to optimization-based defibrillation.

    Science.gov (United States)

    Muzdeka, S; Barbieri, E

    2001-01-01

    The purpose of this paper is to develop a new model for optimal cardiac defibrillation, based on simultaneous minimization of energy consumption and defibrillation time requirements. In order to generate optimal defibrillation waveforms that will accomplish the objective stated above, one parameter rho has been introduced as a part of the performance measure to weigh the relative importance of time and energy. All the results of this theoretical study have been obtained for the proposed model, under the assumption that cardiac tissue can be represented by a simple parallel resistor-capacitor circuit. It is well known from modern control theory that the selection of a numerical value of the weight factor is the matter of subjective judgment of a designer. However, it has been shown that defining a cost function can help in selecting a value for rho. Some results of the mathematical development of the algorithm and computer simulations will be included in the paper. PMID:11347410

  13. Praehospital-hjertestopbehandling med semiautomatisk defibrillator--Heartstart 2000

    DEFF Research Database (Denmark)

    Fonsmark, L; Sandøe, E; Kastrup, J;

    1989-01-01

    In order to test the efficacy of a semiautomatic defibrillator (Heartstart 2000) in connection with cardiac arrest outside hospital, the apparatus was installed in two of the ambulances belonging to the Copenhagen Fire Service. The ambulance district involved was also equipped with an ambulance...... staffed by a doctor. A total of 48 patients with cardiac arrest were found and 16 of these had ventricular fibrillation. Six of the 16 patients have since been discharged from hospital (37.5%). The defibrillator had a high diagnostic certainty with a sensitivity of 96.5% and a specificity of 100%. No...... practical problems of note occurred in connection with employment of the defibrillator. The ambulance staffs underwent six hours of training and this appeared to be adequate. It is concluded that Heartstart 2000 functions well and effectively in connection with revival of patients with cardiac arrest...

  14. Towards the Automated Analysis and Database Development of Defibrillator Data from Cardiac Arrest

    Directory of Open Access Journals (Sweden)

    Trygve Eftestøl

    2014-01-01

    Full Text Available Background. During resuscitation of cardiac arrest victims a variety of information in electronic format is recorded as part of the documentation of the patient care contact and in order to be provided for case review for quality improvement. Such review requires considerable effort and resources. There is also the problem of interobserver effects. Objective. We show that it is possible to efficiently analyze resuscitation episodes automatically using a minimal set of the available information. Methods and Results. A minimal set of variables is defined which describe therapeutic events (compression sequences and defibrillations and corresponding patient response events (annotated rhythm transitions. From this a state sequence representation of the resuscitation episode is constructed and an algorithm is developed for reasoning with this representation and extract review variables automatically. As a case study, the method is applied to the data abstraction process used in the King County EMS. The automatically generated variables are compared to the original ones with accuracies ≥90% for 18 variables and ≥85% for the remaining four variables. Conclusions. It is possible to use the information present in the CPR process data recorded by the AED along with rhythm and chest compression annotations to automate the episode review.

  15. Breast calcifications following electrical defibrillation: An unusual mammographic appearance.

    Science.gov (United States)

    Westphal, Steven M; Jani, Manish; Badve, Sunil

    2010-01-01

    We present a case of a 57-year-old woman with a past medical history of end-stage renal disease and a recent history of electrical defibrillation who arrived for her annual mammogram with no breast-related complaints. The mammogram showed interval development of unusual clusters of heterogeneous calcifications. The patient underwent stereotactic core-needle biopsy for definitive diagnosis. The pathologic evaluation revealed fibrosis, abnormal adipocytes, and calcifications with no evidence of malignancy. The constellation of findings was consistent with fat necrosis and fibrosis related to tissue damage sustained during the recent defibrillation. PMID:27307857

  16. Frequency of inappropriate therapy in patients implanted with dual- versus single-chamber ICD devices in the ICD arm of MADIT-CRT

    DEFF Research Database (Denmark)

    Ruwald, Anne-Christine H; Sood, Nitesh; Ruwald, Martin H;

    2013-01-01

    The majority of implantable cardioverter defibrillators (ICDs) are dual-chamber devices, but studies on the frequency of inappropriate therapy in dual- versus single-chamber devices have shown conflicting results. The aim of this study is to determine whether implantation of dual-chamber ICD...

  17. 心脏除颤器的质量控制%Quality Control of Cardiac Defibrillator/Defibrillation Monitor

    Institute of Scientific and Technical Information of China (English)

    崔亮; 崔骊; 苏燕平

    2012-01-01

    目的:通过对心脏除颤器/除颤监护仪进行质量控制检测,分析检测中发现的问题,提出解决方案,以确保该设备的安全使用.方法:采用除颤器检定仪检测,并分析失准设备的检测数据.结果:通过分析心脏除颤器/除颤监护仪的失准原因,及时维修,解决了检测中出现的问题,保障了除颤器/除颤监护仪的临床使用安全.结论:对除颤器/除颤监护仪进行质量控制非常必要,可以预防因设备失准而引起的医疗事故.%Objective: Through quality control testing to the cardiac defibrillator/defibrilLation monitor, we can analyze the problems of testing and propose solutions to ensure the use of safety in the clinical. Methods: Through the detector to detect the defibrillator, so we can analyze the data of misalignment equipment. Results: Trough analyzing and solving the problems in the testing, ensure the safety of the defibrillator. Conclusion: It is very necessary to test the cardiac defibrillator/defibrillation monitor that can prevent the medical accident, which caused by misalignment of medical equipment.

  18. Cardiac or Other Implantable Electronic Devices and Sleep-disordered Breathing – Implications for Diagnosis and Therapy

    OpenAIRE

    Fox, Henrik; Bitter, Thomas; Gutleben, Klaus-Jürgen; Horstkotte, Dieter; Oldenburg, Olaf

    2014-01-01

    Sleep-disordered breathing (SDB) is of growing interest in cardiology because SDB is a highly prevalent comorbidity in patients with a variety of cardiovascular diseases. The prevalence of SDB is particularly high in patients with cardiac dysrhythmias and/or heart failure. In this setting, many patients now have implantable cardiac devices, such as pacemakers, implantable cardioverter-defibrillators or implanted cardiac resynchronisation therapy devices (CRT). Treatment of SDB using implantab...

  19. Electronic article surveillance systems and interactions with implantable cardiac devices: risk of adverse interactions in public and commercial spaces.

    Science.gov (United States)

    Gimbel, J Rod; Cox, James W

    2007-03-01

    Electronic article surveillance (EAS) systems are widely implemented in public spaces and can adversely affect the performance of pacemakers and implantable cardioverter defibrillators. The interaction between implantable devices and EAS systems is a serious problem that can be minimized through appropriate facility design. Careful facility design and employee education along with patient vigilance remain imperative in avoiding potentially life-threatening EAS system-implantable device interactions. PMID:17352368

  20. Implanted cardiac devices are reliably detected by commercially available metal detectors

    DEFF Research Database (Denmark)

    Holm, Katja Fiedler; Hjortshøj, Søren; Pehrson, Steen;

    2013-01-01

    Explosions of Cardiovascular Implantable Electronic Devices (CIEDs) (pacemakers, defibrillators, and loop recorders) are a well-recognized problem during cremation, due to lithium-iodine batteries. In addition, burial of the deceased with a CIED can present a potential risk for environmental...

  1. Advantage of four-electrode over two-electrode defibrillators.

    Science.gov (United States)

    Bragard, J; Šimić, A; Laroze, D; Elorza, J

    2015-12-01

    Defibrillation is the standard clinical treatment used to stop ventricular fibrillation. An electrical device delivers a controlled amount of electrical energy via a pair of electrodes in order to reestablish a normal heart rate. We propose a technique that is a combination of biphasic shocks applied with a four-electrode system rather than the standard two-electrode system. We use a numerical model of a one-dimensional ring of cardiac tissue in order to test and evaluate the benefit of this technique. We compare three different shock protocols, namely a monophasic and two types of biphasic shocks. The results obtained by using a four-electrode system are compared quantitatively with those obtained with the standard two-electrode system. We find that a huge reduction in defibrillation threshold is achieved with the four-electrode system. For the most efficient protocol (asymmetric biphasic), we obtain a reduction in excess of 80% in the energy required for a defibrillation success rate of 90%. The mechanisms of successful defibrillation are also analyzed. This reveals that the advantage of asymmetric biphasic shocks with four electrodes lies in the duration of the cathodal and anodal phase of the shock. PMID:26764786

  2. Hvor er den automatiske eksterne defibrillator? Udvikling og uddannelse

    DEFF Research Database (Denmark)

    Løfgren, Bo; Grove, Erik; Krarup, Niels Henrik

    2009-01-01

    The International Liaison Committee on Resuscitation has presented a universal sign to indicate the presence of automated external defibrillators (AED). To disseminate the knowledge of this important signage, a review in a Danish context is presented. It is essential that the public in general and...

  3. Where Does It Lead? Imaging Features of Cardiovascular Implantable Electronic Devices on Chest Radiograph and CT

    Energy Technology Data Exchange (ETDEWEB)

    Lanzman, Rotem S.; Blondin, Dirk; Furst, Gunter; Scherer, Axel; R Miese, Falk; Kroepil, Patric [University of Duesseldorf, Medical Faculty, 40225 Duesseldorf (Germany); Winter, Joachim [University Hospital Duesseldorf, 40225 Duesseldorf (Germany); Abbara, Suhny [Massachusetts General Hospital, Boston, MA (US)

    2011-10-15

    Pacemakers and implantable cardioverter defibrillators (ICDs) are being increasingly employed in patients suffering from cardiac rhythm disturbances. The principal objective of this article is to familiarize radiologists with pacemakers and ICDs on chest radiographs and CT scans. Therefore, the preferred lead positions according to pacemaker types and anatomic variants are introduced in this study. Additionally, the imaging features of incorrect lead positions and defects, as well as complications subsequent to pacemaker implantation are demonstrated herein.

  4. Non-linear dynamical signal characterization for prediction of defibrillation success through machine learning

    OpenAIRE

    Shandilya Sharad; Ward Kevin; Kurz Michael; Najarian Kayvan

    2012-01-01

    Abstract Background Ventricular Fibrillation (VF) is a common presenting dysrhythmia in the setting of cardiac arrest whose main treatment is defibrillation through direct current countershock to achieve return of spontaneous circulation. However, often defibrillation is unsuccessful and may even lead to the transition of VF to more nefarious rhythms such as asystole or pulseless electrical activity. Multiple methods have been proposed for predicting defibrillation success based on examinatio...

  5. Dental Implants

    Medline Plus

    Full Text Available Dental Implants A fuller, more complete smile is within reach. The following information is designed to provide helpful ... whether dental implants are right for your situation. Dental Implants and Roots The key benefit of dental implants ...

  6. Breast calcifications following electrical defibrillation: An unusual mammographic appearance

    OpenAIRE

    Westphal, Steven M.; Jani, Manish; BADVE, SUNIL

    2015-01-01

    We present a case of a 57-year-old woman with a past medical history of end-stage renal disease and a recent history of electrical defibrillation who arrived for her annual mammogram with no breast-related complaints. The mammogram showed interval development of unusual clusters of heterogeneous calcifications. The patient underwent stereotactic core-needle biopsy for definitive diagnosis. The pathologic evaluation revealed fibrosis, abnormal adipocytes, and calcifications with no evidence of...

  7. Why We Need Postmortem Analysis of Cardiac Implantable Electronic Devices.

    Science.gov (United States)

    Mauf, Sabrina; Jentzsch, Thorsten; Laberke, Patrick J; Thali, Michael J; Bartsch, Christine

    2016-07-01

    The prevalence of cardiac implantable electronic devices (CIEDs), pacemakers and implantable cardioverter defibrillators (ICDs) is increasing. However, postmortem analysis of CIEDs is not performed routinely. Fourteen consecutive CIEDs were analyzed. The indication for and date of implantation, technical data, CIED reprogramming, heart rhythm disturbances, patient demographics and medical consultations were investigated. Death during the first year after implantation was seen in 54%, whereof 71% consulted a physician within 10 days before death. The time of death was attributed to a particular day in 29%. There was a relationship between CIEDs and cause/manner of death in 50%. Although limited by a small sample size, this study advocates the routine postmortem CIED analysis for forensic and clinical purposes in selected cases. Patients with CIEDs seem to show an increased risk of death during the first year after implantation. The analysis of CIEDs can be helpful in evaluating the time/cause/manner of death. PMID:27364278

  8. Automatic sequences

    CERN Document Server

    Haeseler, Friedrich

    2003-01-01

    Automatic sequences are sequences which are produced by a finite automaton. Although they are not random they may look as being random. They are complicated, in the sense of not being not ultimately periodic, they may look rather complicated, in the sense that it may not be easy to name the rule by which the sequence is generated, however there exists a rule which generates the sequence. The concept automatic sequences has special applications in algebra, number theory, finite automata and formal languages, combinatorics on words. The text deals with different aspects of automatic sequences, in particular:· a general introduction to automatic sequences· the basic (combinatorial) properties of automatic sequences· the algebraic approach to automatic sequences· geometric objects related to automatic sequences.

  9. Pediatric defibrillation after cardiac arrest: initial response and outcome

    Science.gov (United States)

    Rodríguez-Núñez, Antonio; López-Herce, Jesús; García, Cristina; Domínguez, Pedro; Carrillo, Angel; Bellón, Jose María

    2006-01-01

    Introduction Shockable rhythms are rare in pediatric cardiac arrest and the results of defibrillation are uncertain. The objective of this study was to analyze the results of cardiopulmonary resuscitation that included defibrillation in children. Methods Forty-four out of 241 children (18.2%) who were resuscitated from inhospital or out-of-hospital cardiac arrest had been treated with manual defibrillation. Data were recorded according to the Utstein style. Outcome variables were a sustained return of spontaneous circulation (ROSC) and one-year survival. Characteristics of patients and of resuscitation were evaluated. Results Cardiac disease was the major cause of arrest in this group. Ventricular fibrillation (VF) or pulseless ventricular tachycardia (PVT) was the first documented electrocardiogram rhythm in 19 patients (43.2%). A shockable rhythm developed during resuscitation in 25 patients (56.8%). The first shock (dose, 2 J/kg) terminated VF or PVT in eight patients (18.1%). Seventeen children (38.6%) needed more than three shocks to solve VF or PVT. ROSC was achieved in 28 cases (63.6%) and it was sustained in 19 patients (43.2%). Only three patients (6.8%), however, survived at 1-year follow-up. Children with VF or PVT as the first documented rhythm had better ROSC, better initial survival and better final survival than children with subsequent VF or PVT. Children who survived were older than the finally dead patients. No significant differences in response rate were observed when first and second shocks were compared. The survival rate was higher in patients treated with a second shock dose of 2 J/kg than in those who received higher doses. Outcome was not related to the cause or the location of arrest. The survival rate was inversely related to the duration of cardiopulmonary resuscitation. Conclusion Defibrillation is necessary in 18% of children who suffer cardiac arrest. Termination of VF or PVT after the first defibrillation dose is achieved in a low

  10. Is an atrial defibrillator still an option in treating patients with atrial fibrillation?

    Directory of Open Access Journals (Sweden)

    Ziad El Khoury MD

    2013-02-01

    Full Text Available trial fibrillation (AF is a common disorder associated with significant morbidities and presents several challenges for the control of symptoms and prevention of long-term implications. Atrial defibrillators (ADs, used for rhythm control in patients with symptoms refractory to medical therapy, can detect recurrences of the arrhythmia, allow prompt patient-directed treatment, and have the potential to reduce hospitalizations and improve quality of life. The efficacy of this form of therapy is highest in patients with paroxysmal AF, and with the use of a coronary sinus shocking lead. While R-wave synchronized shocks are a prerequisite for a safe use, the procedure is well-tolerated and usually not associated with long-term psychological side effects. Limitations of ADs include acute and chronic complications related to a cardiac rhythm device implantation, the requirement in some cases for more than one shock to terminate AF, the discomfort from shocks, as well as the need for sedation to alleviate pain from the shocks. With the ever expanding role of catheter-based therapies for AF, it seems that the role of ADs in this regard is rather limited.

  11. Dental Implants

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    Full Text Available Dental Implants A fuller, more complete smile is within reach. The following information is designed to provide ... whether dental implants are right for your situation. Dental Implants and Roots The key benefit of dental ...

  12. Dental Implants

    Science.gov (United States)

    Dental Implants A fuller, more complete smile is within reach. The following information is designed to provide ... whether dental implants are right for your situation. Dental Implants and Roots The key benefit of dental ...

  13. Management of Patients With Cardiovascular Implantable Electronic Devices in Dental, Oral, and Maxillofacial Surgery.

    Science.gov (United States)

    Tom, James

    2016-01-01

    The prevalence of cardiovascular implantable electronic devices as life-prolonging and life-saving devices has evolved from a treatment of last resort to a first-line therapy for an increasing number of patients. As these devices become more and more popular in the general population, dental providers utilizing instruments and medications should be aware of dental equipment and medications that may affect these devices and understand the management of patients with these devices. This review article will discuss the various types and indications for pacemakers and implantable cardioverter-defibrillators, common drugs and instruments affecting these devices, and management of patients with these devices implanted for cardiac dysrhythmias. PMID:27269668

  14. Dental Implants

    Medline Plus

    Full Text Available ... helpful facts so you can make an informed decision as to whether dental implants are right for your situation. Dental Implants and Roots The key benefit of dental implants over other tooth replacement systems is that an implant connects directly to the ...

  15. The Effect of Compressor-Administered Defibrillation on Peri-shock Pauses in a Simulated Cardiac Arrest Scenario

    Directory of Open Access Journals (Sweden)

    Joshua Glick

    2014-03-01

    Full Text Available Introduction: Coordination of the tasks of performing chest compressions and defibrillation can lead to communication challenges that may prolong time spent off the chest. The purpose of this study was to determine whether defibrillation provided by the provider performing chest compressions led to a decrease in peri-shock pauses as compared to defibrillation administered by a second provider, in a simulated cardiac arrest scenario. Methods: This was a randomized, controlled study measuring pauses in chest compressions for defibrillation in a simulated cardiac arrest model. We approached hospital providers with current CPR certification for participation between July, 2011 and October, 2011. Volunteers were randomized to control (facilitator-administered defibrillation or experimental (compressor-administered defibrillation groups. All participants completed one minute of chest compressions on a mannequin in a shockable rhythm prior to administration of defibrillation. We measured and compared pauses for defibrillation in both groups. Results: Out of 200 total participants, we analyzed data from 197 defibrillations. Compressor-initiated defibrillation resulted in a significantly lower pre-shock hands-off time (0.57 s; 95% CI: 0.47-0.67 compared to facilitator-initiated defibrillation (1.49 s; 95% CI: 1.35-1.64. Furthermore, compressor-initiated defibrillation resulted in a significantly lower peri-shock hands-off time (2.77 s; 95% CI: 2.58-2.95 compared to facilitator-initiated defibrillation (4.25 s; 95% CI: 4.08-4.43. Conclusion: Assigning the responsibility for shock delivery to the provider performing compressions encourages continuous compressions throughout the charging period and decreases total time spent off the chest. However, as this was a simulation-based study, clinical implementation is necessary to further evaluate these potential benefits. [West J Emerg Med. 2014;15(2:246–250.

  16. Peer-led training in basic life support and resuscitation using an automatic external defibrillator

    DEFF Research Database (Denmark)

    Løfgren, Bo; Petersen, Christina Børlum; Mikkelsen, Ronni;

    2009-01-01

    Peer-led training has been identified as a useful tool for delivering undergraduate healthcare training. In this paper we describe the implementation of the European Resuscitation Council BLS/AED Course as a peer-led training program for medical students....

  17. Cardiac Implantable Electronic Devices and End-of-Life Care: An Australian Perspective.

    Science.gov (United States)

    Alhammad, Nasser J; O'Donnell, Mark; O'Donnell, David; Mariani, Justin A; Gould, Paul A; McGavigan, Andrew D

    2016-08-01

    Cardiac implantable electronic devices (pacemakers and defibrillators) are increasingly common in modern cardiology practice, and health professionals from a variety of specialties will encounter patients with such devices on a frequent basis. This article will focus on the subset of patients who may request, or be appropriate for, device deactivation and discuss the issues surrounding end-of-life decisions, along with the ethical and legal implications of device deactivation. PMID:27320854

  18. Where Does It Lead? Imaging Features of Cardiovascular Implantable Electronic Devices on Chest Radiograph and CT

    OpenAIRE

    Lanzman, Rotem S.; Winter, Joachim; Blondin, Dirk; Fürst, Günter; Scherer, Axel; Miese, Falk R; Abbara, Suhny; Kröpil, Patric

    2011-01-01

    Pacemakers and implantable cardioverter defibrillators (ICDs) are being increasingly employed in patients suffering from cardiac rhythm disturbances. The principal objective of this article is to familiarize radiologists with pacemakers and ICDs on chest radiographs and CT scans. Therefore, the preferred lead positions according to pacemaker types and anatomic variants are introduced in this study. Additionally, the imaging features of incorrect lead positions and defects, as well as complica...

  19. Defibrillator charging before rhythm analysis significantly reduces hands-off time during resuscitation

    DEFF Research Database (Denmark)

    Hansen, L. K.; Folkestad, L.; Brabrand, M.

    2013-01-01

    tachycardia and asystole were presented randomly to all participants in a simulation setting. A manikin (Resusci Anne; Laerdal Scandinavia A/S, Stavanger, Norway) and a defibrillator (LIFEPACK 12; Physio-Control, Inc, Redmond, WA, USA) were used. In ALT, chest compressions were only interrupted for...... observed in either of the asystole scenarios. CONCLUSION: In a simulation setting, we demonstrated that charging of the defibrillator before rhythm analysis significantly reduced hands-off time compared with the ERC 2005 and ERC 2010 guidelines....

  20. 基于有限元方法的心脏除颤仿真研究%Simulation Study of Heart Defibrillation Based on Finite Element Method

    Institute of Scientific and Technical Information of China (English)

    杨圣均; 郑懿; 邬小玫; 魏大名; 方祖祥

    2011-01-01

    临床动物电击除颤实验无法精确测量放电电场在心脏上的实际分布情况,且存在诸多不便利和不安全因素.鉴于此,提出了一种基于心脏建模及有限元求解的心脏除颤电场分布仿真研究方法,心脏模型包含了完整的心房心室解剖结构和左右心腔,考虑了心肌细胞和血液的电阻率,然后采用有限元方法进行分析,并使用Abaqus集成环境进行求解,求解结果与文献报道的参考标准进行对比.仿真结果在除颤电压阈值和能量阈值方面与目前的植入式心脏复律除颤器( ICD)的临床应用效果具有相当的吻合度,能量阈值相对误差仅为10%,验证了所提出方法的可行性.%Clinical animal defibrillation experiments can not measure the electrical field distribution of heart precisely, also with inconvenience and unsafety. Thereby, a method for studying heart defibrillation electric field distribution based on heart modeling and finite element solution was proposed in this paper. The heart model covers integrated anatomy of atria and ventricles, with taking resistivity of cardiac muscle cells and blood into account. And then, finite element method and Abaqus Integrated Environment was adopted. Lastly, the result was put into contrast with the benchmark. In defibrillation voltage and energy threshold, the simulation result coincided with the clinical effect of Implantable Cardioverter Defibrillator (ICD) very well, with the relative error of energy threshold limited to 10% , which verified the feasibility of the proposed method.

  1. Defibrillation overload recovery performance test system for ECG electrode%心电电极除颤过载恢复性能测试系统

    Institute of Scientific and Technical Information of China (English)

    罗兰英; 田学隆; 周平; 李一言

    2011-01-01

    除颤过载恢复是心电电极的重要电性能,它的优劣直接影响到除颤后心电波形的检测和显示,进而影响对患者的抢救和治疗进程.文中开发了一种心电电极除颤过载性能测试系统,根据最新医药行业标准,基于C8051 F340的硬件系统,通过USB协议进行数据传输,在LabVIEW的软件平台上,实现了对除颤恢复性能指标的检测(包括交流阻抗的测试).系统采用良好的电隔离控制和检测,能精确控制测试过程中的充放电时间.实验结果表明,该系统能准确有效的测试电极对的除颤过载恢复性能,并具有安全、准确、操作简单等优点.%Defibrillation overload recovery performance is one of the most important electrical properties of ECG electrodes, which directly affects the ECG display after the patient is defibrillated, thereby affects the diagnosis and treatment of the patient. A defibrillation overload recovery performance test system for ECG electrodes was developed according to the latest pharmaceutical industry standards and based on the C8051F340 hardware system. With USB protocol data transfer, the detection of defibrillation overload recovery performance parameters (including AC impedance) is implemented on Lab VIEW software platform. The system has good electrical isolation control, which can accurately operate the charging and discharging time during test process automatically. Experiment result shows that this system has good performance, and features safe, accurate and easy to operate.

  2. Carmustine Implant

    Science.gov (United States)

    Carmustine implant is used along with surgery and sometimes radiation therapy to treat malignant glioma (a certain type of ... Carmustine implant comes as a small wafer that is placed in the brain by a doctor during surgery to ...

  3. Goserelin Implant

    Science.gov (United States)

    Goserelin implant is used in combination with radiation therapy and other medications to treat localized prostate cancer and is ... treatment of abnormal bleeding of the uterus. Goserelin implant is in a class of medications called gonadotropin- ...

  4. Dental Implants

    Medline Plus

    Full Text Available ... is lost for the most predictable esthetic outcome. Timeline Replacing a tooth with an implant and a ... months to complete the process . Due to the timeline, dental implants are actually a series of steps; ...

  5. Hypersensitivity reactions to metallic implants-diagnostic algorithm and suggested patch test series for clinical use

    DEFF Research Database (Denmark)

    Schalock, Peter C; Menné, Torkil; Johansen, Jeanne D; Taylor, James S; Maibach, Howard I; Lidén, Carola; Bruze, Magnus; Thyssen, Jacob P

    2011-01-01

    algorithm to guide the selection of screening allergen series for patch testing is provided. At a minimum, an extended baseline screening series and metal screening is necessary. Static and dynamic orthopaedic implants, intravascular stent devices, implanted defibrillators and dental and gynaecological......Cutaneous and systemic hypersensitivity reactions to implanted metals are challenging to evaluate and treat. Although they are uncommon, they do exist, and require appropriate and complete evaluation. This review summarizes the evidence regarding evaluation tools, especially patch and lymphocyte...... transformation tests, for hypersensitivity reactions to implanted metal devices. Patch test evaluation is the gold standard for metal hypersensitivity, although the results may be subjective. Regarding pre-implant testing, those patients with a reported history of metal dermatitis should be evaluated by patch...

  6. Poor perceived social support in implantable cardioverter defibrillator (ICD) patients and their partners

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Spinder, Helle; Erdman, Ruud A M;

    2009-01-01

    Social support is a known buffer of psychological distress and has also been shown to influence adverse medical outcomes.......Social support is a known buffer of psychological distress and has also been shown to influence adverse medical outcomes....

  7. Long-term mortality risk in patients with an implantable cardioverter-defibrillator

    DEFF Research Database (Denmark)

    Hoogwegt, Madelein T; Theuns, Dominic A M J; Pedersen, Susanne S.;

    2014-01-01

    .9)). The impact of heart rate and QRS duration on time to all-cause mortality was separately assessed with Cox proportional hazard regression analysis, adjusting for clinical factors and symptoms of depression and anxiety. RESULTS: Mean (SD) heart rate was 68.0 ± 13.3 bpm and mean QRS duration was 130.9 ± 36.9 ms....... Heart rate of ≥80 bpm was associated with increased risk of mortality (HR=1.86; 95% CI=1.15-3.00; p=.011) in unadjusted analysis. In adjusted analyses, this relationship remained significant both with depression (HR=1.86, 95% CI=1.12-3.09; p=.017) and anxiety (HR=1.82, 95% CI=1.10-3.03; p=.021...

  8. My Child Needs or Has an Implantable Cardioverter-Defibrillator: What Should I Do?

    Science.gov (United States)

    ... it is important to provide open, honest, and age-appropriate information to provide the tools for adaptation. You can ... 502 Boston, MA 02118 email: circ@circulationjournal.org Information for: Advertisers Subscribers Subscriber ... National Center 7272 Greenville Ave. Dallas, TX 75231 Customer Service 1-800-AHA-USA-1 1-800- ...

  9. Low disease prevalence and inappropriate implantable cardioverter defibrillator shock rate in Brugada syndrome

    DEFF Research Database (Denmark)

    Holst, Anders Gaarsdal; Jensen, Henrik Kjærulf; Eschen, Ole;

    2012-01-01

    Brugada syndrome (BrS) is an inherited channelopathy that predisposes to malignant ventricular arrhythmias and thereby syncope and sudden cardiac death. Prior studies characterizing BrS patients have used highly selected referral populations from tertiary centres and prevalence estimates have bee...

  10. Emotional distress in partners of patients with an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Van Den Broek, Krista C; Habibović, Mirela; Pedersen, Susanne S.

    2010-01-01

    care of the ICD patient, helplessness and uncertainties related to shocks, role changes, sexual activities, overprotectiveness, and driving. Partner levels of distress may be as high as that of ICD patients. Research with large samples is needed to further investigate the course and determinants of...

  11. Coping with Trauma and Stressful Events As a Patient with an Implantable Cardioverter-Defibrillator

    Science.gov (United States)

    ... LIBRARY Hello, Guest! My alerts Sign In Join Facebook Twitter Home About this Journal Editorial Board General Statistics Circulation Cover Doodle → Blip the Doodle Go Red For Women's Issue Information for Advertisers Author Reprints Commercial Reprints Customer Service and Ordering ...

  12. Trajectories of Patient-Reported Health Status in Patients With an Implantable Cardioverter Defibrillator

    DEFF Research Database (Denmark)

    Mastenbroek, Mirjam H; Denollet, Johan; Versteeg, Henneke;

    2015-01-01

    failure, ICD shock, psychotropic medication, negative affectivity, and type D personality were identified as independent determinants of poorer physical health status. For mental health status, 6 trajectories were identified. Younger age, low educational level, symptomatic heart failure, renal failure, no...

  13. Differences between out-of-hospital cardiac arrest in residential and public locations and implications for public-access defibrillation

    DEFF Research Database (Denmark)

    Folke, Fredrik; Gislason, Gunnar H; Lippert, Freddy; Nielsen, Søren L; Weeke, Peter; Hansen, Morten L; Fosbøl, Emil L; Andersen, Søren; Rasmussen, Søren; Schramm, Tina K; Køber, Lars; Torp-Pedersen, Christian

    2010-01-01

    The majority of out-of-hospital cardiac arrests (OHCAs) occur in residential locations, but knowledge about strategic placement of automated external defibrillators in residential areas is lacking. We examined whether residential OHCA areas suitable for placement of automated external...... defibrillators could be identified on the basis of demographic characteristics and characterized individuals with OHCA in residential locations....

  14. Tachyarrhythmia Cycle Length in Appropriate versus Inappropriate Defibrillator Shocks in Brugada Syndrome, Early Repolarization Syndrome, or Idiopathic Ventricular Fibrillation

    Science.gov (United States)

    Lee, Woo Seok; Kwon, Chang-Hee; Choi, Jin Hee; Jo, Uk; Kim, Yoo Ri; Nam, Gi-Byoung; Choi, Kee-Joon; Kim, You-Ho

    2016-01-01

    Background and Objectives Implantable cardioverter–defibrillators (ICDs) are indicated in patients with Brugada syndrome (BS), early repolarization syndrome (ERS), or idiopathic ventricular fibrillation (IVF) who are at high risk for sudden cardiac death. The optimal ICD programming for reducing inappropriate shocks in these patients remains to be determined. We investigated the difference in the mean cycle length of tachyarrhythmias that activated either appropriate or inappropriate ICD shocks in these three patient groups to determine the optimal ventricular fibrillation (VF) zone for minimizing inappropriate ICD shocks. Subjects and Methods We selected 41 patients (35 men) (mean age±standard deviation=42.6±13.0 year) who received ICD shocks between April 1996 and April 2014 to treat BS (n=24), ERS (n=9), or IVF (n=8). Clinical and ICD interrogation data were retrospectively collected and analyzed for all events with ICD shocks. Results Of the 244 episodes, 180 (73.8%) shocks were appropriate and 64 (26.2%) were inappropriate. The mean cycle lengths of the tachyarrhythmias that activated appropriate and inappropriate shocks were 178.9±28.7 ms and 284.8±24.4 ms, respectively (pIVF could reduce inappropriate ICD shocks, with a low risk of missing appropriate shocks. PMID:27014348

  15. The use of wearable cardioverter-defibrillators in Europe: results of the European Heart Rhythm Association survey.

    Science.gov (United States)

    Lenarczyk, Radosław; Potpara, Tatjana S; Haugaa, Kristina H; Hernández-Madrid, Antonio; Sciaraffia, Elena; Dagres, Nikolaos

    2016-01-01

    The aim of this European Heart Rhythm Association (EHRA) survey was to collect data on the use of wearable cardioverter-defibrillators (WCDs) among members of the EHRA electrophysiology research network. Of the 50 responding centres, 23 (47%) reported WCD use. Devices were fully reimbursed in 17 (43.6%) of 39 respondents, and partially reimbursed in 3 centres (7.7%). Eleven out of 20 centres (55%) reported acceptable patients' compliance (WCD worn for >90% of time). The most common indications for WCD (8 out of 10 centres; 80%) were covering the period until re-implantation of ICD explanted due to infection, in patients with left ventricular impairment due to myocarditis or recent myocardial infarction and those awaiting heart transplantation. Patient life expectancy of success rate in terminating ventricular arrhythmias was 95-100% in 6 of 15 centres (40%), 85-95% in 4 (26.7%), 75-85% in 2 (13.3%), and definition of indications for WCD in specific patient groups. PMID:26842735

  16. Sexual concerns and practices after ICD implantation

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Elleman-Jensen, Line; Zwisler, Ann-Dorthe;

    2013-01-01

    Background:Studies show that patients with implantable cardioverter defibrillators (ICD) frequently experience sexual dysfunction. These experiences are often linked to exercise intolerance, side-effects of medication, and psychological problems.Objective:To describe (a) the level of information...... given about sexual activity, (b) the areas of patient concerns related to sexual function and the ICD, and (c) changes in sexual behavior.Methods:A randomized controlled trial including 196 patients (1:1) was designed, including 12 weeks of exercise training and 1 year of psycho-educational follow......-up focusing on modifiable factors associated with poor outcomes, including sexual functioning. The Sex After ICD Survey was administered 6 months after the randomization as part of the planned explorative outcomes. 141 patients responded.Results:The analyses showed that 37 of the 69 (55.2%) patients of the...

  17. L'efecte dels camps elèctrics de freqüència extremadament baixa (ELF) en el desfibril·lador automàtic implantable (DAI)

    OpenAIRE

    González Sosa, Jarold Aurelio

    2012-01-01

    Projecte realitzat en el marc d'un programa de mobilitat amb la Tampere University of Technology. [ANGLÈS] Through research and technological advances, modern society has developed a variety of implantable devices that helps to optimize human's life quality. One of these devices is the implantable cardioverter defibrillator (ICD). Our unit, ERP Environmental Health, in previous investigations has found that, in some cases, the ICD receives certain disturbances under the power lines. Theref...

  18. Utilization of youtube as a tool to assess patient perception regarding implanted cardiac devices

    Directory of Open Access Journals (Sweden)

    Kevin Hayes

    2014-01-01

    Full Text Available Background: The outreach of YouTube may have a dramatic role in the widespread dissemination of knowledge on implantable cardioverter devices (ICD. Aims: This study was designed to review and analyze the information available on YouTube pertaining to implantable cardiac devices such as implantable cardioverter defibrillators (ICDs and pacemakers. Materials and Methods: YouTube was queried for the terms "ICD", "Implantable Cardioverter Defibrillator", and "Pacemaker". The videos were reviewed and categorized as according to content; number of views and "likes" or "dislikes" was recorded by two separate observers. Results: Of the 55 videos reviewed, 18 of the videos were categorized as patient education, 12 were advertisements, 8 were intraoperative videos documenting the device implantation procedures, 7 of the videos were produced to document personal patient experiences, and 4 were categorized as documentation of a public event. 3 were intended to educate health care workers. The remaining 3 were intended to raise public awareness about sudden cardiac death. The videos portraying intraoperative procedures generated the most "likes" or "dislikes" per view. Conclusion: While YouTube provides a logical platform for delivery of health information, the information on this platform is not regulated. Initiative by reputed authorities and posting accurate information in such platform can be a great aid in public education regarding device therapy.

  19. Late Development of a Bronchocutaneous Fistula due to an Epicardial Cardioverter-Defibrillator Lead

    Directory of Open Access Journals (Sweden)

    Vasileios Patris

    2015-10-01

    Full Text Available Cutaneous complications caused by a pacemaker or defibrillator are widely documented, but the development of a bronchocutaneous fistula has never been described before. We report the case of a 79-year-old man who was admitted to our hospital because of a seemingly superficial cutaneous infection, externalized defibrillator leads, and hemoptysis. Bronchoscopical investigation proved the existence of the fistula, which connected the epicardium, the left main bronchus, and the aforementioned site of skin infection. The patient refused an operation for the complete removal of the epicardial defibrillator and was treated conservatively. This case demonstrated that the long-term presence of foreign bodies in the epicardium may cause serious complications

  20. Use and benefits of public access defibrillation in a nation-wide network

    DEFF Research Database (Denmark)

    Nielsen, Anne Møller; Folke, Fredrik; Lippert, Freddy Knudsen;

    2013-01-01

    BACKGROUND: Automated External Defibrillators (AEDs) are known to increase survival after out-of-hospital cardiac arrest (OHCA). The aim of this study was to examine the use and benefit of public-access defibrillation (PAD) in a nation-wide network. We primarily sought to assess survival at 1 month...... was connected to an OHCA victim prior to the arrival of Emergency Medical Services (EMS) in 48 instances. Ten percent of bystanders were off-duty healthcare professionals. Shockable arrests (N=31, 70%) were significantly more likely to be witnessed (94% vs. 54%) to occur at sports facilities (74% vs...

  1. Ion implantation

    International Nuclear Information System (INIS)

    It is the purpose of the present paper to give a review of surface alloy processing by ion implantation. However, rather than covering this vast subject as a whole, the survey is confined to a presentation of the microstructures that can be found in metal surfaces after ion implantation. The presentation is limited to alloys processed by ion implantation proper, that is to processes in which the alloy compositions are altered significantly by direct injection of the implanted ions. The review is introduced by a presentation of the processes taking place during development of the fundamental event in ion implantation - the collision cascade, followed by a summary of the various microstructures which can be formed after ion implantation into metals. This is compared with the variability of microstructures that can be achieved by rapid solidification processing. The microstructures are subsequently discussed in the light of the processes which, as the implantations proceed, take place during and immediately after formation of the individual collision cascades. These collision cascades define the volumes inside which individual ions are slowed down in the implanted targets. They are not only centres for vigorous agitation but also the sources for formation of excess concentrations of point defects, which will influence development of particular microstructures. A final section presents a selection of specific structures which have been observed in different alloy systems. (orig./GSCH)

  2. Implantable rhythm devices and electromagnetic interference: myth or reality?

    Science.gov (United States)

    Dyrda, Katia; Khairy, Paul

    2008-07-01

    Current medical guidelines have prompted implementation of increasing numbers of implantable rhythm devices, be they pacemakers, internal cardioverter-defibrillators or loop recorders. These devices rely on complex microcircuitry and use electromagnetic waves for communication. They are, therefore, susceptible to interference from surrounding electromagnetic radiation and magnetic energy. Hermetic shielding in metallic cases, filters, interference rejection circuits and bipolar sensing have contributed to their relative resistance to electromagnetic interference (EMI) in household and workplace environments. Device interactions have occurred in hospitals where EMI sources are ubiquitous, including radiation, electrocautery and MRI exposures. However, with rapidly evolving technology, devices and potential sources of EMI continue to change. This review provides a contemporary overview of the current state of knowledge regarding risks attributable to EMI; highlights current limitations of implantable rhythm devices; and attempts to distinguish myths from realities. PMID:18570620

  3. Quality control of cardiac defibrillator/defibrillation monitor%心脏除颤器/除颤监护仪的质量控制

    Institute of Scientific and Technical Information of China (English)

    崔亮; 崔骊; 黄韬

    2011-01-01

    目的:确保除颤器临床使用的安全性.方法:采用除颤器检定仪检测;结果:分析并解决了检测中出现的问题,保障了除颤器的安全使用.结论:对除颤器进行质量控制,可以预防因医疗设备失准而引起的医疗事故.%Objective: To ensure the safety of defibrillator that is usually used in clinical practice. Methods: The detector was used for examination of the defibriilator. Results: The problems in the testing were analyzed and solved to ensure the safety of the defibrillator. Conclusion: The medical accident that caused by misalignment of medical equipment can be prevented through the quality control.

  4. Pseudodefects in SPET myocardium imaging after placement of a defibrillator patch electrode; Pseudodefekte bei der Myokard-SPECT durch implantierte Defibrillator-Patches: Phantommessungen mit SPECT und PET

    Energy Technology Data Exchange (ETDEWEB)

    Buchert, R. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Nuklearmedizin der Radiologischen Klinik; Rickers, C. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. Kardiologie der Klinik fuer Innere Medizin; Fuchs, C. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Nuklearmedizin der Radiologischen Klinik; Nienaber, C.A. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. Kardiologie der Klinik fuer Innere Medizin; Luebeck, M. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Nuklearmedizin der Radiologischen Klinik

    1996-12-01

    Aim and Methods: In order to estimate the effect of an epicardial or subcutan defibrillator patch electrode on the imaging of myocardium with SPET and PET we performed measurements with a body phantom and two different patch electrodes. Results: We found that in {sup 201}Tl-SPET with epicardial placing one electrode causes significant pseudodefects, which might lead to the impression of an infarction (`pseudoinfarction`), particularly in the case of reduced myocardial wall thickness. Measurements with {sup 99m}Tc show the same pseudodefects. In case of subcutaneous placing the electrodes are much less likely to cause relevant absorption effects. With PET even epicardially placed both patch electrodes do not produce pseudodefects. Therefore the risk of false-positive findings is very small with PET. Conclusion: In order to avoid false positive findings in cardiovascular nuclear medicine caused by defibrillator patch electrodes, patients with patch electrodes should be referred to PET, if available. (orig.) [Deutsch] Ziel und Methoden: Um den Effekt eines epikardial oder subkutan implantierten Defibrillator-Patches bei der nuklearmedizinischen Herzdiagnostik mittels SPECT und PET abzuschaetzen, wurden Messungen an einem Koerperphantom mit zwei verschiedenen Patchelektroden durchgefuehrt. Ergebnisse: Es zeigte sich, dass bei der {sup 201}Tl-SPECT bei epikardialer Plazierung eine der beiden Elektroden Pseudodefekte verursacht, die insbesondere im Falle duennwandiger Herzen die Beurteilung erschweren oder sogar zu falsch-positiven Befunden (`Pseudoinfarkte`) fuehren koennen. Bei Messungen mit {sup 99m}Tc findet man dieselben Pseudodefekte in nahezu gleicher Auspraegung. Im Falle subkutaner Plazierung sind beide Elektroden sowohl bei der {sup 201}Tl-SPECT als auch bei der {sup 99m}Tc-SPECT unkritisch. Bei der PET stellen die untersuchten Patchelektroden selbst bei epikardialer Plazierung keine erkennbare Stoerung dar, so dass hier die Gefahr eines falsch

  5. The cardiac implantable electronic device power source: evolution and revolution.

    Science.gov (United States)

    Mond, Harry G; Freitag, Gary

    2014-12-01

    Although the first power source for an implantable pacemaker was a rechargeable nickel-cadmium battery, it was rapidly replaced by an unreliable short-life zinc-mercury cell. This sustained the small pacemaker industry until the early 1970s, when the lithium-iodine cell became the dominant power source for low voltage, microampere current, single- and dual-chamber pacemakers. By the early 2000s, a number of significant advances were occurring with pacemaker technology which necessitated that the power source should now provide milliampere current for data logging, telemetric communication, and programming, as well as powering more complicated pacing devices such as biventricular pacemakers, treatment or prevention of atrial tachyarrhythmias, and the integration of innovative physiologic sensors. Because the current delivery of the lithium-iodine battery was inadequate for these functions, other lithium anode chemistries that can provide medium power were introduced. These include lithium-carbon monofluoride, lithium-manganese dioxide, and lithium-silver vanadium oxide/carbon mono-fluoride hybrids. In the early 1980s, the first implantable defibrillators for high voltage therapy used a lithium-vanadium pentoxide battery. With the introduction of the implantable cardioverter defibrillator, the reliable lithium-silver vanadium oxide became the power source. More recently, because of the demands of biventricular pacing, data logging, and telemetry, lithium-manganese dioxide and the hybrid lithium-silver vanadium oxide/carbon mono-fluoride laminate have also been used. Today all cardiac implantable electronic devices are powered by lithium anode batteries. PMID:25387600

  6. Subpectoral implantation of ICD generators: long-term follow-up.

    Science.gov (United States)

    Thakur, R K; Ip, J H; Mehta, D; Jung, J Y; Collar, A; Camunas, J; Gomes, J A

    1995-01-01

    A nonthoracotomy surgical approach using an endocardial electrode and combined implantation of a subcutaneous patch and the implantable cardioverter defibrillator (ICD) generator in a subpectoral pocket has been described. We report the long-term follow-up results in patients undergoing implantation using this approach. The patient population consisted of 28 patients (22 men and 6 women) with a mean age of 59 +/- 12 years. The underlying heart disease consisted of coronary artery disease in 20 patients and dilated cardiomyopathy in 8 patients. Sustained ventricular tachycardia was the mode of presentation in 16 patients and sudden cardiac death in 12 patients. The mean left ventricular ejection fraction was 31% +/- 6%. The lead system consisted of an 8 French bipolar passive fixation rate sensing lead positioned at the right ventricular apex, an 11 French spring coil electrode positioned at the superior vena cava-right atrial junction (surface area 700 mm2), and submuscular placement of a large patch (surface area 28 cm2) on the anterolateral chest wall near the cardiac apex via a submammary incision. A defibrillation threshold of submammary incision, and the large patch was placed epicardially. The mean R wave amplitude was 12 +/- 3 mV, the mean pacing threshold was 1.0 +/- 0.5 V at 0.5 msec, and the mean defibrillation threshold was 12.6 +/- 3 J. ICD generators implanted were the Ventak-P in 17, PCD-7217 in 5, and the Cadence V-100 in 6 patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7724391

  7. Out-of-hospital cardiac arrest and placement of automated external defibrillators in the community

    DEFF Research Database (Denmark)

    Folke, Fredrik

    2010-01-01

    INDLEDNING Chancen for at overleve et hjertestop udenfor hospital er i de første minutter efter kollaps afhængig af hjælpen fra nærmeste tilstedeværende. Dette har faciliteret strategier for placering af automatiske eksterne defibrillatorer (AED) i det offentlige rum og muliggjort hurtig defibril...

  8. 78 FR 17890 - Effective Date of Requirement for Premarket Approval for Automated External Defibrillator System.

    Science.gov (United States)

    2013-03-25

    ... 8, 2004 (69 FR 10615). B. Device Subject to This Proposal--Automated External Defibrillator (Sec... order (74 FR 16214, April 9, 2009) requiring manufacturers to submit information about a number of...-month period has expired (see 68 FR 61342, October 28, 2003). If a PMA is not filed for such...

  9. Data management in automated external defibrillators: a call for a standardised solution

    DEFF Research Database (Denmark)

    Nielsen, Anne Møller; Rasmussen, L S

    2011-01-01

    The ECG data stored in automated external defibrillators (AEDs) may be valuable for establishing a final diagnosis and deciding further diagnostics and treatment. Different data management systems are used and this may create significant problems for data storage and access for physicians treating...

  10. Successful out-of-hospital defibrillation for ventricular fibrillation complicating solvent abuse.

    OpenAIRE

    Nee, P A; Llewellyn, T; Pritty, P E

    1990-01-01

    The Authors describe the case history of a child who suffered a cardiac arrest with ventricular fibrillation after deliberate inhalation of 1,1,1-Trichloroethane in typewriter correction fluid thinners. Successful out-of-hospital defibrillation was carried out and the patient made a full recovery. The literature relating to this particular form of volatile substance abuse is reviewed.

  11. Dental Implants

    Medline Plus

    Full Text Available ... are lost, it’s not uncommon to suffer from social consequences and poor nutrition. Rebuilding Bone When the ... not a one-day procedure. The implant needs time to properly adhere to the bone and create ...

  12. Cochlear Implants

    Science.gov (United States)

    ... on this topic can be found in our Audiology Information Series [PDF]. How does a cochlear implant ... speech-language pathologists; speech, language, and hearing scientists; audiology and speech-language pathology support personnel; and students. ...

  13. Implanted near-infrared spectroscopy for cardiac monitoring

    Science.gov (United States)

    Bhunia, Sourav K.; Cinbis, Can

    2011-02-01

    Implanted Cardioverter Defibrillator (ICD) provides one of the most effective therapies for the prevention of sudden cardiac death, but also delivers some high voltage shocks inappropriately, causing morbidity and mortality. Implanted near-infrared spectroscopy (NIRS) may augment ICD arrhythmia detection by monitoring skeletal muscle perfusion. A two-wavelength, single-distance, continuous-wave implanted NIRS has been evaluated in-vivo. A weighted difference of the changes in attenuation at two wavelengths, across the isobestic point of the hemoglobin spectra, was taken to be the microvascular oxygenation trend indicator (O2 Index). Although the exact weight depends on the local vascular distribution and their oxygen levels, the hypothesis that a constant weight may be adequate for hemodynamic trending during short arrhythmic episodes, was tested. The sensor was implanted subcutaneously both on fresh tissue and inside scar tissue that formed around a pre-existing implant, in 3 animals each. Attenuations were recorded at 660 and 890 nm during normal sinus rhythm (NSR) and induced ventricular fibrillation (VF). The slope of the O2 Index over 10 seconds was computed for 7 NSR and 8 VF episodes in fresh and 13 NSR and 15 VF episodes in scar tissue pockets. The mean O2 Index slope was significantly different (pdetection of VF during electromagnetic interference, double counting of ECG T-wave as an R-wave, ICD lead failure, electrocardiographic aberrancy etc.

  14. Cardiac arrhythmias

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008272 Prospective study on the prognosis in patients with ventricular tachycardia or fibrillation treated with implantable automatic cardiovertor defibrillator. LIU Zhongmei(刘中梅), et al. Dept Cardiol, 1st Affili Hosp, Kunming Med Coll, Kunming 650032. Chin J Cardiol 2008;36(4):309-312.Objective To explore the effect of implantable automatic cardiovertor defibrillator(ICD)on improvement of the prognosis of patients with ventricular tachycardia or fibrillation(VT/VF).To compare the advantages and

  15. Infection control in implantation of cardiac implantable electronic devices: current evidence, controversial points, and unresolved issues.

    Science.gov (United States)

    Korantzopoulos, Panagiotis; Sideris, Skevos; Dilaveris, Polychronis; Gatzoulis, Konstantinos; Goudevenos, John A

    2016-04-01

    A significant increase in the implantation of cardiac implantable electronic devices (CIEDs) is evident over the past years, while there is evidence for a disproportionate increase in CIED-related infections. The cumulative probability of device infection seems to be higher in implantable cardioverter defibrillator and in cardiac resynchronization therapy patients compared with permanent pacemaker patients. Given that more than a half of CIED infections are possibly related to the operative procedure, there is a need for effective periprocedural infection control. However, many of the current recommendations are empirical and not evidence-based, while questions, unresolved issues, and conflicting evidence arise. The perioperative systemic use of antibiotics confers significant benefit in prevention of CIED infections. However, there are no conclusive data regarding the specific value of each agent in different clinical settings, the value of post-operative antibiotic treatment as well as the optimal duration of therapy. The merit of local pocket irrigation with antibiotic and/or antiseptic agents remains unproved. Of note, recent evidence indicates that the application of antibacterial envelopes into the device pocket markedly decreases the infection risk. In addition, limited reports on strict integrated infection control protocols show a dramatic reduction in infection rates in this setting and therefore deserve further attention. Finally, the relative impact of particular factors on the infection risk, including the type of the CIED, patients' individual characteristics and comorbidities, should be further examined since it may facilitate the development of tailored prophylactic interventions for each patient. PMID:26516219

  16. Treatment of atrial fibrillation with a dual defibrillator in heart failure patients (TRADE HF: protocol for a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Grandinetti Giuseppe

    2011-02-01

    Full Text Available Abstract Background Heart failure(HF and atrial fibrillation(AF frequently coexist in the same patient and are associated with increased mortality and frequent hospitalizations. As the concomitance of AF and HF is often associated with a poor prognosis, the prompt treatment of AF in HF patients may significantly improve outcome. Methods/design Recent implantable cardiac resynchronization (CRT devices allow electrical therapies to treat AF automatically. TRADE-HF (trial registration: NCT00345592; http://www.clinicaltrials.gov is a prospective, randomized, double arm study aimed at demonstrating the efficacy of an automatic, device-based therapy for treatment of atrial tachycardia and fibrillation(AT/AF in patients indicated for CRT. The study compares automatic electrical therapy to a traditional more usual treatment of AT/AF: the goal is to demonstrate a reduction in a combined endpoint of unplanned hospitalizations for cardiac reasons, death from cardiovascular causes or permanent AF when using automatic atrial therapy as compared to the traditional approach involving hospitalization for symptoms and in-hospital treatment of AT/AF. Discussion CRT pacemaker with the additional ability to convert AF as well as ventricular arrhythmias may play a simultaneous role in rhythm control and HF treatment. The value of the systematic implantation of CRT ICDs with the capacity to deliver atrial therapy in HF patients at risk of AF has not yet been explored. The TRADE-HF study will assess in CRT patients whether a strategy based on automatic management of atrial arrhythmias might be a valuable option to reduce the number of hospital admission and to reduce the progression the arrhythmia to a permanent form. Trial registration NCT00345592

  17. Integration of Attributes from Non-Linear Characterization of Cardiovascular Time-Series for Prediction of Defibrillation Outcomes.

    Directory of Open Access Journals (Sweden)

    Sharad Shandilya

    Full Text Available The timing of defibrillation is mostly at arbitrary intervals during cardio-pulmonary resuscitation (CPR, rather than during intervals when the out-of-hospital cardiac arrest (OOH-CA patient is physiologically primed for successful countershock. Interruptions to CPR may negatively impact defibrillation success. Multiple defibrillations can be associated with decreased post-resuscitation myocardial function. We hypothesize that a more complete picture of the cardiovascular system can be gained through non-linear dynamics and integration of multiple physiologic measures from biomedical signals.Retrospective analysis of 153 anonymized OOH-CA patients who received at least one defibrillation for ventricular fibrillation (VF was undertaken. A machine learning model, termed Multiple Domain Integrative (MDI model, was developed to predict defibrillation success. We explore the rationale for non-linear dynamics and statistically validate heuristics involved in feature extraction for model development. Performance of MDI is then compared to the amplitude spectrum area (AMSA technique.358 defibrillations were evaluated (218 unsuccessful and 140 successful. Non-linear properties (Lyapunov exponent > 0 of the ECG signals indicate a chaotic nature and validate the use of novel non-linear dynamic methods for feature extraction. Classification using MDI yielded ROC-AUC of 83.2% and accuracy of 78.8%, for the model built with ECG data only. Utilizing 10-fold cross-validation, at 80% specificity level, MDI (74% sensitivity outperformed AMSA (53.6% sensitivity. At 90% specificity level, MDI had 68.4% sensitivity while AMSA had 43.3% sensitivity. Integrating available end-tidal carbon dioxide features into MDI, for the available 48 defibrillations, boosted ROC-AUC to 93.8% and accuracy to 83.3% at 80% sensitivity.At clinically relevant sensitivity thresholds, the MDI provides improved performance as compared to AMSA, yielding fewer unsuccessful defibrillations

  18. del Nido versus St. Thomas Cardioplegia Solutions: A Single-Center Retrospective Analysis of Post Cross-Clamp Defibrillation Rates.

    Science.gov (United States)

    Buel, Shane T; Striker, Carrie Whittaker; O'Brien, James E

    2016-06-01

    There are many cardioplegia solutions currently in use for pediatric cardiopulmonary bypass (CPB). The most common being del Nido solution. Another common cardioplegia solution used for pediatric CPB is St. Thomas. In October 2014, Children's Mercy Kansas City changed from the use of modified St. Thomas to del Nido. This study compared rates of post cross-clamp fibrillation requiring defibrillation between del Nido solution and modified St. Thomas solution stratified by weight at Children's Mercy Kansas City. This retrospective study consisted of 394 patients who underwent cardiac surgery requiring cardioplegia between January 1, 2014 and July 31, 2015. The outcome measured was defibrillation upon cross-clamp removal. Statistical significance was determined using Fishers exact test with a two-sided significance level of .05. Incidence of defibrillation post cross-clamp removal was 4.4% in the del Nido group and 26.8% in the St. Thomas group (p 60-kg category had an incidence of defibrillation of 16.7% in the del Nido group and 63% in the St. Thomas group (p < .0623). This study demonstrates a 6-fold decrease in the overall rate of defibrillation post cross-clamp removal between St. Thomas and del Nido cardioplegia solutions. Analyses of weight stratifications demonstrate a decrease in the rate of defibrillation post cross-clamp removal in all categories within the del Nido group. PMID:27578896

  19. Combining multiple ECG features does not improve prediction of defibrillation outcome compared to single features in a large population of out-of-hospital cardiac arrests

    OpenAIRE

    He, Mi; Gong, Yushun; Li, Yongqin; Mauri, Tommaso; Fumagalli, Francesca; Bozzola, Marcella; Cesana, Giancarlo; Latini, Roberto; Pesenti, Antonio; Ristagno, Giuseppe

    2015-01-01

    Introduction Quantitative electrocardiographic (ECG) waveform analysis provides a noninvasive reflection of the metabolic milieu of the myocardium during resuscitation and is a potentially useful tool to optimize the defibrillation strategy. However, whether combining multiple ECG features can improve the capability of defibrillation outcome prediction in comparison to single feature analysis is still uncertain. Methods A total of 3828 defibrillations from 1617 patients who experienced out-of...

  20. Critical appraisal of cardiac implantable electronic devices: complications and management

    Directory of Open Access Journals (Sweden)

    Padeletti L

    2011-09-01

    Full Text Available Luigi Padeletti1, Giosuè Mascioli2, Alessandro Paoletti Perini1, Gino Grifoni1, Laura Perrotta1, Procolo Marchese3, Luca Bontempi3, Antonio Curnis31Istituto di Clinica Medica e Cardiologia, Università degli Studi di Firenze, Italia; 2Elettrofisiologia, Istituto Humanitas Gavazzeni, Bergamo, Italia; 3Elettrofisiologia, Spedali Civili, Brescia, ItaliaAbstract: Population aging and broader indications for the implant of cardiac implantable electronic devices (CIEDs are the main reasons for the continuous increase in the use of pacemakers (PMs, implantable cardioverter-defibrillators (ICDs and devices for cardiac resynchronization therapy (CRT-P, CRT-D. The growing burden of comorbidities in CIED patients, the greater complexity of the devices, and the increased duration of procedures have led to an augmented risk of infections, which is out of proportion to the increase in implantation rate. CIED infections are an ominous condition, which often implies the necessity of hospitalization and carries an augmented risk of in-hospital death. Their clinical presentation may be either at pocket or at endocardial level, but they can also manifest themselves with lone bacteremia. The management of these infections requires the complete removal of the device and subsequent, specific, antibiotic therapy. CIED failures are monitored by competent public authorities, that require physicians to alert them to any failures, and that suggest the opportune strategies for their management. Although the replacement of all potentially affected devices is often suggested, common practice indicates the replacement of only a minority of devices, as close follow-up of the patients involved may be a safer strategy. Implantation of a PM or an ICD may cause problems in the patients' psychosocial adaptation and quality of life, and may contribute to the development of affective disorders. Clinicians are usually unaware of the psychosocial impact of implanted PMs and ICDs. The

  1. Cochlear Implant

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    In this text, the authors recall the main principles and data ruling cochlear implants. Then, a first circle of technical equipment for assistance is presented. This circle includes: device setting (DS), Electrically evoked Auditory Brainstem Responses (EABR), Neural Response Telemetry (NRT), Stapedial Reflex (SR) and Electrodogram Acquisition (EA). This first cycle becomes more and more important as children are implanted younger and younger; the amount of data available with this assistance makes necessary the use of models (implicit or explicit) to handle this information. Consequently, this field is more open than ever.

  2. 单双线圈除颤电极临床效果的Meta分析%A Meta analysis of clinical efficiency of single and dual-coil coil defibrillation leads

    Institute of Scientific and Technical Information of China (English)

    童琳; 蔡琳; 邓晓奇; 李锦

    2016-01-01

    Objective To analyze the clinical efficiency of single - coil and dual - coil defibrillation lead. Methods From the Cochrane library,Medline,Embase and CBM,VIP,CNKI database,collect relevant literatures on the clinical efficiency comparement of single - coil and dual - coil defibrillation lead by two evaluators,in accordance with the relevant qualification screened out into standard documents,using Rev-Man5. 3 Meta analysis. Results A total of 13 clinical study with 6273 patients were included in the analysis,there are 6 items are randomized controlled trials,the rest is a randomized controlled trial. Threshold test results suggested single - coil defibrillation threshold value was higher than the dual - coil groups(95% CI:0. 2 ~ 1. 29,P = 0. 2)and single - coil set high defibrillation threshold rate was higher than the dual - coil group (95% CI,1. 29 to 5. 08;P = 1. 29),single and dual - coil group of ventricular tachycardia/ ventricular fibrillation implantable defibrillator (ICD)at a time when there was no significant difference between defibrillation success rate(95% CI:0. 96 ~ 1. 05,P = 0. 96),single - coil to-tal mortality slightly was higher than that of dual - coil group,but the difference was not significant(95% CI:0. 75 ~ 1. 26,P = 0. 75),single and dual - coil group lead failure rate had no significant difference(95% CI:0. 48 ~ 18. 44,P = 0. 48). Conclusion Single - coil defibrillation lead in the threshold test defibrillation threshold value is higher than dual - coil lead,at the same time single - coil of defibrillation lead high threshold percentage is higher than that of dual - coil group,both in the ventricular tachycardia/ ventricular fibrillation when a defibrillation success rate,total mortality,lead failure rate have no significant differences. But 6 items included in the study are randomized controlled trials,therefore, it still need a certain amount,high quality randomized controlled trials to make further verification.%目的:分析单线

  3. Cochlear implant

    Science.gov (United States)

    ... are sent along the auditory nerve to the brain. A deaf person does not have a functioning inner ear. A cochlear implant tries to replace the function of the inner ear by ... signals to the brain. Sound is picked up by a microphone worn ...

  4. Cochlear Implants

    Science.gov (United States)

    ... an optimal period to develop speech and language skills. Research has shown that when these children receive a cochlear implant followed by intensive therapy before they are 18 months ... age develop language skills at a rate comparable to children with normal ...

  5. Dental Implants

    Medline Plus

    Full Text Available ... suffer from social consequences and poor nutrition. Rebuilding Bone When the supporting alveolar bone melts away , it’s gone for good, but through grafting, a skilled dental professional can recreate bone to fuse with and support an implant. This ...

  6. Dental Implants

    Medline Plus

    Full Text Available ... an implant connects directly to the jaw bone. It’s obviously not the same as the original connection , ... may feel you don’t need to replace it, since no one can see that it’s missing ...

  7. Dental Implants

    Medline Plus

    Full Text Available Dental Implants A fuller, more complete smile is within reach. The following information is designed to provide helpful facts so you ... found in nature. What Happens When You Lose a Tooth? When you lose a tooth, especially a ...

  8. Development of Pacing, Electrophysiology and Defibrillation in India

    OpenAIRE

    Nair, Mohan; Francis, Johnson; Venugopal, K

    2002-01-01

    History of cardiac pacing in India dates back to late 1960s. Kar1 reported that cardiac pacing was introduced in India in 1966. Basu2 while discussing on cardiac pacemaking in Calcutta, mentions that the first pacing was performed in April 1967 at the Institute of Post Graduate Medical Education and Research (IPGME&R). Bhatia et al3 started pacemaker implantation at AIIMS, New Delhi in 1968. Their first patient was a doctor from Assam and the pulse generator was supplied by Medtronic Inc. Th...

  9. Reliability and Validity of the Self Efficacy Expectations and Outcome Expectations After ICD Implantation Scales

    OpenAIRE

    DOUGHERTY, CYNTHIA M.; Johnston, Sandra K.; Thompson, Elaine Adams

    2007-01-01

    The purpose of this study was to assess the reliability and validity characteristics of two new scales that measure self-efficacy expectations (SE-ICD) and outcome expectations (OE-ICD) in survivors (n=168) of sudden cardiac arrest (SCA), all of whom received an implantable cardioverter defibrillator (ICD). Cronbach's alpha reliability demonstrated good internal consistency (SE-ICD α = 0.93 and OE-ICD α = 0.81). Correlations with other self-efficacy instruments (general self-efficacy and soci...

  10. 9. Incidence of tricuspid valve regurgitation following pacemaker/defibrillator lead extraction

    Directory of Open Access Journals (Sweden)

    A. AlFagih

    2016-07-01

    Full Text Available Despite advanced sterile techniques in cardiac device implantations, long-term complications such as wound infections and/or lead-induced endocarditis can develop mandating lead and device extraction. It has been suggested that lead extraction carries a risk of new-onset Tricuspid Regurgitation (TR, or a deterioration of a formerly known regurgitant valve. Yet, there is no enough scientific evidence to our knowledge to back this claim. In this study we aim to explore the risk of TR following lead extraction.We conducted a retrospective chart review in 113 patients whom underwent lead extraction at Prince Sultan Cardiac Center in Saudi Arabia during the period of Jan, 2002 to Jul, 2015. Six patients underwent lead extraction twice, making the total number of extractions to be 119. Of this study cohort, we include 52 cases who had Tricuspid valve function evaluation via Transthoracic Echocardiography (TTE prior to and after device and lead extraction. TR severity was assessed using a grading system as the following; normal, mild, mild-to-moderate, moderate-to-severe, and severe. Worsening or improvement by more than 1 grade was considered clinically significant. TR following lead extraction was examined over a median of 5 months. Of the 52 cases included in this study, 37 (71.2% were males and 15 (28.8% were females, with a mean age of 46 (SD = 18 years. Eleven patients (21.2% experienced worsening of TR (3 had normal functioning valves before extraction, and 8 were known to have TR prior to extraction, 2 (3.8% had improvement, and the majority (75.0% did not experience any significant changes. Compared with those who had no change, average lead duration was higher in the worsening TR group (67.2 vs. 27.9 months. A lead-attached vegetation was detected in 4 out of the 11 patients with TR. Lead type (High-voltage vs. Pacing was not predictive of TR, 5 (45.5% of the patients in the worsening group had high-voltage leads, while the remaining (54

  11. The critical importance of minimal delay between chest compressions and subsequent defibrillation: a haemodynamic explanation.

    Science.gov (United States)

    Steen, Stig; Liao, Qiuming; Pierre, Leif; Paskevicius, Audrius; Sjöberg, Trygve

    2003-09-01

    Outcome after prehospital defibrillation remains dire. The aim of the present study was to elucidate the pathophysiology of cardiac arrest and to suggest ways to improve outcome. Ventricular fibrillation (VF) was induced in air-ventilated pigs, after which ventilation was withdrawn. After 6.5 min of VF, ventilation with 100% oxygen was initiated. In six pigs (group I), defibrillation was the only treatment carried out. In another six pigs (group II), mechanical chest compression-decompression CPR (mCPR) was carried out for 3.5 min followed by a 40-s hands-off period before defibrillation. If unsuccessful, mCPR was resumed for a further 30 s before a second or a third, 40-s delayed, shock was given. In a final six pigs (group III) mCPR was applied for 3.5 min after which up to three shocks (if needed) were given during on-going mCPR. Return of spontaneous circulation (ROSC) occurred in none of the pigs in group I (0%), in 1 of six pigs in group II (17%) and in five of six pigs in group III (83%). During the first 3 min of VF arterial blood was transported to the venous circulation, with the consequence that the left ventricle emptied and the right ventricle became greatly distended. It took 2 min of mCPR to establish an adequate coronary perfusion pressure, which was lost when the mCPR was interrupted. During 30 s of mCPR coronary perfusion pressure was negative, but a carotid flow of about 25% of basal value was obtained. In this pig model, VF caused venous congestion, an empty left heart, and a greatly distended right heart within 3 min. Adequate heart massage before and during defibrillation greatly improved the likelihood of return of spontaneous circulation (ROSC). PMID:12969599

  12. An open source HPC-enabled model of cardiac defibrillation of the human heart

    OpenAIRE

    Bernabeu Llinares, Miguel Oscar; Pitt-Francis, Joe; Rodriguez, Blanca; Kay, David

    2011-01-01

    Sudden cardiac death following cardiac arrest is a major killer in the industrialised world. The leading cause of sudden cardiac death are disturbances in the normal electrical activation of cardiac tissue, known as cardiac arrhythmia, which severely compromise the ability of the heart to fulfill the body's demand of oxygen. Ventricular fibrillation (VF) is the most deadly form of cardiac arrhythmia. Furthermore, electrical defibrillation through the application of strong electric shocks to t...

  13. Cost of a Recall of a Single-Center Experience Managing the Riata Defibrillator Lead

    OpenAIRE

    Hussain, Sarah; Moorman, Liza; Moorman, J. Randall; DiMarco, John P.; Malhotra, Rohit; Darby, Andrew; Bilchick, Kenneth; Mangrum, J. Michael; Ferguson, John D.; Mason, Pamela K.

    2014-01-01

    Riata and Riata ST defibrillator leads (St. Jude Medical, Sylmar, California) were recalled in 2011 due to increased risk of insulation failure leading to externalized cables. Fluoroscopic screening can identify insulation failure, although the relation between mechanical failure and electrical failure is unclear. At the time of the recall, the University of Virginia developed a screening program, including fluoroscopic evaluation, education sessions, device interrogation, and remote monitori...

  14. Study on the Switching Time-Variation of Simultaneously Controlled IGBT: Case of Defibrillators Design

    OpenAIRE

    Mudrov T.; Kostov J.

    2009-01-01

    Samples of integrated gain bipolar transistors (IGBT) of the same type but produced under different technologies were tested about the switching time-variation. This is of high importance when several IGBT are connected in series to commutate high voltage defibrillation shocks. Very often, a short voltage overload of one of the IGBT in group leads to electrical breakdown of all transistors, due to nonsynchronised driving of the gate-emitter circuits. The goal of the study was to check whether...

  15. [When do you implant a pacemaker in myotonic dystrophy?].

    Science.gov (United States)

    Babuty, Dominique; Lallemand, Bénédicte; Laurent, Valérie; Clémenty, Nicolas; Pierre, Bertrand; Fauchier, Laurent; Raynaud, Martine; Pellieux, Sybille

    2011-01-01

    Myotonic dystrophy is the most frequent adult form of hereditary muscular dystrophy caused by a mutation on the DMPK gene. Myotonic dystrophy leads to multiple systemic complications related to weakness, respiratory failure, cardiac arrhythmias and cardiac conduction disturbances. Age of death is earlier in myotonic dystrophy patients than in general population with a high frequency of sudden death. Several mechanisms are involved in sudden death: atrio-ventricular block, severe ventricular arrhythmias or non-cardiac mechanism. The high degree of atrio-ventricular block is a well-recognized indication of pacemaker implantation but the prophylactic implantation of pacemaker should be considered to prevent sudden death in asymptomatic myotonic dystrophy patients. A careful clinical evaluation needs to be done for the identification of patients at high risk of sudden death. The resting ECG and SA ECG are non-invasive tools useful to select the patients who need an electrophysiologic study. In presence of prolonged HV interval more than or equal to 70 ms one can discuss the implantation of a prophylactic pacemaker. The choice of an implantable cardiac defibrillator is preferred in presence of spontaneous ventricular tachycardia or an alteration of the left ventricular ejection fraction. PMID:21549556

  16. Cochlear implants

    OpenAIRE

    Despotović, Adrijana

    2011-01-01

    The aim of the thesis is to analyze the performance of the child with cochlear implant (CI) at language, math and movement activities. For the purpose of research exercises from all three above mentioned activities are prepared. Results of the exercises constitute the ground for the comparison of a child with CI and children with no hearing disability. Testing language skills was performed with exercises that included understanding, diction and identifying syllables. Mathematic skills...

  17. Non-linear dynamical signal characterization for prediction of defibrillation success through machine learning

    Directory of Open Access Journals (Sweden)

    Shandilya Sharad

    2012-10-01

    Full Text Available Abstract Background Ventricular Fibrillation (VF is a common presenting dysrhythmia in the setting of cardiac arrest whose main treatment is defibrillation through direct current countershock to achieve return of spontaneous circulation. However, often defibrillation is unsuccessful and may even lead to the transition of VF to more nefarious rhythms such as asystole or pulseless electrical activity. Multiple methods have been proposed for predicting defibrillation success based on examination of the VF waveform. To date, however, no analytical technique has been widely accepted. We developed a unique approach of computational VF waveform analysis, with and without addition of the signal of end-tidal carbon dioxide (PetCO2, using advanced machine learning algorithms. We compare these results with those obtained using the Amplitude Spectral Area (AMSA technique. Methods A total of 90 pre-countershock ECG signals were analyzed form an accessible preshosptial cardiac arrest database. A unified predictive model, based on signal processing and machine learning, was developed with time-series and dual-tree complex wavelet transform features. Upon selection of correlated variables, a parametrically optimized support vector machine (SVM model was trained for predicting outcomes on the test sets. Training and testing was performed with nested 10-fold cross validation and 6–10 features for each test fold. Results The integrative model performs real-time, short-term (7.8 second analysis of the Electrocardiogram (ECG. For a total of 90 signals, 34 successful and 56 unsuccessful defibrillations were classified with an average Accuracy and Receiver Operator Characteristic (ROC Area Under the Curve (AUC of 82.2% and 85%, respectively. Incorporation of the end-tidal carbon dioxide signal boosted Accuracy and ROC AUC to 83.3% and 93.8%, respectively, for a smaller dataset containing 48 signals. VF analysis using AMSA resulted in accuracy and ROC AUC of 64

  18. 鱼油对心脏复律除颤器植入患者室性快速性心律失常及死亡的影响ω-3脂肪酸与室性心律失常随机试验研究(SOFA)%Effect of Fish Oil on Ventricular Tachyarrhythmia and Death in Patients With Implantable Cardioverter Defibrillators The Study on Omega-3 Fatty Acids and Ventricular Arrhythmia (SOFA) Randomized Trial

    Institute of Scientific and Technical Information of China (English)

    Ingeborg A. Brouwer; Peter L. Zock; A. John Camm; 顾佳

    2007-01-01

    背景:人们认为,鱼体内的长链多元不饱和脂肪酸(ω-3PUFAs)可减少心律失常的发生,从而降低猝死的风险.目的:比较鱼油保健品及安慰剂对室性快速性心律失常及死亡的影响.设计、地点及患者:"ω-3脂肪酸与室性心律失常关系研究"(Study on Omega-3 Fatty acids and ventricular Arrhythmia,SOFA)是在欧洲26家心脏诊所中开展的一项随机、平行、安慰剂对照、双盲试验.自2001年10月起至2004年8月止,共有546名携有植入式心脏复律除颤器(implantable cardioverterdefibrillators,ICDs)的恶性室性心动过速(ventricular tachycardia,VT)患者和心室纤颤(ventricular fibrillation,VF)患者纳入研究.这些患者随机服用鱼油(2 g/d,n=273)或安慰剂(n=273),平均356天(范围为14~379天).主要观测指标:VT或VF患者接受ICD干预的情况以及全因死亡率.结果:主要研究终点见于81例(30%)服用鱼油的患者和90例(33%)服用安慰剂的患者(风险比[hazard ratio,HR],0.86;95%可信区间[confidence interval,CI],0.64~1.16;P=0.33).特定的亚组分析显示,有411例患者在纳入研究前一年内出现了VT,有332例患者既往曾患有心肌梗死,其中服用鱼油者与服用安慰剂者相比HR分别为0.91(95%CI,0.66~1.26)和0.76(95%CI,0.52~1.11).结论:我们的结果显示,摄入鱼油中的ω-3 PUFAs并不能对携有ICDs的室性心律失常患者产生强有力的保护作用.

  19. Analysis of Clinical Application of Electric Defibrillation%电除颤的临床应用分析

    Institute of Scientific and Technical Information of China (English)

    李黎

    2015-01-01

    Objective To analyse the clinical application of electric defibril ation. Methods Our hospital admissions for patients with cardiac ar est in 78 cases as the research object, conform to the requirements of electric defibril ation indications, according to ventricular fibril ation cardiac arrest - time (T) divided into study group and control group, 40 cases in the study group, T 2min defibril ator. Comparative analysis of two groups of the successful rate of CPR and defibril ation ef iciency. Results The ef ective rate of the study group the successful rate of CPR and defibril ation were significantly higher than those in the control group ( 2min除颤。对比分析两组复苏成功率与除颤有效率。结果研究组复苏成功率与除颤有效率皆明显高于对照组(<0.05)。结论确保心脏骤停患者符合电除颤适应症且排除禁忌症情况下,尽早予以电除颤可提高复苏成功率与除颤有效率,值得借鉴。

  20. Thin-film Rechargeable Lithium Batteries for Implantable Devices

    Science.gov (United States)

    Bates, J. B.; Dudney, N. J.

    1997-05-01

    Thin films of LiCoO{sub 2} have been synthesized in which the strongest x ray reflection is either weak or missing, indicating a high degree of preferred orientation. Thin film solid state batteries with these textured cathode films can deliver practical capacities at high current densities. For example, for one of the cells 70% of the maximum capacity between 4.2 V and 3 V ({approximately}0.2 mAh/cm{sup 2}) was delivered at a current of 2 mA/cm{sup 2}. When cycled at rates of 0.1 mA/cm{sup 2}, the capacity loss was 0.001%/cycle or less. The reliability and performance of Li LiCoO{sub 2} thin film batteries make them attractive for application in implantable devices such as neural stimulators, pacemakers, and defibrillators.

  1. Defibrillation efficacy of a newly developed automated external defibrillator in a swine ventricular tachycardia/fibrillation model%自主研发体外自动除颤器的实验研究

    Institute of Scientific and Technical Information of China (English)

    惠杰; 蒋文平; 谷云飞; 邬小玫; 朱宗成; 宋建平; 杨向军; 刘志华; 蒋廷波; 方祖祥

    2009-01-01

    Objective The aim of this study was to evaluate the recognition and defibrillation efficiency of a newly developed automated extemal defibrillator (AED). Method Ventricular tachycardia (VT) /ventricular fibrillation (VF) was induced by alternating current (50 Hz) through an electrode placed on apex of right ventricle in 23 anesthetized swine and recorded, recognized and defibrillated by a newly developed AED. Results A total of 96 VF was induced and 145 defibrillations were recorded. We analyzed available 167 electrocardiosignal with a total length of 103 740 seconds. The accuracy, sensitivity and the specificity of the AED on VT/VF recognition are 99.5%, 98.2% and 99.6%, respectively. The success rate of defibrillation was 33.4% which increased in proportion to defibrillation energy. The defibrillation threshold of energy is 29.10-116.91 (78.75±35.64 ) J, the defibrillation threshold of electric quantity is (0.11±0.04)C and the defibrillation threshold of voltage is (1216.67±260.87) V. Conclusions This newly developed AED has high sensitivity and the specificity on recognizing VT/VF. The lower success rate of defibrillation of this AED is associated with the low defibrillation energy during defibrillation which needs to be improved on further development.%目的 评价自主设计和研制体外自动除颤器(AED)对室性心动过速(室速)/心室颤动(室颤)识别的敏感性、特异性以及除颤效果.方法 应用交流电刺激实验动物诱发室速/室颤,记录并分析AED对窜速/室颤的识别以及除颤放电的整个过程,评价其诊断识别和除颤性能.结果 诱颤96次,除颤145次,记录心电数据167段次,共计103 740 S.室速/室颤的识别准确性为99.5%,敏感性为98.2%,特异性为99.6%.除颤成功率和除颤能量呈正相关,成功除颤的能量阈值为(78.75±35.64)J,电量阈值为(0.11±0.04)C,电压阈值为(1216.67±260.87)V.结论 自主研制的AED具有较高的识别敏感性和特异性,其识别和

  2. Improved arrhythmia detection in implantable loop recorders

    DEFF Research Database (Denmark)

    Brignole, M.; Black, C.L.B.; Sutton, R.;

    2008-01-01

    , bradyarrhythmia, and tachyarrhythmia events, which is implemented in the next generation device (Reveal DX/XT). Methods and Results: The new scheme employs an automatically adjusting R-wave sensing threshold, enhanced noise rejection, and algorithms to detect asystole, bradyarrhythmia, and tachyarrhythmia....... Performance of the new algorithms was evaluated using 2,613 previously recorded, automatically detected Reveal Plus episodes from 533 patients. A total of 71.9% of episodes were inappropriately detected by the original ILR, and at least 88.6% of patients had one or more inappropriate episodes, with most......Improved Arrhythmia Detection. Introduction: Implantable loop recorders (ILR) have an automatic arrhythmia detection feature that can be compromised by inappropriately detected episodes. This study evaluated a new ILR sensing and detection scheme for automatically detecting asystole...

  3. Malfunctions of Implantable Cardiac Devices in Patients Receiving Proton Beam Therapy: Incidence and Predictors

    Energy Technology Data Exchange (ETDEWEB)

    Gomez, Daniel R., E-mail: dgomez@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Poenisch, Falk [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Pinnix, Chelsea C. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Sheu, Tommy [Department of Experimental Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Chang, Joe Y. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Memon, Nada [Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mohan, Radhe [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Rozner, Marc A. [Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Dougherty, Anne H. [Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2013-11-01

    Purpose: Photon therapy has been reported to induce resets of implanted cardiac devices, but the clinical sequelae of treating patients with such devices with proton beam therapy (PBT) are not well known. We reviewed the incidence of device malfunctions among patients undergoing PBT. Methods and Materials: From March 2009 through July 2012, 42 patients with implanted cardiac implantable electronic devices (CIED; 28 pacemakers and 14 cardioverter-defibrillators) underwent 42 courses of PBT for thoracic (23, 55%), prostate (15, 36%), liver (3, 7%), or base of skull (1, 2%) tumors at a single institution. The median prescribed dose was 74 Gy (relative biological effectiveness; range 46.8-87.5 Gy), and the median distance from the treatment field to the CIED was 10 cm (range 0.8-40 cm). Maximum proton and neutron doses were estimated for each treatment course. All CIEDs were checked before radiation delivery and monitored throughout treatment. Results: Median estimated peak proton and neutron doses to the CIED in all patients were 0.8 Gy (range 0.13-21 Gy) and 346 Sv (range 11-1100 mSv). Six CIED malfunctions occurred in 5 patients (2 pacemakers and 3 defibrillators). Five of these malfunctions were CIED resets, and 1 patient with a defibrillator (in a patient with a liver tumor) had an elective replacement indicator after therapy that was not influenced by radiation. The mean distance from the proton beam to the CIED among devices that reset was 7.0 cm (range 0.9-8 cm), and the mean maximum neutron dose was 655 mSv (range 330-1100 mSv). All resets occurred in patients receiving thoracic PBT and were corrected without clinical incident. The generator for the defibrillator with the elective replacement indicator message was replaced uneventfully after treatment. Conclusions: The incidence of CIED resets was about 20% among patients receiving PBT to the thorax. We recommend that PBT be avoided in pacing-dependent patients and that patients with any type of CIED receiving

  4. Cochlear Implant

    Directory of Open Access Journals (Sweden)

    Mehrnaz Karimi

    1992-04-01

    Full Text Available People with profound hearing loss are not able to use some kinds of conventional amplifiers due to the nature of their loss . In these people, hearing sense is stimulated only when the auditory nerve is activated via electrical stimulation. This stimulation is possible through cochlear implant. In fact, for the deaf people who have good mental health and can not use surgical and medical treatment and also can not benefit from air and bone conduction hearing aids, this device is used if they have normal central auditory system. The basic parts of the device included: Microphone, speech processor, transmitter, stimulator and receiver, and electrode array.

  5. Nanotechnology and Dental Implants

    OpenAIRE

    Sandrine Lavenus; Guy Louarn; Pierre Layrolle

    2010-01-01

    The long-term clinical success of dental implants is related to their early osseointegration. This paper reviews the different steps of the interactions between biological fluids, cells, tissues, and surfaces of implants. Immediately following implantation, implants are in contact with proteins and platelets from blood. The differentiation of mesenchymal stem cells will then condition the peri-implant tissue healing. Direct bone-to-implant contact is desired for a biomechanical anchoring of i...

  6. Discussion on Quality Control of Defibrillator Monitor%除颤监护器质量控制探讨

    Institute of Scientific and Technical Information of China (English)

    朱悦; 尹钢; 廖云粤

    2016-01-01

    In reference to Calibration Specification for Defibrillator Monitor, this paper adopted the Fluke Impluse7000DP Defibrillator Analyzers to conduct quality control to test five parameters of cardiac de-fibrillator monitors in our hospital, including appearance and function, delivered energy, charging time, delay time under synchronizer, and heart rate value. Timely maintenance was carried out on defibrillators with certain problems to ensure the safe use of defibrillators in clinical practice. Meanwhile a compar-ative analysis was conducted on the results of quality control. The research explored a quality control program that was appropriate for defibrillator quality control in the context of clinical experience in the hospital.%本文参照国家对除颤监护器的校准规范,采用Fluke Impluse7000DP除颤器分析仪,对本院的全部除颤监护器进行了外观功能、释放能量准确性、充电时间、同步延时时间、心率示值这5个项目的质控检测,对存在问题的除颤器及时进行维修,保证了除颤器的临床使用安全。同时对质控检测结果进行了比较分析,并结合临床的使用体验,探索适合我院除颤监护器质量控制方案。

  7. The evolution of the cardiac implantable electronic device connector.

    Science.gov (United States)

    Mond, Harry G; Helland, John R; Fischer, Avi

    2013-11-01

    Cardiac implantable electronic devices (CIEDs) play a vital role in the management of cardiac rhythm disturbances. The devices are comprised of two primary components: a generator and lead joined by a connector. Original pacemaker lead connectors were created de novo at the time of implantation or replacement and were very unreliable. With the development of new lead designs, creation of a standard connector configuration, the IS-1 connector became mandatory. Similar connector development also occurred with the advent of the implantable cardioverter defibrillator (ICD), resulting in creation of the high voltage standard: the DF-1 connector. Differing from a pacemaker lead, the ICD lead connector requires one IS-1 connector and one or two DF-1 connectors, resulting in a large cumbersome lead connector and generator header block. Recently, a revolutionary quad pole single plug connector standard has been approved for market release. These are the single-pin DF4 and IS4 lead connectors that carry low- and high-voltage poles or all low-voltage poles, respectively. These connectors, together with new labeling guidelines, have simplified operative procedures and reduced errors, when mating lead connectors into the generator's connector block. PMID:23808816

  8. Effect of obesity on the effectiveness of cardiac resynchronization to reduce the risk of first and recurrent ventricular tachyarrhythmia events

    OpenAIRE

    Szepietowska, Barbara; Polonsky, Bronislava; Sherazi, Saadia; Biton, Yitschak; Kutyifa, Valentina; McNitt, Scott; AKTAS, Mehmet; Moss, Arthur J.; Zareba, Wojciech

    2016-01-01

    Background Obesity is associated with multiple adverse cardiovascular conditions and may increase the risk of ventricular tachyarrhythmias (VT/VF). There is limited data on the association between obesity and risk of VT/VF requiring appropriate implantable cardioverter-defibrillator (ICD) therapies and the effectiveness of cardiac resynchronization therapy (CRT) to reduce risk for VT/VF. The multicenter automatic defibrillator implantation trial with cardiac resynchronization therapy (MADIT-C...

  9. Is there an Optimal Shape of the Defibrillation Shock: Constant Current vs. Pulsed Biphasic Waveforms

    OpenAIRE

    Ivan Dotsinsky; Tsvetan Mudrov; Vessela Krasteva; Jecho Kostov

    2013-01-01

    Three waveforms for transthoracic defibrillation are assessed and compared: the Pulsed Biphasic Waveform (PBW), the Rectilinear Biphasic Waveform (RBW), and the "lossless" constant current (LLCC) pulses. Two indices are introduced: 1) kf = W/W0 - the ratio between the delivered energy W and the energy W0 of a rectangular pulse with the same duration and electric charge; 2) ηC = W/WC0 - the level of utilizing the initially loaded capacitor energy WC0. The envisioned comparative study shows tha...

  10. Prospective Nationwide Fluoroscopic and Electrical Longitudinal Follow-up of Recalled Riata Defibrillator Leads in Denmark

    DEFF Research Database (Denmark)

    Larsen, Jacob M.; Nielsen, Jens C; Johansen, Jens B;

    2014-01-01

    BACKGROUND Recalled St. Jude Medical Riata defibrillator leads are prone to insulation failures with externalized conductors (ECs). Longitudinal studies are needed to guide lead management. OBJECTIVE The purpose of this study was to describe the dynamic nature of EC and the association with...... electrical abnormalities and lead extraction outcomes. METHODS A nationwide cohort established in 2012 of 295 patients with recalled Riata leads with dwell time 5.1 +/- 1.1 years, 34 ECs, and 19 electrical abnormalities were followed until death, lead discontinuation with fluoroscopy, or a new 2013 screening...

  11. Study on the Switching Time-Variation of Simultaneously Controlled IGBT: Case of Defibrillators Design

    Directory of Open Access Journals (Sweden)

    Mudrov T.

    2009-12-01

    Full Text Available Samples of integrated gain bipolar transistors (IGBT of the same type but produced under different technologies were tested about the switching time-variation. This is of high importance when several IGBT are connected in series to commutate high voltage defibrillation shocks. Very often, a short voltage overload of one of the IGBT in group leads to electrical breakdown of all transistors, due to nonsynchronised driving of the gate-emitter circuits. The goal of the study was to check whether compensation of the delays introduced throughout the IGBT control circuits might be efficient despite the own dispersion of the transistor parameters.

  12. Automatic input rectification

    OpenAIRE

    Long, Fan; Ganesh, Vijay; Carbin, Michael James; Sidiroglou, Stelios; Rinard, Martin

    2012-01-01

    We present a novel technique, automatic input rectification, and a prototype implementation, SOAP. SOAP learns a set of constraints characterizing typical inputs that an application is highly likely to process correctly. When given an atypical input that does not satisfy these constraints, SOAP automatically rectifies the input (i.e., changes the input so that it satisfies the learned constraints). The goal is to automatically convert potentially dangerous inputs into typical inputs that the ...

  13. Automatic Fiscal Stabilizers

    Directory of Open Access Journals (Sweden)

    Narcis Eduard Mitu

    2013-11-01

    Full Text Available Policies or institutions (built into an economic system that automatically tend to dampen economic cycle fluctuations in income, employment, etc., without direct government intervention. For example, in boom times, progressive income tax automatically reduces money supply as incomes and spendings rise. Similarly, in recessionary times, payment of unemployment benefits injects more money in the system and stimulates demand. Also called automatic stabilizers or built-in stabilizers.

  14. Automatic differentiation bibliography

    Energy Technology Data Exchange (ETDEWEB)

    Corliss, G.F. (comp.)

    1992-07-01

    This is a bibliography of work related to automatic differentiation. Automatic differentiation is a technique for the fast, accurate propagation of derivative values using the chain rule. It is neither symbolic nor numeric. Automatic differentiation is a fundamental tool for scientific computation, with applications in optimization, nonlinear equations, nonlinear least squares approximation, stiff ordinary differential equation, partial differential equations, continuation methods, and sensitivity analysis. This report is an updated version of the bibliography which originally appeared in Automatic Differentiation of Algorithms: Theory, Implementation, and Application.

  15. Retrograde peri-implantitis.

    Science.gov (United States)

    Mohamed, Jumshad B; Shivakumar, B; Sudarsan, Sabitha; Arun, K V; Kumar, T S S

    2010-01-01

    Retrograde peri-implantitis constitutes an important cause for implant failure. Retrograde peri-implantitis may sometimes prove difficult to identify and hence institution of early treatment may not be possible. This paper presents a report of four cases of (the implant placed developing to) retrograde peri-implantitis. Three of these implants were successfully restored to their fully functional state while one was lost due to extensive damage. The paper highlights the importance of recognizing the etiopathogenic mechanisms, preoperative assessment, and a strong postoperative maintenance protocol to avoid retrograde peri-implant inflammation. PMID:20922082

  16. Automatic Training of Rat Cyborgs for Navigation

    OpenAIRE

    Yu, Yipeng; Wu, Zhaohui; Xu, Kedi; Gong, Yongyue; Zheng, Nenggan; Zheng, Xiaoxiang; Pan, Gang

    2016-01-01

    A rat cyborg system refers to a biological rat implanted with microelectrodes in its brain, via which the outer electrical stimuli can be delivered into the brain in vivo to control its behaviors. Rat cyborgs have various applications in emergency, such as search and rescue in disasters. Prior to a rat cyborg becoming controllable, a lot of effort is required to train it to adapt to the electrical stimuli. In this paper, we build a vision-based automatic training system for rat cyborgs to rep...

  17. Is there an Optimal Shape of the Defibrillation Shock: Constant Current vs. Pulsed Biphasic Waveforms

    Directory of Open Access Journals (Sweden)

    Ivan Dotsinsky

    2013-04-01

    Full Text Available Three waveforms for transthoracic defibrillation are assessed and compared: the Pulsed Biphasic Waveform (PBW, the Rectilinear Biphasic Waveform (RBW, and the "lossless" constant current (LLCC pulses. Two indices are introduced: 1 kf = W/W0 - the ratio between the delivered energy W and the energy W0 of a rectangular pulse with the same duration and electric charge; 2 ηC = W/WC0 - the level of utilizing the initially loaded capacitor energy WC0. The envisioned comparative study shows that ηC index is favorable for both PBW and LLCC, while kf of both RBW and LLCC demonstrates advantage over the PBW in the range of small inter-electrode thoracic impedances below 80 Ω. Some design considerations are also discussed. The attractive LLCC concept needs large and heavy inductive coil to support the constant current amplitude, besides it is capable to induce strong electromagnetic influences due to the complex current control. The RBW technology controls the delivery of current through a series of internal resistors which are, however, a source of high heat losses. The PBW implements controlled duty cycle of high-frequency chopped pulses to adapt the energy delivery in respect of the patient impedance measured at the beginning of the shock. PBW technology makes use of small capacitors which allows the construction of light weight and small-size portable devices for transthoracic defibrillation.

  18. Hospital-wide first-responder automated external defibrillator programme: 1 year experience.

    Science.gov (United States)

    Hanefeld, Christoph; Lichte, Carolin; Mentges-Schröter, Ina; Sirtl, Clemens; Mügge, Andreas

    2005-08-01

    The first year experience with a hospital-wide first-responder automated external defibrillator (AED) programme implemented in a 683-bed University Hospital is reported. Throughout the hospital, 14 "AED access spots" were identified which could be easily reached from all wards and diagnostic rooms within 30s. AEDs were installed (Lifepak 500; Medtronik PhysioControl Corp., Redmond, USA, equipped with a Biolog 3000i portable ECG monitor; Micromedical Industries Ltd., Labrador, Australia). Within 3 months, 120 medical officers, 750 nurses, and 50 administrative or technical staff underwent a 2h training programme. An AED was applied and activated by nurses/medical staff before the cardiac arrest team arrived in 27 of 33 cases (81.8%) of witnessed cardiac arrest. The median time from onset of the emergency call to the activation of the AED (record of ECG) was on average 2.1 min (range 1.0--4.5 min). In 18 of 27 cases in which the AED was installed promptly, the primary arrest rhythm was either VT or VF, and the AED delivered a shock. For this subgroup, the rate of return of spontaneous circulation and the rate of discharge at home were 88.9 and 55.6%, respectively. This encourages us to extend the concept of first-responder AED-defibrillation throughout our hospital. PMID:16053941

  19. A Comparison of the Effect of Square and Circular Electrodes During Defibrillation

    Science.gov (United States)

    Langrill Beaudoin, Deborah M.; Roth, Bradley J.

    2004-10-01

    The mechanism by which defibrillation-strength electric fields affect the heart has been studied extensively. Widely cited experiments designed to look at this effect incorporated plunge electrodes, made up of insulated, 21-gauge needles, to record the transmural, extracellular potential. In a previous paper (Langrill and Roth, IEEE Trans. Biomed. Eng. 48:1207-1211, 2001), we looked at the effect of a single circular plunge electrode in a passive, two-dimensional model of cardiac tissue under the influence of a defibrillation-strength electric field. In a more recent paper, we looked at 9 square plunge electrodes. It is our hypothesis that the shape of the electrode does not make a significant difference in the response of the tissue to the electric field. We perform the same simulations as in the circular plunge electrode paper and compare the two sets of data. We find that although there are some quantitative differences between the two shapes, the overall response is nearly identical.

  20. Automated external defibrillators inaccessible to more than half of nearby cardiac arrests in public locations during evening, nighttime, and weekends

    DEFF Research Database (Denmark)

    Hansen, Carolina Malta; Wissenberg, Mads; Weeke, Peter;

    2013-01-01

    BACKGROUND: Despite wide dissemination, use of automated external defibrillators (AEDs) in community settings is limited. We assessed how AED accessibility affected coverage of cardiac arrests in public locations. METHODS AND RESULTS: We identified cardiac arrests in public locations (1994-2011) in...

  1. Survival and health care costs until hospital discharge of patients treated with onsite, dispatched or without automated external defibrillator

    NARCIS (Netherlands)

    J. Berdowski; M.J. Kuiper; M.G.W. Dijkgraaf; J.G.P. Tijssen; R.W. Koster

    2010-01-01

    Background: This study aimed to determine whether automated external defibrillator (AED) use during resuscitation is associated with lower in-hospital health care costs. Methods: For this observational prospective study, we included all treated out-of-hospital cardiac arrests of suspected cardiac ca

  2. Implant success!!!.....simplified

    OpenAIRE

    Luthra Kaushal

    2009-01-01

    The endeavor towards life-like restoration has helped nurture new vistas in the art and science of implant dentistry. The protocol of “restoration-driven implant placement” ensures that the implant is an apical extension of the ideal future restoration and not the opposite. Meticulous pre-implant evaluation of soft and hard tissues, diagnostic cast and use of aesthetic wax-up and radiographic template combined with surgical template can simplify the intricate roadmap for appropriate implant t...

  3. Small bowel capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter defibrillators: Outcome analysis using telemetry review

    OpenAIRE

    2012-01-01

    AIM: To determine if there were any interactions between cardiac devices and small bowel capsules secondary to electromagnetic interference (EMI) in patients who have undergone small bowel capsule endoscopy (SBCE).

  4. Computer-aided recognition of dental implants in X-ray images

    Science.gov (United States)

    Morais, Pedro; Queirós, Sandro; Moreira, António H. J.; Ferreira, Adriano; Ferreira, Ernesto; Duque, Duarte; Rodrigues, Nuno F.; Vilaça, João. L.

    2015-03-01

    Dental implant recognition in patients without available records is a time-consuming and not straightforward task. The traditional method is a complete user-dependent process, where the expert compares a 2D X-ray image of the dental implant with a generic database. Due to the high number of implants available and the similarity between them, automatic/semi-automatic frameworks to aide implant model detection are essential. In this study, a novel computer-aided framework for dental implant recognition is suggested. The proposed method relies on image processing concepts, namely: (i) a segmentation strategy for semi-automatic implant delineation; and (ii) a machine learning approach for implant model recognition. Although the segmentation technique is the main focus of the current study, preliminary details of the machine learning approach are also reported. Two different scenarios are used to validate the framework: (1) comparison of the semi-automatic contours against implant's manual contours of 125 X-ray images; and (2) classification of 11 known implants using a large reference database of 601 implants. Regarding experiment 1, 0.97±0.01, 2.24±0.85 pixels and 11.12±6 pixels of dice metric, mean absolute distance and Hausdorff distance were obtained, respectively. In experiment 2, 91% of the implants were successfully recognized while reducing the reference database to 5% of its original size. Overall, the segmentation technique achieved accurate implant contours. Although the preliminary classification results prove the concept of the current work, more features and an extended database should be used in a future work.

  5. Chest Compressions Cause Recurrence of Ventricular Fibrillation After the First Successful Conversion by Defibrillation in Out-of-Hospital Cardiac Arrest

    NARCIS (Netherlands)

    J. Berdowski; J.G.P. Tijssen; R.W. Koster

    2010-01-01

    Background-Unlike Resuscitation Guidelines (GL) 2000, GL2005 advise resuming cardiopulmonary resuscitation (CPR) immediately after defibrillation. We hypothesized that immediate CPR resumption promotes earlier recurrence of ventricular fibrillation (VF). Methods and Results-This study used data of a

  6. The effect of pinacidil on postshock activation and ventricular defibrillation threshold in canine hearts

    Institute of Scientific and Technical Information of China (English)

    Qi JIN; Ning ZHANG; Jian ZHOU; Chang-jian LIN; Yang PANG; Gang GU; Wei-feng SHEN; Li-qun WU

    2012-01-01

    Aim: To determine the postshock activation patterns with both successful and failed shocks in a canine model of ventricular fibrillation,and whether piniacidil,an early after-depolarization (EAD) inhibitor,altered the defibrillation threshold (DFT) and postshock activation patterns.Methods: In 6 beagles,a basket catheter with 64 unipolar electrodes was placed in the LV for global endocardial mapping,a monophasic action potential catheter was inserted into the LV apex,and a catheter with the negative electrode in the right ventricle and the positive electrode in the superior vena cava was inserted for defibrillation.The DFT,90% action potential duration (APD90) and activation recovery interval (ARI) were evaluated before and after pinacidil administration (loading dosage 0.5 mg/kg and maintenance dosage 0.5 mg·kg-1-h-1,iv).Electrical heterogeneities were defined with the dispersion of ARI.After successful and failed shocks with nearDFT strength,the earliest postshock activation patterns (focal or nonfocal endocardial activation),interval and location were detected.Results: Pinacidil significantly decreased APD90 (from 178±16 ms to 168±18 ms) and ARI from (152±10 ms to 143±10 ms) at pacing cycle length of 300 ms.The drug significantly increased VF activation rate (from 10.0±1.9 Hz to 10.8±2.0 Hz).The drug did not affect the dispersion of ARI,neither it changed DFT (baseline: 480±110 V; pinacidil: 425±55 V,P>O.05).The earliest postshock activation arose locally on the LV apical endocardium before and after the drug treatment.Pinacidil significantly prolonged the postshock cycle length of cycles 2 to 5 for the successful episodes but not for the failed episodes.Conclusion: Pinacidil increases the postshock cycle length suggesting that EAD may play a role in postshock activation,while it fails to alter DFT suggesting that EAD produced by shock does not determine a defibrillation success or failure.

  7. Automatic Payroll Deposit System.

    Science.gov (United States)

    Davidson, D. B.

    1979-01-01

    The Automatic Payroll Deposit System in Yakima, Washington's Public School District No. 7, directly transmits each employee's salary amount for each pay period to a bank or other financial institution. (Author/MLF)

  8. Automatic Arabic Text Classification

    OpenAIRE

    Al-harbi, S; Almuhareb, A.; Al-Thubaity , A; Khorsheed, M. S.; Al-Rajeh, A.

    2008-01-01

    Automated document classification is an important text mining task especially with the rapid growth of the number of online documents present in Arabic language. Text classification aims to automatically assign the text to a predefined category based on linguistic features. Such a process has different useful applications including, but not restricted to, e-mail spam detection, web page content filtering, and automatic message routing. This paper presents the results of experiments on documen...

  9. [Detection and therapy of respiratory dysfunction by implantable (cardiac) devices].

    Science.gov (United States)

    Fox, H; Oldenburg, O; Nölker, G; Horstkotte, D; Gutleben, K-J

    2014-02-01

    Sleep-disordered breathing (SDB) represents a common comorbidity in cardiac patients. The prevalence of obstructive sleep apnea (OSA) and central sleep apnea (CSA) is very high, particularly in patients with heart rhythm disorders and heart failure (HF). Patients with pacemakers (PM) and implantable defibrillators (ICD) including cardiac resynchronization therapy (CRT) show SDB prevalences up to 75%. However, some modern PM, ICD and CRT devices allow the detection of SDB via transthoracic impedance analysis with high sensitivity compared to polysomnographic (PSG) controls. Thus, this method could be of relevance in screening and monitoring SDB in patients with implantable cardiac devices. Preliminary studies demonstrated the possibility to treat OSA in selected patients by stimulation of the cranial nerves, especially the hypoglossal nerve. However, this requires extensive diagnostics and advanced surgical approaches including many medical disciplines and is not part of this review article. However, unilateral and transvenous stimulation of the phrenic nerve to treat central sleep apnea and Cheyne-Stokes respiration in HF patients in particular can be performed by cardiologists. This article summarizes preliminary data on the results of this promising therapy. PMID:24638158

  10. Urinary incontinence - injectable implant

    Science.gov (United States)

    Injectable implants are injections of material into the urethra to help control urine leakage ( urinary incontinence ) caused by a ... into the tissue next to the sphincter. The implant procedure is usually done in the hospital. Or ...

  11. Cardiac Resynchronization Therapy Defibrillator Treatment in a Child with Heart Failure and Ventricular Arrhythmia.

    Science.gov (United States)

    Kim, Hak Ju; Cho, Sungkyu; Kim, Woong-Han

    2016-08-01

    Cardiac resynchronization therapy (CRT) is a new treatment for refractory heart failure. However, most patients with heart failure treated with CRT are adults, middle-aged or older with idiopathic or ischemic dilated cardiomyopathy. We treated a 12-year-old boy, who was transferred after cardiac arrest, with dilated cardiomyopathy, left bundle-branch block, and ventricular tachycardia. We performed cardiac resynchronization therapy with a defibrillator (CRT-D). After CRT-D, left ventricular ejection fraction improved from 22% to 44% assessed by echocardiogram 1 year postoperatively. On electrocardiogram, QRS duration was shortened from 206 to 144 ms. The patient's clinical symptoms also improved. For pediatric patients with refractory heart failure and ventricular arrhythmia, CRT-D could be indicated as an effective therapeutic option. PMID:27525239

  12. PDE constrained optimization of electrical defibrillation in a 3D ventricular slice geometry.

    Science.gov (United States)

    Chamakuri, Nagaiah; Kunisch, Karl; Plank, Gernot

    2016-04-01

    A computational study of an optimal control approach for cardiac defibrillation in a 3D geometry is presented. The cardiac bioelectric activity at the tissue and bath volumes is modeled by the bidomain model equations. The model includes intramural fiber rotation, axially symmetric around the fiber direction, and anisotropic conductivity coefficients, which are extracted from a histological image. The dynamics of the ionic currents are based on the regularized Mitchell-Schaeffer model. The controls enter in the form of electrodes, which are placed at the boundary of the bath volume with the goal of dampening undesired arrhythmias. The numerical optimization is based on Newton techniques. We demonstrated the parallel architecture environment for the computation of potentials on multidomains and for the higher order optimization techniques. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26249168

  13. Implantable electronic medical devices

    CERN Document Server

    Fitzpatrick, Dennis

    2014-01-01

    Implantable Electronic Medical Devices provides a thorough review of the application of implantable devices, illustrating the techniques currently being used together with overviews of the latest commercially available medical devices. This book provides an overview of the design of medical devices and is a reference on existing medical devices. The book groups devices with similar functionality into distinct chapters, looking at the latest design ideas and techniques in each area, including retinal implants, glucose biosensors, cochlear implants, pacemakers, electrical stimulation t

  14. Physical activity in primary versus secondary prevention indication implantable cardioverter defibrillator recipients 6-12 months after implantation - a cross-sectional study with register follow up

    DEFF Research Database (Denmark)

    Berg, S. K.; Thygesen, L. C.; Svendsen, J. H.;

    2015-01-01

    MEASURES: Questions regarding physical activity and the IPAQ questionnaire were used to assess physical activity. RESULTS: The response rate was 71.7%. Mean age 65.5 years with 82% males. 37% participated in a rehabilitation programme. 21 % were sedentary compared to 8 % in the reference population (p < 0.......11;13.71) p<0.05, however not statistically significant when adjusted for age, sex, marital status and co-morbidity. CONCLUSION: Guidelines for exercise and participation in rehabilitation are not meet for this population which leave a great potential for future interventions improving the clinical outcomes...

  15. HA-Coated Implant

    DEFF Research Database (Denmark)

    Daugaard, Henrik; Søballe, Kjeld; Bechtold, Joan E

    2014-01-01

    The goal of osseointegration of orthopedic and dental implants is the rapid achievement of a mechanically stable and long lasting fixation between living bone and the implant surface. In total joint replacements of cementless designs, coatings of calcium phosphates were introduced as a means of...... evaluating bone-implant fixation with HA coatings....

  16. Candida and cardiovascular implantable electronic devices: a case of lead and native aortic valve endocarditis and literature review.

    Science.gov (United States)

    Glavis-Bloom, Justin; Vasher, Scott; Marmor, Meghan; Fine, Antonella B; Chan, Philip A; Tashima, Karen T; Lonks, John R; Kojic, Erna M

    2015-11-01

    Use of cardiovascular implantable electronic devices (CIED), including permanent pacemakers (PPM) and implantable cardioverter defibrillators (ICD), has increased dramatically over the past two decades. Most CIED infections are caused by staphylococci. Fungal causes are rare and their prognosis is poor. To our knowledge, there has not been a previously reported case of multifocal Candida endocarditis involving both a native left-sided heart valve and a CIED lead. Here, we report the case of a 70-year-old patient who presented with nausea, vomiting, and generalised fatigue, and was found to have Candida glabrata endocarditis involving both a native aortic valve and right atrial ICD lead. We review the literature and summarise four additional cases of CIED-associated Candida endocarditis published from 2009 to 2014, updating a previously published review of cases prior to 2009. We additionally review treatment guidelines and discuss management of CIED-associated Candida endocarditis. PMID:26403965

  17. Electromagnetic interference of mobile phones with electronic implants

    International Nuclear Information System (INIS)

    Chapter 1:Interference matrix: The objective of Chapter 1 was to give an overview of the implants used at present and their electromagnetic compatibility (EMC). The evaluation of the available literature provides an estimate of the probability of electronic implants being influenced by various interference sources. A literature search at the AKH (Allgemeines Krankenhaus) in Vienna and at the Technical University of Vienna in the FIZ (Fach-Informations-Zentrum) -Biomedizinische Technik, Medline, Pascal Biomed, CC Search und Embase databases yielded 236 relevant publications. At present 12 different implants are used: pacemaker, defibrillator, cochlear and brain-stem implants, neurostimulators, spinal-cord stimulators, spinal-fusion stimulators, telemetry systems, artificial hearts, drug-delivery systems, neurological pulse generators, visual prosthetics and implantable patient chips. The frequency with which they are used and the EMC on exposure to the various interference sources was summarized. Publications on EMC were found only for the first six implant types and only for 30% of the possible combinations of implant type and interference source. Based on the number of the implants examined, the probability of interference was calculated and summarized in the interference matrix. Chapter 2:Measurements on the phantom: No publication on the electromagnetic compatibility of neurological pulse generators (NPG) could be found. This implant has been used increasingly in the last few years to treat Parkinson's disease. A phantom was built to examine this implant at 900 MHz. The electromagnetic compatibility was measured by exposing the NPG to the fields of ten different 900 MHz GSM mobile phones. Every mobile phone was tested in three different positions relative to the phantom, with four electrode configurations and four stimulation parameters. No interference was found even at a maximum transmit power of 2 watts. Further tests with half-wave dipoles and increased

  18. Spontaneous defibrillation after cessation of resuscitation in out-of-hospital cardiac arrest: a case of Lazarus phenomenon.

    Science.gov (United States)

    Kämäräinen, Antti; Virkkunen, Ilkka; Holopainen, Leevi; Erkkilä, Elja-Pekka; Yli-Hankala, Arvi; Tenhunen, Jyrki

    2007-12-01

    This report describes a case of out-of-hospital cardiac arrest with spontaneous defibrillation and subsequent return of circulation after cessation of resuscitative efforts. A 47-year-old man was found in cardiac arrest and resuscitation was initiated. As no response was achieved, the efforts were withdrawn and final registered cardiac rhythm was ventricular fibrillation. Fifteen minutes later the patient was found to be normotensive and breathing spontaneously. The patient made a poor neurological recovery and died 3 months after the arrest. The authors are unable to give an explanation to the event, but suspect the effect of adrenaline combined with mild hypothermia to have contributed to the self-defibrillation of the myocardium. PMID:17629389

  19. Interference of implanted cardiac pacemakers with TASER X26 dart mode application.

    Science.gov (United States)

    Leitgeb, Norbert; Niedermayr, Florian; Neubauer, Robert

    2012-06-01

    The prevalence of pacemaker patients among the general population and of conducted energy devices for law enforcement and self-defence is increasing. Consequently, the question on whether cardiac pacemaker patients are at particular risk becomes increasingly important, in particular, as the widespread use of such devices is planned in Europe. The risk of pacemaker patients has been investigated by numerical simulation at detailed anatomical models of patients with cardiac pacemakers implanted in left pectoral, right pectoral, and abdominal positions, with the monopolar electrode placed at the ventricular apex. The induced cardiac pacemaker interference voltages have been assessed for distant application of TASER X26 devices with dart electrodes propelled towards a subject. It could be shown that interference voltages are highest in abdominal pacemaker implantation, while they are about 20% lower in left or right pectoral sites. They remain below the immunity threshold level as defined by safety standards of implanted cardiac pacemakers and of implanted cardioverter defibrillators to prevent persisting malfunction or damage. However, induced voltages are high enough to be sensed by the pacemaker and to capture pacemaker function in case of hits at thorax and abdomen, frontal as well as dorsal. PMID:22691428

  20. Active implantable medical device EMI assessment for wireless power transfer operating in LF and HF bands

    Science.gov (United States)

    Hikage, Takashi; Nojima, Toshio; Fujimoto, Hiroshi

    2016-06-01

    The electromagnetic interference (EMI) imposed on active implantable medical devices by wireless power transfer systems (WPTSs) is discussed based upon results of in vitro experiments. The purpose of this study is to present comprehensive EMI test results gathered from implantable-cardiac pacemakers and implantable cardioverter defibrillators exposed to the electromagnetic field generated by several WPTSs operating in low-frequency (70 kHz–460 kHz) and high-frequency (6.78 MHz) bands. The constructed in vitro experimental test system based upon an Irnich’s flat torso phantom was applied. EMI test experiments are conducted on 14 types of WPTSs including Qi-compliant system and EV-charging WPT system mounted on current production EVs. In addition, a numerical simulation model for active implantable medical device (AIMD) EMI estimation based on the experimental test system is newly proposed. The experimental results demonstrate the risk of WPTSs emitting intermittent signal to affect the correct behavior of AIMDs when operating at very short distances. The proposed numerical simulation model is applicable to obtain basically the EMI characteristics of various types of WPTSs.