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Sample records for cardioverter defibrillator icd

  1. 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 ...

  2. 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 ...

  3. 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. ...

  4. 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- ...

  5. 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 ...

  6. 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...

  7. 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.

  8. 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...

  9. 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

  10. 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

  11. 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 ...

  12. 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....

  13. 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.

  14. 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...

  15. 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...

  16. 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

  17. 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...

  18. 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)

  19. 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...

  20. 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

  1. 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....

  2. 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...

  3. 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...

  4. 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.

  5. 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...

  6. 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....

  7. 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...

  8. 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- ...

  9. 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...

  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. 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...

  12. 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...

  13. 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...

  14. 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.

  15. 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.)

  16. 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

  17. 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.

  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. 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

  20. 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.

  1. 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.

  2. 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 ...

  3. 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...

  4. 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...

  5. 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...

  6. 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....

  7. 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...

  8. 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...

  9. 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...

  10. 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

  11. 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 ...

  12. 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...

  13. 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.

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. 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

  19. 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 ...

  20. 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...

  1. 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 ...

  2. 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...

  3. 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 ...

  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. 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...

  6. 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....

  7. 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....

  8. 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...

  9. 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

  10. 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

  11. 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...

  12. 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.

  13. 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...

  14. 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.

  15. 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...

  16. 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...

  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. 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....

  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. [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

  1. 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....

  2. 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.

  3. 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, ...

  4. 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

  5. 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...

  6. 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.

  7. 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.

  8. 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)

  9. 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.

  10. 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

  11. 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....

  12. 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.

  13. 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.

  14. 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...

  15. 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)....

  16. 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.

  17. 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.

  18. 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.)

  19. 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

  20. 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

  1. 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...

  2. 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...

  3. 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.

  4. 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

  5. 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.

  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. 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

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. 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...

  18. Does ICD indication affect quality of life and levels of distress?

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Sears, Samuel F; Burg, Matthew M;

    2009-01-01

    The implantable cardioverter defibrillator (ICD) is the treatment of choice for life-threatening arrhythmias, with ICD indications having recently been extended to include primary prophylaxis. Despite the medical benefits of the ICD, there is an ongoing debate as to the impact of the ICD on...

  19. 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.

  20. 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

  1. 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....

  2. 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....

  3. 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...

  4. 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.

  5. 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

  6. 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

  7. 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.

  8. 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

  9. 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...

  10. 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

  11. 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

  12. Relevance of guideline-based ICD indications to clinical practice

    OpenAIRE

    Al-Jefairi, Nora; Burri, Haran

    2014-01-01

    The implantable cardioverter-defibrillator (ICD) has established itself as life-saving therapy in patients at risk for sudden cardiac death. Remarkable technological advances have made ICDs easier and safer to implant, with improved therapeutic and diagnostic functions and reduced morbidity.

  13. 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

  14. 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

  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. 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

  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. 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...

  19. 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...

  20. 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

  1. 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.

  2. 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

  3. 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...

  4. 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.

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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...

  10. 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

  11. 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

  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. 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.

  14. 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...

  15. 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...

  16. 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....

  17. 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

  18. 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

  19. 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...

  20. 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

  1. 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...

  2. 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.

  3. 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.

  4. 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

  5. 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...

  6. Erfahrung mit der Extraktion von transvenösen Kardioverter-Defibrillator (ICD Sonden

    Directory of Open Access Journals (Sweden)

    Dörnberger V

    1999-01-01

    Full Text Available Die ICD-Therapie ist ein bewährtes Verfahren zur Behandlung lebensbedrohlicher ventrikulärer Herzrhythmusstörungen. Defekte der komplex aufgebauten transvenösen Sondensysteme sind beschrieben. Meist ist eine komplette Entfernung defekter Sonden sinnvoll. Wir berichten über unsere Erfahrung mit der Entfernung von 13 transvenösen Elektrodensystemen. In 7 Fällen handelt es sich um eine Endotak C 0072 Sonde (CPI/Guidant und in 6 Fällen um eine Medtronic Transvene 6936 Elektrode. Das Sondenalter zum Zeitpunkt der Extraktion lag zwischen 1,5 und 77,6 Monaten (Mittelwert 36,3 ± 18. Als Extraktionshilfen wurden das VascoExtor Stylet S (Vascomed in 6 Fällen und das Byrd Locking-Stylet 0.017 (0.018 inches (Cook in 4 Fällen verwendet. Alle Extraktionen erfolgten unter transösophagealem Echokardiographie-Monitoring (TEE und Herz-Lungenmaschinen-Bereitschaft (HLM. Ohne Dilatations-Sheath war eine Extraktion nur innerhalb der ersten 3 Monate nach Implantation möglich (n = 3. Ein besonderes Problem stellt der im Vergleich zum Sondenkörper größere Durchmesser der Schockwendel dar, da die Sonde im Verlauf von einem Bindegewebsmantel fest umschlossen und mit der Venenwand verwachsen ist. Mit dem Byrd Dilatator-Schleusenset 10,0 Fr, 11,5 Fr und 13,0 Fr war in allen Fällen eine Lösung von der Venenwand möglich. Eine Extraktion einer Sonde (Medtronic Transvene war nach auswärtigen Vorversuchen mit Zerstörung der inneren Wendel nicht mehr möglich. In einem weiteren Fall konnten zwar die venösen Wandadhäsionen gelöst werden, die distale Schockwendel war jedoch in voller Länge mit dem Endokard verwachsen und konnte nur in einer offenen Herzoperation entfernt werden. In keinem Fall kam es zu einem bedeutsamen Perikarderguß. Kein Patient verstarb in Folge der Sondenextraktion. Zusammenfassend ist die Extraktion von ICD Sonden auch lange nach Implantation möglich. Trotz unserer relativ guten Erfahrung mit der Extraktion von ICD Sonden sollte

  7. Statins Decrease Oxidative Stress and ICD Therapies

    Directory of Open Access Journals (Sweden)

    Heather L. Bloom

    2010-01-01

    Full Text Available Recent studies demonstrate that statins decrease ventricular arrhythmias in internal cardioverter defibrillator (ICD patients. The mechanism is unknown, but evidence links increased inflammatory and oxidative states with increased arrhythmias. We hypothesized that statin use decreases oxidation. Methods. 304 subjects with ICDs were surveyed for ventricular arrhythmia. Blood was analyzed for derivatives of reactive oxygen species (DROMs and interleukin-6 (IL-6. Results. Subjects included 252 (83% men, 58% on statins, 20% had ventricular arrhythmias. Average age was 63 years and ejection fraction (EF 20%. ICD implant duration was 29 ± 27 months. Use of statins correlated with lower ICD events (r=0.12, P=.02. Subjects on statins had lower hsCRP (5.2 versus 6.3; P=.05 and DROM levels (373 versus 397; P=.03. Other factors, including IL-6 and EF did not differ between statin and nonstatin use, nor did beta-blocker or antiarrhythmic use. Multivariate cross-correlation analysis demonstrated that DROMs, statins, IL-6 and EF were strongly associated with ICD events. Multivariate regression shows DROMs to be the dominant predictor. Conclusion. ICD event rate correlates with DROMs, a measure of lipid peroxides. Use of statins is associated with reduced DROMs and fewer ICD events, suggesting that statins exert their effect through reducing oxidation.

  8. 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.

  9. 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

  10. 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...

  11. Anxiety Predicts Mortality in ICD Patients

    DEFF Research Database (Denmark)

    Kikkenborg Berg, Selina; Caspar Thygesen, Lau; Hastrup Svendsen, Jesper;

    2014-01-01

    BACKGROUND: Although highly effective in preventing arrhythmic death, patients receiving an implantable cardioverter defibrillator (ICD) may still experience psychological difficulties such as anxiety, depression, and reduced quality of life. The objectives of this study were to describe patient...... receiving ICD between January 1, 2011 and June 30, 2011 (n = 499). The following instruments were used: SF-36, Hospital Anxiety and Depression Scale, HeartQoL, EQ-5D, and the Multidimensional Fatigue Inventory. RESULTS: The response rate was 72%. Mean age was 65.5 years and 82% patients were males. Fifty...... perceived health, quality of life, and fatigue; for example, physical health 39.8 versus 44.3 points, compared to secondary prevention indication. Anxiety, poor perceived health, fatigue, and low quality of life were all predictors of mortality, anxiety being the strongest with an adjusted odds ratio of 4...

  12. Gender differences in psychological distress and quality of life in patients with an ICD 1-year postimplant

    DEFF Research Database (Denmark)

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

    2014-01-01

    Background Gender differences in patient-reported outcomes in patients with an implantable cardioverter defibrillator (ICD) have been researched, but findings are inconclusive and mostly based on cross-sectional study designs. To gain a better insight into potential determinants of psychological...... distress and health-related quality of life (HQOL), we examined the relationship between gender and patient-reported outcomes in patients with an ICD in the first year after ICD implantation. Methods Consecutive patients (N = 300) receiving an ICD between September 2007 and February 2010 at Medisch...... Spectrum Twente hospital, the Netherlands, completed several questionnaires to assess psychological distress and HQOL prior to ICD implantation and at 2 months, 5 months, 8 months, and 12 months postimplantation. Results Correcting for clinical confounders (e.g., left ventricular ejection fraction, ICD...

  13. Predictors of appropriate ICD therapy in patients with arrhythmogenic right ventricular cardiomyopathy: long term experience of a tertiary care center.

    Directory of Open Access Journals (Sweden)

    Pia K Schuler

    Full Text Available INTRODUCTION: Arrhythmogenic right ventricular cardiomyopathy (ARVC is a rare genetically transmitted disease prone to ventricular arrhythmias. We therefore investigated the clinical, echocardiographical and electrophysiological predictors of appropriate implantable cardioverter defibrillator (ICD therapy in patients with ARVC. METHODS: A retrospective analysis was performed in 26 patients (median age of 40 years at diagnosis, 21 males and 5 females with ARVC who underwent ICD implantation. RESULTS: Over a median (range follow-up period of 10 (2.7, 37 years, appropriate ICD therapy for ventricular arrhythmias was documented in 12 (46% out of 26 patients. In all patients with appropriate ICD therapy the ICD was originally inserted for secondary prevention. Median time from ICD implantation to ICD therapy was 9 months (range 3.6, 54 months. History of heart failure was a significant predictor of appropriate ICD therapy (p = 0.033. Left ventricular disease involvement (p = 0.059 and age at implantation (p = 0.063 were borderline significant predictors. Patients with syncope at time of diagnosis were significantly less likely to receive ICD therapy (p = 0.02. Invasive electrophysiological testing was not significantly associated with appropriate ICD therapy. CONCLUSION: In our cohort of patients with ARVC, history of heart failure was a significant predictor of appropriate ICD therapy, whereas left ventricular involvement and age at time of ICD implantation were of borderline significance. These predictors should be tested in larger prospective cohorts to optimize ICD therapy in this rare cardiomyopathy.

  14. 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.

  15. 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.

  16. 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

  17. 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.

  18. 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。

  19. 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...

  20. 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.

  1. Combined etiology of anaphylactic cardiogenic shock: Amiodarone, epinephrine, cardioverter defibrillator, left ventricular assist devices and the Kounis syndrome

    Directory of Open Access Journals (Sweden)

    Nicholas G Kounis

    2015-01-01

    Full Text Available Anaphylactic shock is a life-threatening condition which needs detailed and mediculous clinical assessment and thoughtful treatment. Several causes can join forces in order to degranulate mast cells. Amiodarone which is an iodine-containing highly lipophilic benzofuran can induce allergic reactions and anaphylactic shock in sensitized patients. Epinephrine is a life saving drug, but in sulfite allergic patients it should be given with caution due its metabisulfite preservative. Metals covering cardiac defibrillators and pacemakers can act as antigens attached to serum proteins and induce allergic reactions. In anaphylactic shock, myocardial involvement due to vasospasm-induced coronary blood flow reduction manifesting as Kounis syndrome should be always considered. Clinically, combined treatment targeting the primary cause of anaphylaxis together with protection of cardiac tissue seems to be of paramount importance.

  2. 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....

  3. 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

  4. DDD-ICD: discrimination of supraventricular tachyarrhythmias

    Directory of Open Access Journals (Sweden)

    REVISHVILI Amiran R.

    1999-01-01

    Full Text Available Background: Dual Chamber Implantable Cardioverter Defibrillator (ICD in addition to providing hemodynamically improved bradycardia support can also reduce the incidence of inappropriate ventricular shocks owing to episodes of Supraventricular Tachycardia (SVT, with reported incidence of up to 41% of patients. An atrio-ventricular (AV discrimination algorithm is needed in dual chamber implantable cardioverter-defibrillators (ICD to avoid these inappropriate shocks. Methods: An AV discrimination algorithm, SMART DetectionTM, has been developed to differentiate between episodes of ventricular tachycardia (VT and SVT. It relies on the concept that the chamber with the higher rate is the origin of the tachycardia. The ventricular rate stability criterion is also used to detect concurrent VT during an episode of SVT. Other parameters used in the discrimination algorithm are: atrial and ventricular rhythm multiplicity, P-R regularity, sudden onset. The SMART DetectionTM algorithm has been implemented in the Biotronik Phylax® AV dual chamber ICD. The original SMART DetectionTM has been improved recently with the addition of active detection in the case of 1:1 AV conduction. Results: 10 patients were implanted with Phylax® AV's at the Bakoulev Institute. Analyses of stored dual chamber intracardiac electrogram (IEGM indicate that all episodes of VTs and Ventricular Fibrillations (VF were terminated following appropriate therapies. No episode of Atrial Flutter (Afl or Atrial Fibrillation (AF was treated even though the majority of patients have a history of SVTs. In one patient, an episode of Sinus Tachycardia (ST was inappropriately treated. Increasing the sudden onset criterion, which is used only in the case of stable 1:1 rhythms, was sufficient to prevent recurrence of inappropriate therapy. To avoid the necessity of setting the, not very reliable, sudden onset criterion an active detection procedure was developed. Isolated Premature Ventricular

  5. Traumatic Tension Pneumothorax as a Cause of ICD Failure: A Case Report and Review of the Literature.

    Science.gov (United States)

    Ul Haq, Ehtesham; Omar, Bassam

    2014-01-01

    Background. Tension pneumothorax can infrequently cause ventricular arrhythmias and increase the threshold of defibrillation. It should be suspected whenever there is difficulty in defibrillation for a ventricular arrhythmia. Purpose. To report a case of traumatic tension pneumothorax leading to ventricular tachycardia and causing defibrillator failure. Case. A 65-year-old African-American female was brought in to our emergency department complaining of dyspnea after being forced down by cops. She had history of mitral valve replacement for severe mitral regurgitation and biventricular implantable cardioverter defibrillator inserted for nonischemic cardiomyopathy. Shortly after arrival, she developed sustained ventricular tachycardia, causing repetitive unsuccessful ICD shocks. She was intubated and ventricular tachycardia resolved with amiodarone. Chest radiograph revealed large left sided tension pneumothorax which was promptly drained. The patient was treated for congestive heart failure; she was extubated on the third day of admission, and the chest tube was removed. Conclusion. Prompt recognition of tension pneumothorax is essential, by maintaining a high index of suspicion in patients with an increased defibrillation threshold causing ineffective defibrillations. PMID:25400953

  6. 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 ...

  7. Optimal tachycardia programming in ICDs : Recommendations in the post-MADIT-RIT era.

    Science.gov (United States)

    Israel, Carsten W; Burmistrava, Tatsiana

    2016-09-01

    Optimal implantable cardioverter-defibrillator (ICD) programming can reduce the incidence of inappropriate shock therapy and improve prognosis in patients with an ICD. Only after results from randomized trials became available was the "safety first" feeling overcome that mandated early shock therapy, waived the use of antitachycardia pacing and forced shock therapy after a time of 30 s expired, even if tachycardia discriminators would have withheld the therapy. The strong evidence to limit ICD therapy to longer ventricular tachycardia (VT) should not result in individually dangerous ICD programming, particularly in patients with a high risk of slow VT (known monomorphic VT, post VT ablation, during treatment with amiodarone, very dilated left ventricle). Monitoring zones may aid to detect unexpected slow VT and to explain symptoms such as presyncope without exposing the patient to an unnecessary risk of inappropriate therapy. This review summarizes our current knowledge on optimal ICD programming and explains exactly how we should program device parameters in practice in single- or dual-chamber ICDs by different manufacturers and in different groups of patients. PMID:27624808

  8. A comparison of the health status and psychological distress of partners of patients with a left ventricular assist device versus an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Brouwers, Corline; Caliskan, Kadir; de Jonge, Nicolaas;

    2014-01-01

    therefore an important aspect in the care of LVAD and ICD patients. METHODS: Multi-center prospective observational study with 6 months follow-up of 33 LVAD partners (27% men; mean age = 54 ± 10 years) and 414 ICD partners (22% men; mean age = 60 ± 12 years). RESULTS: LVAD partners reported better physical...

  9. 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

  10. A prospective study of anxiety in ICD patients with a pilot randomized controlled trial of cognitive behavioral therapy for patients with moderate to severe anxiety

    DEFF Research Database (Denmark)

    Qintar, Mohammed; George, Jason J; Panko, Melanie;

    2015-01-01

    PURPOSE: Stress and anxiety are potential consequences from arrhythmias and implantable cardioverter defibrillator (ICD) shocks that can contribute to substantial morbidity. We assessed anxiety associated with an ICD and whether cognitive behavioral therapy (CBT) reduces anxiety. METHODS: The study...... consisted of two parts: part 1 (N = 690) was a prospective cross-sectional observational study of consecutive ICD patients. Patients completed the Beck Anxiety Inventory (BAI), Generalized Anxiety Disorder Scale (GAD-7), Florida Shock Anxiety Scale (FSAS), and Florida Patient Acceptance Survey (FPAS......) psychometric tests. Part 2 (N = 29) was a pilot randomized controlled trial of CBT (three sessions in 3 months) vs. usual care (UC) in patients with BAI ≥ 19 from part 1. RESULTS: The median BAI and GAD-7 scores were 5 and 2, respectively. By BAI scores, 64.5 % had minimal and 3.9 % had severe anxiety. By GAD...

  11. 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.

  12. 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.

  13. 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...

  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. 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

  16. 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.

  17. The Curious Case of the De-ICD: Negotiating the Dynamics of Autonomy and Paternalism in Complex Clinical Relationships.

    Science.gov (United States)

    Pullman, Daryl; Hodgkinson, Kathleen

    2016-08-01

    This article discusses the response of our ethics consultation service to an exceptional request by a patient to have his implantable cardioverter defibrillator (ICD) removed. Despite assurances that the device had saved his life on at least two occasions, and cautions that without it he would almost certainly suffer a potentially lethal cardiac event within 2 years, the patient would not be swayed. Although the patient was judged to be competent, our protracted consultation process lasted more than 8 months as we consulted, argued with, and otherwise cajoled him to change his mind, all to no avail. Justifying our at times aggressive paternalistic intervention helped us to reflect on the nature of autonomy and the dynamics of the legal, moral, and personal relationships in the clinical decision-making process. PMID:27366835

  18. 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

  19. 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...

  20. 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

  1. 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

  2. Improved survival of patients with coronary artery disease and low ejection fraction with ICD implantation versus conventional therapy in a real world survey

    Directory of Open Access Journals (Sweden)

    Aschenbrenner Timo

    2012-07-01

    Full Text Available Abstract Background Coronary artery disease (CAD is associated with an increased risk for sudden cardiac death. Randomized controlled trials have shown that implantable cardioverter defibrillators (ICD improve life expectancy unless they are implanted within the first days after an acute myocardial infarction and guidelines recommend their use. We aimed to validate that these results also apply to patients of a typical community hospital in Germany. Methods This was a retrospective analysis of patients undergoing coronary angiography in the Lippe-Detmold Hospital between 2003 and 2006. They had to have significant CAD and an ejection fraction (EF ≤ 35% and no acute myocardial infarction within 28 days of implantation and no history of ventricular fibrillation. Results 213 patients were included; 70 of which received an ICD. Patients with an ICD implantation were younger (64.8 ± 9.9 vs. 67.9 ± 9.8 years; p = 0.034, had single vessel CAD more frequently (22.9 vs. 11.2%; p = 0.025 and a lower EF (26.7 ± 6.3 vs. 29.1 ± 4.6%; p = 0.006. Hospital readmissions were comparable between the ICD and the control group (68.6 vs. 72.0%; p = 0.602. ICD therapy was associated with a considerable survival benefit compared to conventional therapy (HR 0.52; 95%CI 0.29-0.93; p = 0.027 in a Cox-Proportional Hazards Regression analysis. Conclusions Appreciating the potential limitations of retrospective studies, we found that ICD use was associated with improved survival in patients with significant CAD and an EF

  3. 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.

  4. Predictive value of cardiac autonomic indexes and MIBG washout in ICD recipients with mild to moderate heart failure

    International Nuclear Information System (INIS)

    We aimed at evaluating the combined use of heart rate variability (HRV), baroreflex sensitivity (BRS), and metaiodobenzylguanidine (MIBG) imaging in the risk stratification for sudden cardiac death (SCD) of patients with mild to moderate heart failure. Twenty-five patients (17 male and 8 female, mean age 63±5 years, mean left ventricular ejection fraction (LVEF) 36±3%) with a recently implanted cardioverter-defibrillator (ICD) and mild (NYHA I-II) heart failure due to either ischemic (n=15) or dilated (n=10) cardiomyopathy were studied. One week after ICD implantation they underwent baroreflex sensitivity (BRS) evaluation to bolus phenylephrine by the Oxford method, 24-h heart rate variability (HRV) assessment, and MIBG imaging. The mean patient follow-up was 32±10 months. Simple correlation and stepwise multiple regression analysis was performed to evaluate if the number of sustained ventricular tachycardia (cycle length <330 ms) or fibrillation episodes per month is related to one or more of MIBG, BRS, and HRV indexes and if MIBG % washout is related to HRV and/or BRS. The frequency of fast ventricular arrhythmic episodes (FVAE) demonstrated an inverse relation to BRS (p<0.0001), rMSSD (p=0.001), and pNN50 (p=0.0034), while it was positively related to low frequency (LF) (p<0.0001) and MIBG % washout (p=0.001). BRS, LF, rMSSD, and MIBG washout were also independent predictors of FVAE. MIBG washout was related to only one HRV marker (SDNN-I, p<0.0001), while no correlation was observed with BRS. In ICD recipients with well-compensated heart failure, autonomic markers derived from BRS, HRV, and MIBG studies are related to FVAE. These markers have limited inter-dependency and constitute useful means for SCD risk stratification in this subgroup of patients. (author)

  5. Uniform pacemaker and ICD information system in the Netherlands

    NARCIS (Netherlands)

    Hooijschuur, CAM; Dijk, WA; van der Velde, W; Sanon, B; Ammeraal, C; Dassen, WRM; Spruijt, HJ; Murray, A

    2002-01-01

    In the Netherlands the Central Pacemaker Patient Registry (CPPR) collects information of pacemaker and ICD (Implantable Cardio Defibrillator) patients from all 109 Dutch hospitals. Many pacemaker clinics are using a computer to store their implant and follow-up data in a database. Because the device

  6. 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

  7. 78 FR 43533 - Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical...

    Science.gov (United States)

    2013-07-19

    ..., Ninth Revision, Clinical Modification ICD Implantable cardioverter defibrillator ICU Intensive care unit...: Cardiac Rehabilitation Measure: Patient Referral From an Outpatient Setting D. Quality Measures...

  8. 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.

  9. 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

  10. 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

  11. 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...

  12. 具有"起死回生"功能的ICD

    Institute of Scientific and Technical Information of China (English)

    曾治宇; 王方正

    2004-01-01

    @@ ICD全称植入型心律转复除颤器(implantable cardioverter-defibrillator),是一种可埋植于人体内的能够自动识别恶性心律失常并予终止的器械,因其特殊的治疗价值,近年来在世界范围内特别是发达国家得到了越来越广泛的应用.

  13. 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...

  14. 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 ...

  15. 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 ...

  16. 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)

  17. 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

  18. 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...

  19. Management of radiation oncology patients with a pacemaker or ICD: A new comprehensive practical guideline in The Netherlands

    International Nuclear Information System (INIS)

    Current clinical guidelines for the management of radiotherapy patients having either a pacemaker or implantable cardioverter defibrillator (both CIEDs: Cardiac Implantable Electronic Devices) do not cover modern radiotherapy techniques and do not take the patient’s perspective into account. Available data on the frequency and cause of CIED failure during radiation therapy are limited and do not converge. The Dutch Society of Radiotherapy and Oncology (NVRO) initiated a multidisciplinary task group consisting of clinical physicists, cardiologists, radiation oncologists, pacemaker and ICD technologists to develop evidence based consensus guidelines for the management of CIED patients. CIED patients receiving radiotherapy should be categorised based on the chance of device failure and the clinical consequences in case of failure. Although there is no clear cut-off point nor a clear linear relationship, in general, chances of device failure increase with increasing doses. Clinical consequences of device failures like loss of pacing, carry the most risks in pacing dependent patients. Cumulative dose and pacing dependency have been combined to categorise patients into low, medium and high risk groups. Patients receiving a dose of less than 2 Gy to their CIED are categorised as low risk, unless pacing dependent since then they are medium risk. Between 2 and 10 Gy, all patients are categorised as medium risk, while above 10 Gy every patient is categorised as high risk. Measures to secure patient safety are described for each category. This guideline for the management of CIED patients receiving radiotherapy takes into account modern radiotherapy techniques, CIED technology, the patients’ perspective and the practical aspects necessary for the safe management of these patients. The guideline is implemented in The Netherlands in 2012 and is expected to find clinical acceptance outside The Netherlands as well

  20. 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...

  1. 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 ...

  2. Laser extraction of a trapped infected port catheter in a child using existing experience from pacemaker and ICD lead removal.

    Science.gov (United States)

    Bastian, Dirk; Fessele, Klaus; Bednarski, Piotr; Bodenschatz, Karl; Pauschinger, Matthias; Göhl, Konrad

    2011-01-01

    A 9-year-old girl presented with systemic infection related to a Port-a-Cath system (PAC); therefore, the urgent removal of the PAC was indicated. However, the catheter was trapped and not extractable by conventional means. Using existing comprehensive experience in the removal of pacemaker and implantable cardioverter defibrillator leads, the entrapped PAC was successfully extracted by laser technique, thus avoiding open heart surgery. PMID:20345621

  3. 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

  4. 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

  5. 经胸双相波除颤的进展

    Institute of Scientific and Technical Information of China (English)

    RogerDWhiteMD

    2005-01-01

    In 1996 the United States Food and Drug Administration approved the first biphasic waveform for external defibrillation after the safety and efficacy of biphasic waveforms had been well-established for defibrillation with internal cardioverter-defibrillators (ICDs). The first approved waveform was incorporated in an automated external defibrillator (AED) marketed as the ForeRunner ((Philips Medical Systems,

  6. Plötzlicher Herztod und ICD-Therapie

    Directory of Open Access Journals (Sweden)

    Schirdewahn P

    2004-01-01

    Full Text Available Der plötzliche Herztod ist die häufigste Todesursache bei Erwachsenen. Da zwei Drittel auf ventrikuläre Tachykardien oder Kammerflimmern zurückzuführen sind, spielt der implantierbare Defibrillator (ICD in der Primär- und Sekundärprophylaxe eine wichtige Rolle. Die Ergebnisse zahlreicher Studien zur Prävention des plötzlichen Herztodes führten zu einer erheblichen Ausweitung der Indikationen, insbesondere in der Primärprophylaxe bei ischämischer Kardiomyopathie. In der vorliegenden Arbeit sollen die wesentlichen Studien dargestellt und kritisch gewertet werden.

  7. 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' ...

  8. 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 -- ...

  9. 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 ...

  10. 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)

  11. 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

  12. 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.

  13. Therapeutic options in chronic heart failure. Findings on chest X-ray; Nicht medikamentoese Therapieoptionen der chronischen Herzinsuffizienz. Befunde in der Projektionsradiografie des Thorax

    Energy Technology Data Exchange (ETDEWEB)

    Granitz, M.R.; Meissnitzer, T.; Meissnitzer, M.W.; Hergan, K.; Altenberger, J.; Granitz, C. [Uniklinikum Salzburg - Landeskrankenhaus (Austria)

    2016-05-15

    The contribution covers drugless therapeutic options for chronic heart failure: the implantable cardioverter/defibrillator (ICD), the cardiac resynchronization therapy (CRT), the interventional catheter treatment of functional mitral insufficiency, and mechanical heart supporting systems and heart transplantation.

  14. Co-constructing IT and Healthcare

    DEFF Research Database (Denmark)

    Andersen, Tariq; Bansler, Jørgen; Bjørn, Pernille;

    The CITH project (Co-constructing IT and Healthcare) is an ongoing 4-year interdisciplinary research project, which investigates while intervenes in the collaborative practices involved in disease management of chronic heart patients with an ICD (Implantable Cardioverter Defibrillator)....

  15. Therapeutic options in chronic heart failure. Findings on chest X-ray

    International Nuclear Information System (INIS)

    The contribution covers drugless therapeutic options for chronic heart failure: the implantable cardioverter/defibrillator (ICD), the cardiac resynchronization therapy (CRT), the interventional catheter treatment of functional mitral insufficiency, and mechanical heart supporting systems and heart transplantation.

  16. 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.

  17. 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

  18. 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...

  19. 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.

  20. 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...

  1. Echocardiography and cardiac MRI in mutation-negative hypertrophic cardiomyopathy in an older patient: a case defining the need for ICD.

    Science.gov (United States)

    Rodriguez, Fatima; Degnan, Kathleen O; Seidman, Christine E; Mangion, Judy R

    2014-08-01

    We report the case of a 67-year-old man with hypertrophic cardiomyopathy who presented for a second opinion about implantable cardio-defibrillator (ICD) placement after a witnessed syncopal episode. Despite his older age, being mutation-negative, and having a maximal septal thickness of 2.2 cm on echocardiography, he demonstrated rapid progression of myocardial fibrosis on cardiac MRI, correlating to ventricular tachyarrhythmias and syncope. We review the role of echocardiography and cardiac MRI in optimizing medical care for such patients who may not otherwise meet criteria for an ICD placement or further interventions. PMID:24816179

  2. State of the art of ICD programming

    DEFF Research Database (Denmark)

    Mastenbroek, M H; Pedersen, Susanne S.; Versteeg, H;

    2014-01-01

    life. Hence, there has been an increasing interest in the optimisation of ICD programming to prevent inappropriate and appropriate but unnecessary device therapy. The purpose of the current report is to give an overview of research into the optimisation of ICD programming and present the design of the...... (i) antitachycardia pacing and shocks (both appropriate and inappropriate) and (ii) quality of life and distress. The first results of the ENHANCED-ICD study are expected in 2015....

  3. Risk factors and the effect of cardiac resynchronization therapy on cardiac and non-cardiac mortality in MADIT-CRT

    DEFF Research Database (Denmark)

    Perkiomaki, Juha S; Ruwald, Anne-Christine; Kutyifa, Valentina;

    2015-01-01

    causes, 108 (63.9%) deemed cardiac, and 61 (36.1%) non-cardiac. In multivariate analysis, increased baseline creatinine was significantly associated with both cardiac and non-cardiac deaths [hazard ratio (HR) 2.97, P ...AIMS: To understand modes of death and factors associated with the risk for cardiac and non-cardiac deaths in patients with cardiac resynchronization therapy with implantable cardioverter-defibrillator (CRT-D) vs. implantable cardioverter-defibrillator (ICD) therapy, which may help clarify...

  4. 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 ...

  5. 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

  6. 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...

  7. 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- ...

  8. 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...

  9. 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 ...

  10. 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.

  11. 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

  12. 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

  13. The use of variability of repolarization for monitoring of arrhythmic risk : "the rocking of the boat"

    NARCIS (Netherlands)

    Oosterhoff, P.

    2011-01-01

    The majority of deaths in the western world are of cardiovascular origin. Approximately 60% of these cardiovascular deaths are sudden. Implantation of an implantable cardioverter defibrillator (ICD) has been proven effective in preventing sudden cardiac death in patients at increased risk. An ICD ca

  14. The Effect of ICD Programming on Inappropriate and Appropriate ICD Therapies in Ischemic and Nonischemic Cardiomyopathy

    DEFF Research Database (Denmark)

    Sedláček, Kamil; Ruwald, Anne-Christine; Kutyifa, Valentina;

    2015-01-01

    INTRODUCTION: The MADIT-RIT trial demonstrated reduction of inappropriate and appropriate ICD therapies and mortality by high-rate cut-off and 60-second-delayed VT therapy ICD programming in patients with a primary prophylactic ICD indication. The aim of this analysis was to study effects of MADIT......-RIT ICD programming in patients with ischemic and nonischemic cardiomyopathy. METHODS AND RESULTS: First and total occurrences of both inappropriate and appropriate ICD therapies were analyzed by multivariate Cox models in 791 (53%) patients with ischemic and 707 (47%) patients with nonischemic...... cardiomyopathy. Patients with ischemic and nonischemic cardiomyopathy had similar incidence of first inappropriate (9% and 11%, P = 0.21) and first appropriate ICD therapy (11.6% and 14.1%, P = 0.15). Patients with ischemic cardiomyopathy had higher mortality rate (6.1% vs. 3.3%, P = 0.01). MADIT-RIT high...

  15. Reliability of clinical ICD-10 schizophrenia diagnoses

    DEFF Research Database (Denmark)

    Jakobsen, Klaus D; Frederiksen, Julie N; Hansen, Thomas;

    2005-01-01

    Concern has been expressed as to the reliability of clinical ICD-10 diagnosis of schizophrenia. This study was designed to assess the diagnostic reliability of the clinical ICD-10 diagnosis of schizophrenia in a random sample of Danish in- and outpatients with a history of psychosis. A sample of...... was seen between OPCRIT-derived ICD-10 and DSM-IV diagnoses (kappa=0.87). Thus, this study demonstrates high reliability of the clinical diagnosis of schizophrenia and even more so of the diagnosis of schizophrenia-spectrum disorder....... 100 subjects was assessed using the operational criteria OPCRIT checklist for psychotic and affective illness. The most recent principal and clinical ICD-10 diagnosis was compared with diagnoses generated by the OPCRIT instrument. Data documented very high sensitivity (93%) and positive predictive...

  16. Stereotyped movement disorder in ICD-11

    OpenAIRE

    Dan J. Stein; Woods, Douglas W.

    2014-01-01

    According to current proposals for ICD-11, stereotyped movement disorder will be classified in the grouping of neurodevelopmental disorders, with a qualifier to indicate whether self-injury is present, similar to the classification of stereotypic movement disorder in DSM-5. At the same time, the WHO ICD-11 Working Group on the Classification of Obsessive-Compulsive and Related Disorders has proposed a grouping of body-focused repetitive behavior disorders within the obsessive-compulsive and r...

  17. From syncope to ICD: clinical paths of the Brugada syndrome

    Directory of Open Access Journals (Sweden)

    Ivan Comelli

    2010-09-01

    Full Text Available This review summarizes the evidences in the literature on the management of the Brugada syndrome (BS, an arrhythmogenic disease caused by genetic channelopathies, predisposing to syncope and sudden cardiac death in young, apparently healthy, typically male subjects, in the third and fourth decade of their life. Sudden cardiac death (SCD is defined as natural death from cardiac causes, heralded by abrupt loss of consciousness within one hour of the onset of symptoms. It ranks among the main causes of death in the western world, with an incidence ranging from 0.36 and 1.28‰ inhabitants per year, equal to 300,000 cases a year in the USA. In the majority of the cases it is due to the onset of arrhythmia in subjects with structural cardiac diseases, especially ischemic heart disease. However, in a non-negligible percentage of the cases, about 5-10%, the SCD arises in relatively young individuals in whom cardiac anomalies cannot be detected using traditional diagnostic techniques. About 20% of these cases can be attributed to SB. In spite of the many efforts produced to identify an effective pharmacological treatment, to date the only aid to reduce the mortality rate in subjects with SB is an implantable cardio-defibrillator (ICD. Since this approach often entails complications, the efforts of the scientific community is now focused on the assessment of the arrhythmic risk. The identification of high-risk subjects is one of the chief objectives in the therapeutic decision-making process. ABSTRACT clinica e terapia emergency

  18. Strategies for successful ICD-10 implementation.

    Science.gov (United States)

    Goldstein, Jeffrey

    2015-09-01

    The transition to ICD-10 is the largest mandate in U.S. healthcare history. Full ICD-10 implementation will require diligent, comprehensive actions. The three pillars to ICD-10 success are the same with any enormous organizational change: governance, education, and documentation. Many organizations have called for additional delays before full implementation, while other organizations across the United States have already made significant strides to prepare for the change. But is another delay of ICD-10 the solution? Many believe not, because any further delays can hinder forward momentum. Organizations that fell behind before the delay haven't taken the extra time to get up to speed, and therefore additional time to prepare isn't likely to motivate them any more than the first delay did. ICD-10 readiness is a journey, but unless the fundamentals are in place, moving toward an Oct. 1 launch is an uphill journey on a very steep slope. But with a solid strategy in place, healthcare organizations can complete the transition, even if they're a little late at the start. PMID:26540953

  19. Non-nearest neighbour ICD in clusters

    Science.gov (United States)

    Fasshauer, E.

    2016-04-01

    Interatomic Coulombic decay (ICD) is an electronic decay process of excited, ionized systems. It has been shown to occur in a multitude of small and large systems. The effects of more than one possible decay partner are discussed in detail illustrated by simulated ICD electron spectra of NeAr clusters and pure Ne clusters. Hereby, the mostly underestimated contribution of decay with non-nearest neighbours is highlighted. In the neon clusters, the lifetime of the bulk atoms is found to be in excellent agreement with experiment (Jahnke et al 2004 Phys. Rev. Lett. 93 173401) while the lifetimes of the surface atoms differ significantly. Hence, the experimental lifetime can not purely be explained by the effect of the number of neighbours. We propose the possibility to investigate the transition from small clusters to the solid state by using the ICD electron spectra to distinguish between icosahedral and cuboctahedral cluster structures.

  20. 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.

  1. 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.

  2. OPS und ICD-10-GM 2009

    OpenAIRE

    DIMDI-Pressestelle

    2007-01-01

    Das DIMDI nimmt ab sofort Änderungsvorschläge zu den Klassifikationen ICD-10-GM (Internationale Klassifikation der Krankheiten) und OPS (Operationen- und Prozedurenschlüssel) für die Versionen 2009 entgegen. Der Redaktionsschluss ist am 29. Februar 2008.

  3. OPS und ICD-10-GM 2008

    OpenAIRE

    DIMDI-Pressestelle

    2006-01-01

    Das DIMDI nimmt ab sofort Änderungsvorschläge zu den Klassifikationen ICD-10-GM (Internationale Klassifikation der Krankheiten) und OPS (Operationen- und Prozedurenschlüssel) für die Versionen 2008 entgegen. Der Redaktionsschluss ist am 28. Februar 2007.

  4. Long-term follow-up of patients with familial electric disorder cardiomyopathy without ICD implantation%家族性电紊乱性心脏病未植入心律转复除颤器患者的长期随访研究

    Institute of Scientific and Technical Information of China (English)

    刘金秋; 潘晓杰; 张树龙; 杨延宗; 刘莹; 高连君; 夏云龙; 董颖雪; 李真; 杨东辉; 王莹琦; 洪丽

    2008-01-01

    Objective To evaluate the long-term prophylactics of high-risk patients with hereditary arrhythmia at absence of implantable cardioverter defibrillator(ICD) treatment. Methods Eleven cases of congenital tong QT syndrome (LQTS) and 2 cases Brugada syndrome were enrolled,4 male,9 female with average age (44 ± 19)years. Routine clinical investigation and electrocardiography(ECG) were delivered. All patients experienced syncope or aborted cardiac arrest. Six cases (46%) were hospitalized due to cardiac arrest. Four patients with LQTS were implanted pacemakers. Patients were educated to avoid trigger factors of cardiac events and families were trained with cardiac pulmonary resuscitation. Results LQTS patients still experienced syncope or cardiac arrest after propranolol and pacemaker therapy but attacks occurred less than before. One LQTS had her first cardiac arrest. Five LQTS(39%) had cardiac arrest again during follow-up. Two LQTS cases died. One (0. 8%)died of sudden cardiac attack. The other died of cerebral hemorrhage. Both Brugada syndrome patients had cardiac arrest and survived again. One case experienced 5 times cardiac arrest and was saved by his wife's cardiac pulmonary resuscitations. Conclusiou LQTS and Brugada syndrome patients are in high risk for sudden cardiac death. Β-blocker and pacemaker may be effective to improve symptoms. With or without ICD implantation, patients should be educated to avoid trigger factors of cardiac evens and was families should be trained with cardiac pulmonary resuscitation.%目的 研究家族性电紊乱性心脏病高危患者,未植入心律转复除颤器(ICD)的长期预后.方法 13例患者中11例长QT综合征(LQTS)、2例Brugada综合征,均有心脏性晕厥.男性4例,女性9例,平均年龄(44±19)岁.6例(46%)因心跳骤停住院治疗.4例LQTS植入起搏器,平均随访(7±4)年.结果 11例(85%)患者仍然发作晕厥,1例心脏骤停首次入院,5例(39%)心脏骤停再入院,2例LQTS死亡,其中1

  5. 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...

  6. 植入ICD的患者均需使用抗心律失常药吗?%Antiarrhythmic Drugs for All Patients With an ICD?

    Institute of Scientific and Technical Information of China (English)

    Richard L. Page; 王琳

    2007-01-01

    通常认为,在应用植入式复律除颤器(implantable cardioverter defibrillator,ICD)早期联合应用抗心律失常药物是多余的,这就像用了腰带又加吊带。直到不久前人们才发现,随着时间的推移,许多病人最终仍需在ICD的基础上使用抗心律失常药。在JAMA杂志中,Connolly及其同事报告了“植入式复律除颤器病人最佳药物治疗试验”(Optimal Pharmacological Therapy in Cardioverter Defibrillator Patients,OPTIC)。他们提出这样一个问题,即在植入ICD时是否应该应用抗心律失常药物并加上一种β-阻滞剂,以减少ICD放电。为了回答这个问题,关键是要了解ICD和抗心律失常药物的相互作用以及联合应用的效果。

  7. COPE-ICD: Patient experience of participation in an ICD specific rehabilitation programme

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Pedersen, Birthe Dagmar; Svendsen, Jesper Hastrup;

    2012-01-01

    PURPOSE: Evaluating rehabilitation programmes from the patient's perspective is much needed, as the patients are the most important stakeholders in the health care system. A comprehensive rehabilitation programme, COPE-ICD programme, consists of exercise training and nursing consultations during...... transcribed. The analysis was inspired by Ricoeur's theory of interpretation, which consists of three levels: naive reading, structured analysis and critical interpretation and discussion. RESULTS: The overall concept was that participating in the COPE-ICD programme meant feeling inspired and secure through...... through reflection and professional dialogue, and they dealt with the risk of shock or death. CONCLUSION: Participating in an ICD-specific rehabilitation programme can make patients feel inspired and secure through individualized care. They discover that they have to rethink some of their strategies...

  8. A challenging case of ventricular arrhythmia in a patient with myocarditis: ICD yes/no after ablation

    Directory of Open Access Journals (Sweden)

    Maria L Narducci; Teresa Rio; Francesco Perna; Domenico D�Amario; Biagio Merlino; Riccardo Marano; Gianluigi Bencardino; Frediano Inzani; Gemma Pelargonio; Filippo Crea

    2014-10-01

    Full Text Available In patients with myocarditis, early diagnosis and appropriate therapy are mandatory, as well as close clinical and strumental follow-up with particular regard on progression of disease and ventricular arrhythmias relapse. The management of ventricular arrhythmias should follow current guidelines for ICD implantation, but new therapeutic options could be evaluated in these patients as combined epicardial/endocardial ablation and external wereable defibrillator. Particularly, left ventricular ejection fraction (LVEF represented the only risk stratifier for sudden cardiac death currently used in myocarditis, although the use of single risk factor have limited utility. On this regard, combined analysis of structural myocardial tissue definition by cardiac magnetic resonance (CMR and endomyocardial biopsy, in association with resting cardiac systolic function could improve predictive accuracy for sudden death in patients with myocarditis.

  9. 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

  10. 78 FR 74825 - Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical...

    Science.gov (United States)

    2013-12-10

    ... noted in the correcting document published in the Federal Register on September 6, 2013 (78 FR 54842..., Clinical Modification ICD Implantable cardioverter defibrillator ICU Intensive care unit IHS Indian Health... (APC 0415) b. Direct Laryngoscopy (APC 0074) c. Pulmonary Rehabilitation Services (APC 0077) 10....

  11. Poor health status and distress in cardiac patients

    DEFF Research Database (Denmark)

    Habibović, Mirela; Versteeg, Henneke; Pelle, Aline J M;

    2013-01-01

    Implantable cardioverter defibrillator (ICD) therapy, which includes the risk of shocks, is considered the primary culprit of reductions in patient reported outcomes (PROs; e.g. health status and distress), thereby negating the role of underlying disease severity. We examined the relative influen...

  12. Does electrophysiological testing have any role in risk stratification for sudden cardiac death?

    Institute of Scientific and Technical Information of China (English)

    Fei Lü; Wei Hua

    2010-01-01

    @@ Introduction Implantation of implantable cardioverter defibrillators (ICD) has widely been accepted for secondary prevention of sudden cardiac death (SCD) in cardiac arrest survivors.1 Currently there are increasing interests in primary prevention of SCD in selected high risk patients who have not experienced cardiac arrest.1

  13. Neurodevelopmental Disorders (ASD and ADHD): DSM-5, ICD-10, and ICD-11.

    Science.gov (United States)

    Doernberg, Ellen; Hollander, Eric

    2016-08-01

    Neurodevelopmental disorders, specifically autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) have undergone considerable diagnostic evolution in the past decade. In the United States, the current system in place is the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), whereas worldwide, the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) serves as a general medical system. This review will examine the differences in neurodevelopmental disorders between these two systems. First, we will review the important revisions made from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) to the DSM-5, with respect to ASD and ADHD. Next, we will cover the similarities and differences between ASD and ADHD classification in the DSM-5 and the ICD-10, and how these differences may have an effect on neurodevelopmental disorder diagnostics and classification. By examining the changes made for the DSM-5 in 2013, and critiquing the current ICD-10 system, we can help to anticipate and advise on the upcoming ICD-11, due to come online in 2017. Overall, this review serves to highlight the importance of progress towards complementary diagnostic classification systems, keeping in mind the difference in tradition and purpose of the DSM and the ICD, and that these systems are dynamic and changing as more is learned about neurodevelopmental disorders and their underlying etiology. Finally this review will discuss alternative diagnostic approaches, such as the Research Domain Criteria (RDoC) initiative, which links symptom domains to underlying biological and neurological mechanisms. The incorporation of new diagnostic directions could have a great effect on treatment development and insurance coverage for neurodevelopmental disorders worldwide. PMID:27364515

  14. 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...

  15. 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).

  16. Identification of ICD Codes Suggestive of Child Maltreatment

    Science.gov (United States)

    Schnitzer, Patricia G.; Slusher, Paula L.; Kruse, Robin L.; Tarleton, Molly M.

    2011-01-01

    Objective: In order to be reimbursed for the care they provide, hospitals in the United States are required to use a standard system to code all discharge diagnoses: the International Classification of Disease, 9th Revision, Clinical Modification (ICD-9). Although ICD-9 codes specific for child maltreatment exist, they do not identify all…

  17. Impact of the Transition to ICD-10 on Medicare Payment

    Data.gov (United States)

    U.S. Department of Health & Human Services — Although the transition from the ICD-9-CM to the ICD-10 version of MS-DRGs resulted in 1.68 percent of the patients being assigned to a different MS-DRG, payment...

  18. 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.)

  19. 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.

  20. Verbesserte ICD-10-Suche mittels XML

    Directory of Open Access Journals (Sweden)

    Schweiger R

    2002-01-01

    Full Text Available Mit der Anforderung an Ärzte, ihre Diagnosen zu verschlüsseln, gewinnen effiziente Nachschlagewerke von Verschlüsselungssystemen zunehmend an Bedeutung. Die Universität Gießen hat unter Einsatz neuester und standardisierter Technologien wie XML eine Suchmaschine entwickelt, mit der elektronische Nachschlagewerke und Wörterbücher sehr einfach aufgebaut und gepflegt werden können. XML liefert in diesem Zusammenhang Beziehungen zwischen den Suchbegriffen, die eine hohe Suchqualität (Relevanz und Vollständigkeit garantieren. Die Suchmaschine wurde am Beispiel der ICD-10 bereits erfolgreich getestet und ist unter der Webadresse http://www.lumrix.net frei zugänglich. Da die Suchmaschine komplett im Web-Browser läuft, können Wissen und Information sehr leicht an jeden klinischen Arbeitsplatz mit Internet-Zugang transportiert werden.

  1. Semantic Alignment between ICD-11 and SNOMED CT.

    Science.gov (United States)

    Rodrigues, Jean-Marie; Robinson, David; Della Mea, Vincenzo; Campbell, James; Rector, Alan; Schulz, Stefan; Brear, Hazel; Üstün, Bedirhan; Spackman, Kent; Chute, Christopher G; Millar, Jane; Solbrig, Harold; Brand Persson, Kristina

    2015-01-01

    Due to fundamental differences in design and editorial policies, semantic interoperability between two de facto standard terminologies in the healthcare domain--the International Classification of Diseases (ICD) and SNOMED CT (SCT), requires combining two different approaches: (i) axiom-based, which states logically what is universally true, using an ontology language such as OWL; (ii) rule-based, expressed as queries on the axiom-based knowledge. We present the ICD-SCT harmonization process including: a) a new architecture for ICD-11, b) a protocol for the semantic alignment of ICD and SCT, and c) preliminary results of the alignment applied to more than half the domain currently covered by the draft ICD-11. PMID:26262160

  2. 肠炎的ICD-10编码%The ICD-10 coding of enteritis

    Institute of Scientific and Technical Information of China (English)

    褚云生

    2012-01-01

    Although enteritis is a kind of common and frequent occurred disease in digestive system , there are many difficulties existing in its cod ing . In our country , enteritis supposed to be no infectious are coding in K 52 .9 according to the rules of the first edition of ICD-10 . As the canceling of assumed classification rules in the second edition of ICD-10 , there are as many as dozens of coding of enteritis and different pathogenesis can lead to different coding . So the coders should pay great attention when coding enteritis and avoid haste work as the bigger difficulty comes .%肠炎是消化系统中的常见病、多发病,但对肠炎的编码却存在诸多难点.ICD-10第1版执行假定分类原则,在我国肠炎假定为非传染性的均编码于K52.9.ICD-10第2版取消假定分类原则,意味着分类规则的改变,分类时应依照肠炎的发病病因,病因不同时,肠炎所对应的编码也不同,多达几十个不同编码.相当于增加了编码难度,编码员在对肠炎进行编码时应引起重视,切忌草率编码.

  3. 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.

  4. 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.

  5. 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...

  6. Management of patients with Arrhythmogenic Right Ventricular Cardiomyopathy in the Nordic countries

    DEFF Research Database (Denmark)

    Haugaa, Kristina H; Bundgaard, Henning; Edvardsen, Thor;

    2015-01-01

    -up are required in patients with definite ARVC and in genetic-mutation-positive family members. Furthermore, ARVC patients with and without implantable cardioverter defibrillators (ICDs) require different follow-up strategies. CONCLUSION: Careful follow-up is required in patients with ARVC diagnosis to evaluate...... the need of anti-arrhythmic therapy and ICD implantation. Mutation-positive family members should be followed regularly for detection of early disease and risk stratification of ventricular arrhythmias....

  7. Arrhythmia risk stratification of patients after myocardial infarction using personalized heart models

    OpenAIRE

    Arevalo, Hermenegild J.; Vadakkumpadan, Fijoy; Guallar, Eliseo; Jebb, Alexander; Malamas, Peter; Wu, Katherine C.; Trayanova, Natalia A.

    2016-01-01

    Sudden cardiac death (SCD) from arrhythmias is a leading cause of mortality. For patients at high SCD risk, prophylactic insertion of implantable cardioverter defibrillators (ICDs) reduces mortality. Current approaches to identify patients at risk for arrhythmia are, however, of low sensitivity and specificity, which results in a low rate of appropriate ICD therapy. Here, we develop a personalized approach to assess SCD risk in post-infarction patients based on cardiac imaging and computation...

  8. 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...

  9. Comparing ICD-9-CM and ICD-10 classification systems in a primary health care setting: some initial observations.

    Science.gov (United States)

    Walker, S; Wood, M; Wilks, J; Nicol, J

    1995-01-01

    The ICD-10 is due to be introduced into Australia during the late 1990s, superseding the current and widely used ICD-9-CM. Improvements in areas such as number of codes, an expanded external cause framework, and more context to injuries are expected to make the ICD-10 a more streamlined system for practitioners. The present study examined both classification formats using data from 1183 presentations to primary health clinics at island tourist resorts. Some initial observations are made about differences in the two systems, highlighting the greater coding detail provided by the ICD-10, particularly in the area of injuries. It is recommended that further empirical testing be undertaken using the ICD-10 in a variety of settings so as to identify benefits in the coding of both medical conditions and injuries. PMID:10163113

  10. 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....

  11. 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

  12. Primärprävention des plötzlichen Herztodes mit implantierbaren Cardioverter-Defibrillatoren - Vernünftig oder MADIT?

    Directory of Open Access Journals (Sweden)

    Steinwender C

    2004-01-01

    Full Text Available Mehrere in jüngerer Zeit publizierte Studien belegen die Überlegenheit des implantierbaren Cardioverter-Defibrillators gegenüber einer medikamentösen Therapie in der Primärprävention des plötzlichen Herztodes. Die Kollektive dieser Untersuchungen bestanden aus den bekannten Hochrisikopatienten im Postinfarktstadium mit höher- bis höchstgradig eingeschränkter Linksventrikelfunktion. MADIT II war die erste Studie, die auf eine aufwendige rhythmologische Risikostratifizierung verzichtete und dennoch in sämtlichen Subgruppen einen therapeutischen Benefit durch die Defibrillatortherapie nachwies. Die sich hierdurch ergebende Evidenz fand rasch Eingang in die Richtlinien der großen kardiologischen Gesellschaften. Ungelöst bleiben vorerst zwei große Probleme: 1. die Frage der Finanzierung einer Umsetzung dieser Richtlinien; 2. die weitere Strategie zur effektiven Primärprävention des plötzlichen Herztodes, da durch oben genannte Studien nur ein kleiner Prozentsatz der möglichen künftigen Opfer abgedeckt wird. Als Lösungsansatz bietet sich eine kostengünstige, auf die Erfordernisse der Primärprävention abgestimmte Defibrillator-Technologie an, die gemeinsam mit einer Vereinfachung der Implantationsprozedur die Kosteneffektivität zugunsten der Prophylaxe beeinflussen kann. Weiters müssen zusätzlich große Anstrengungen zur Identifizierung von zukünftigen Opfern des plötzlichen Herztodes vor ihrer ersten Arrhythmie-Episode unternommen werden.

  13. ICD and DSM: neuroplasticity and staging are still missing.

    Science.gov (United States)

    Pallanti, Stefano

    2016-08-01

    The two main diagnostic systems, the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM), have undergone a number of revisions since their first editions: whereas the fifth edition of the DSM has been published in 2013, the eleventh revision of the ICD is expected by 2018. Although the process of harmonization between the 2 systems is still a debated topic, the forthcoming revision of the ICD is seemingly converging toward the DSM approach in regard to the reclassification of a number of disorders. Nevertheless, the 2 systems still exhibit considerable differences, partly due to their different purposes, development and revision processes, and target audiences. Furthermore, while alternative and innovative classification approaches are emerging with the aim of integrating the latest findings from neuroscience and genomics, both the DSM and ICD still fail to incorporate core concepts such as the clinical staging of psychiatric disorders and "neuroprogression," as well as an adequate consideration of endophenotypes. PMID:27503571

  14. 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...

  15. Emergency department coding of bicycle and pedestrian injuries during the transition from ICD-9 to ICD-10

    Science.gov (United States)

    Karkhaneh, M; Hagel, B E; Couperthwaite, A; Saunders, L D; Voaklander, D C

    2011-01-01

    Background The international classification of diseases version 10 (ICD-10) uses alphanumeric expanded codes and external cause of injury codes (E-codes). Objective To examine the reliability and validity of emergency department (ED) coders in applying E-codes in ICD-9 and -10. Methods Bicycle and pedestrian injuries were identified from the ED information system from one period before and two periods after transition from ICD-9 to -10 coding. Overall, 180 randomly selected bicycle and pedestrian injury charts were reviewed as the reference standard (RS). Original E-codes assigned by ED coders (ICD-9 in 2001 and ICD-10 in 2004 and 2007) were compared with charts (validity) and also to ICD-9 and -10 codes assigned from RS chart review, to each case by an independent (IND) coder (reliability). Sensitivity, specificity, simple, and chance-corrected agreements (κ statistics) were calculated. Results Sensitivity of E-coding bicycle injuries by the IND coder in comparison with the RS ranged from 95.1% (95% CI 86.3 to 99.0) to 100% (95% CI 94.0 to 100.0) for both ICD-9 and -10. Sensitivity of ED coders in E-coding bicycle injuries ranged from 90.2% (95% CI 79.8 to 96.3) to 96.7% (95% CI 88.5 to 99.6). The sensitivity estimates for the IND coder ranged from 25.0% (95% CI 14.7 to 37.9) to 45.0% (95% CI 32.1 to 58.4) for pedestrian injuries for both ICD-9 and -10. Conclusion Bicycle injuries are coded in a reliable and valid manner; however, pedestrian injuries are often miscoded as falls. These results have important implications for injury surveillance research. PMID:21705466

  16. The Choice of ICD-10 Code to Granuloma%肉芽肿的ICD-10编码选择

    Institute of Scientific and Technical Information of China (English)

    孙凯; 李春秀

    2011-01-01

    0bjectives to make sure correct ICD-10 code for different granuloma.Methods learning relevant know ledge of different granulom a giving the correct ICD-10 code for them according to classification rules.Results choosing correct code according to causes of disease and location.Conclusions Coder notonly should master ICD-10 coding know ledge, not also need to learn related medical know ledge.They also need to read medical records carefully therefore can im prove the correction of coding and disease classification coding quality in order to provide reliable inform ation materials for clinical scientific research and teaching.%目的确定各类肉芽肿的正确的ICD-10编码.方法学习各类肉芽肿的相关知识,按照分类原则给予正确的ICD-10编码.结果根据病因、部位选择肉芽肿的正确编码.结论编码员不仅要掌握ICD-10编码知识,也要学习相关的医学知识,并仔细阅读病案,才能提高编码的准确性,提高疾病分类编码质量,为临床科研、教学等提供可靠的信息资料.

  17. 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 ...

  18. 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.

  19. Proceedings of the ICDE workshop on qualitative and quantitative use of ICDE data

    International Nuclear Information System (INIS)

    Common-cause-failure (CCF) events can significantly impact the availability of safety systems of nuclear power plants. In recognition of this, CCF data are systematically being collected and analysed in several countries, e.g. in Germany, France, Sweden and the United States A serious obstacle to the use of national qualitative and quantitative data collections by other countries is that the criteria and interpretations applied in the collection and analysis of events and data differ among the various countries. A further impediment is that descriptions of reported events and their root causes, which are important to the assessment of the events, are usually written in the native language of the countries where the events were observed. Preparation for ICDE project was initiated in August of 1994. Swedish and US Nuclear Power Inspectorates (SKI and NRC) identified the need to establish an international project aiming at collection and analysis of CCF data for key components of the main safety systems at for world's nuclear power plants and further exchange of these data between participating countries. Since April 1998, the OECD/NEA has formally operated the project. The Phase II with an agreement period 2000-2002 will be continued with a new phase. The agreement for the phase III covers the period 2002-2005. As for the end of phase II data collection, analysis and exchange have been performed for centrifugal pumps, diesel generators, motor-operated valves, safety and relief valves, check valves and batteries. Final reports for centrifugal pump, diesel generators motor-operated valves and safety relief valves have been developed. Member countries, which formed the ICDE Working Group under the Phase II Agreement of OECD/NEA and the organisations representing them in the project group, were as of 2001: Canada - AECB, Finland - STUK, France - IPSN, Germany - GRS, Spain - CSN, Sweden - SKI, Switzerland - HSK, United Kingdom - NII, United States - NRC. The objective

  20. Rethinking the classification of mixed affective episodes in ICD-11.

    Science.gov (United States)

    Ostergaard, Søren Dinesen; Rothschild, Anthony J; Bertelsen, Aksel; Mors, Ole

    2012-04-01

    Mixed affective episode is a prevalent mood disorder characterized by the coexistence or rapid alternation of manic and depressive symptoms, which is associated with significant suffering and high risk of suicide. Unfortunately, the current diagnostic classification of mixed affective episodes in the ICD-10 lacks a detailed definition with relevant subtypes. This inconsistency has significant negative implications for both research into the disorders in the bipolar spectrum and for clinical practice. For this reason there is a need for special attention on this diagnosis in the revisions of the diagnostic manuals. In this manuscript we suggest a set of clear diagnostic criteria and exhaustive subtypes for the mixed affective episodes aimed at the upcoming ICD-11. The defined syndrome and its subtypes are in close congruence with the suggested DSM-5 "mixed episode specifier", which is an advantage for common understanding and for research across the ICD/DSM border. PMID:22284015

  1. Representing ICD-11 JLMMS Using IHTSDO Representation Formalisms.

    Science.gov (United States)

    Mamou, Marzouk; Rector, Alan; Schulz, Stefan; Campbell, James; Solbrig, Harold; Rodrigues, Jean-Marie

    2016-01-01

    It is investigated whether the content of the Joint Linearization for Mortality and Morbidity Statistics of the 11th ICD revision can be semantically represented by formalisms acting on the clinical terminology SNOMED CT, viz. the IHTSDO Compositional Grammar (CG) and the Expression Constraint Language (ECL). Whereas CG provides a composition syntax for building coordinated SNOMED CT expressions, ECL provides a powerful query mechanism. Both formalisms can be leveraged to guarantee inter-operation between an ontology-based terminology like SNOMED CT and a statistical classification like ICD, characterized by single hierarchies and exhaustive, mutually exclusive classes. We test the feasibility of the method on the circulatory chapter of ICD-11 JLMMS. PMID:27577419

  2. 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 " ...

  3. New/Surface-Modified Biocompatible Polymer for ICD Lead Insulation

    OpenAIRE

    Pisarek, Rubin Berek

    2011-01-01

    The average lifetime of an implanted pacemaker or defibrillator cable (lead) is approximately 10 years. One of the main lead failure mechanisms is deterioration of the insulation, which can be caused by chemical, biological, and mechanical processes. Each time lead failure occurs, an operation for its prompt replacement is required, in order to guarantee the patients' well-being. Since lead failure poses a health risk for the patients, and replacement...

  4. 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.

  5. Psychotic disorders in DSM-5 and ICD-11.

    Science.gov (United States)

    Biedermann, Falko; Fleischhacker, W Wolfgang

    2016-08-01

    The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was published by the American Psychiatric Association (APA) in 2013, and the Work Group on the Classification of Psychotic disorders (WGPD), installed by the World Health Organization (WHO), is expected to publish the new chapter about schizophrenia and other primary psychotic disorders in 2017. We reviewed the available literature to summarize the major changes, innovations, and developments of both manuals. If available and possible, we outline the theoretical background behind these changes. Due to the fact that the development of ICD-11 has not yet been completed, the details about ICD-11 are still proposals under ongoing revision. In this ongoing process, they may be revised and therefore have to be seen as proposals. DSM-5 has eliminated schizophrenia subtypes and replaced them with a dimensional approach based on symptom assessments. ICD-11 will most likely go in a similar direction, as both manuals are planned to be more harmonized, although some differences will remain in details and the conceptual orientation. Next to these modifications, ICD-11 will provide a transsectional diagnostic criterion for schizoaffective disorders and a reorganization of acute and transient psychotic and delusional disorders. In this manuscript, we will compare the 2 classification systems. PMID:27418328

  6. Time to choose – DSM-5, ICD-11 or both?

    Directory of Open Access Journals (Sweden)

    Tyrer, Peter

    2014-09-01

    Full Text Available DSM-5 was published in May 2013, and ICD 11 is not due to be published until the end of 2015 at the earliest. Nevertheless, it is possible to make a comparison at this early stage as much of the main decisions have been made with both classifications. DSM-5 aimed to make a paradigm shift by providing objective, independent measures of classification, but in this respect it clearly failed. It did respond to previous criticisms that there were too many diagnoses in the classification and that eliminated some conditions in favour of larger groupings (eg, autism spectrum disorder, but it has still come in for heavy criticism. ICD 11 deviates from DSM-5 in radically different classifications of personality and stress disorders and in general has pursued a different pathway, concentrating on clinical utility as the main guide to the classification. It is up to practitioners to choose which they prefer, but ICD 11 will be in a much stronger position than ICD 10 was when it was published in 1999.

  7. 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...

  8. 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

  9. 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...

  10. An administrative data merging solution for dealing with missing data in a clinical registry: adaptation from ICD-9 to ICD-10

    Directory of Open Access Journals (Sweden)

    Galbraith P Diane

    2008-01-01

    Full Text Available Abstract Background We have previously described a method for dealing with missing data in a prospective cardiac registry initiative. The method involves merging registry data to corresponding ICD-9-CM administrative data to fill in missing data 'holes'. Here, we describe the process of translating our data merging solution to ICD-10, and then validating its performance. Methods A multi-step translation process was undertaken to produce an ICD-10 algorithm, and merging was then implemented to produce complete datasets for 1995–2001 based on the ICD-9-CM coding algorithm, and for 2002–2005 based on the ICD-10 algorithm. We used cardiac registry data for patients undergoing cardiac catheterization in fiscal years 1995–2005. The corresponding administrative data records were coded in ICD-9-CM for 1995–2001 and in ICD-10 for 2002–2005. The resulting datasets were then evaluated for their ability to predict death at one year. Results The prevalence of the individual clinical risk factors increased gradually across years. There was, however, no evidence of either an abrupt drop or rise in prevalence of any of the risk factors. The performance of the new data merging model was comparable to that of our previously reported methodology: c-statistic = 0.788 (95% CI 0.775, 0.802 for the ICD-10 model versus c-statistic = 0.784 (95% CI 0.780, 0.790 for the ICD-9-CM model. The two models also exhibited similar goodness-of-fit. Conclusion The ICD-10 implementation of our data merging method performs as well as the previously-validated ICD-9-CM method. Such methodological research is an essential prerequisite for research with administrative data now that most health systems are transitioning to ICD-10.

  11. 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

  12. 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

  13. 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.

  14. ICD-11 and SNOMED CT Common Ontology: circulatory system.

    Science.gov (United States)

    Rodrigues, Jean-Marie; Schulz, Stefan; Rector, Alan; Spackman, Kent; Millar, Jane; Campbell, James; Ustün, Bedirhan; Chute, Christopher G; Solbrig, Harold; Della Mea, Vincenzo; Persson, Kristina Brand

    2014-01-01

    The improvement of semantic interoperability between data in electronic health records and aggregated data for health statistics requires efforts to carefully align the two domain terminologies ICD and SNOMED CT. Both represent a new generation of ontology-based terminologies and classifications. The proposed alignment of these two systems and, in consequence, the validity of their cross-utilisation, requires a specific resource, named Common Ontology. We present the ICD-11 SNOMED CT Common Ontology building process including: a) the principles proposed for aligning the two systems with the help of a common model of meaning, b) the design of this common ontology, and c) preliminary results of the application to the diseases of the circulatory system. PMID:25160347

  15. ICD-10 Medical Coding: The Role of Perioperative Services in Addressing Implementation Challenges.

    Science.gov (United States)

    Wing, Toni L

    2016-02-01

    The International Classification of Diseases, 10th Revision (ICD-10) was adopted in the United States on October 1, 2015. Replacing the outdated ICD, Ninth Revision, Clinical Modification (ICD-9-CM) coding system was long overdue, and the updated classifications were needed to accurately collect data and improve patient care. However, the complexity of ICD-10 may present substantial challenges for health information management coders and affect hospital revenue collection. Because the OR generates a large share of a hospital's overall revenue, perioperative services personnel must take a critical look at ICD-10 changes and address adoption challenges to minimize the negative effects ICD-10 may have on surgical revenue and help personnel identify perioperative services' important role in ICD-10 implementation. PMID:26849983

  16. 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

  17. 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...

  18. Transient loss of consciousness in a patient with a Brugada like ECG

    OpenAIRE

    Belinda Sandler; Steve Furniss; Eric McWilliams

    2011-01-01

    Syncope in a patient with a Brugada syndrome channelopathy carries significant prognostic implications and warrants consideration of implantable cardioverter defibrillator (ICD) implantation. We report a case of a 62- year-old gentleman who presented with a transient loss of consciousness and an electrocardiogram (ECG) suggestive of type 1 Brugada syndrome. Further investigation revealed evidence of a silent myocardial infarction and negative ventricular tachycardia stimulation and Ajmaline t...

  19. Mutationsanalyse an 14 Kandidatengenen für autosomal-dominant vererbte arrhythmogene rechtsventrikuläre Kardiomyopathie (ARVD5)

    OpenAIRE

    Brandt, Kalina

    2011-01-01

    Arrhythmogenic right ventricular cardiomyopathy (ARVC) is characterized by fibrofatty replacement of the right ventricular free wall and leads to ventricular arrhythmias, heart failure, and sudden cardiac death. Genetics gains in importance due to the possibility of preventing sudden death by implantation of a cardioverter defibrillator (ICD) in asymptomatic patients with familial history of ARVC. The aim of this thesis was to identify the mutation for autosomal dominant inherited ARVD5 o...

  20. 对埋藏式心脏复律除颤器植入患者的护理

    Institute of Scientific and Technical Information of China (English)

    叶枫; 华雨

    2011-01-01

    @@ 心源性猝死是现代医学所面临的一个重要问题.多个大规模临床试验已证明.埋藏式心脏复律除颤器(Implantable Card-ioverter Defibrillator,ICD)对防治室性心动过速和室颤所致的猝死有明显疗效.

  1. Ventricular Tachycardia Ablation – The Right Approach for the Right Patient

    OpenAIRE

    Sadek, Mouhannad M; Schaller, Robert D; Supple, Gregory E; Frankel, David S; Riley, Michael P.; Mathew D. Hutchinson; Garcia, Fermin C; Lin, David; Dixit, Sanjay; Zado, Erica S; Callans, David J.; Marchlinski, Francis E.

    2014-01-01

    Scar-related reentry is the most common mechanism of monomorphic ventricular tachycardia (VT) in patients with structural heart disease. Catheter ablation has assumed an increasingly important role in the management of VT in this setting, and has been shown to reduce VT recurrence and implantable cardioverter defibrillator (ICD) shocks. The approach to mapping and ablation will depend on the underlying heart disease etiology, VT inducibility and haemodynamic stability. This review explores pr...

  2. An On-Time Power-Aware Scheduling Scheme for Medical Sensor SoC-Based WBAN Systems

    OpenAIRE

    Jung-Guk Kim; Dong-Sun Kim; Tae-Ho Hwang

    2012-01-01

    The focus of many leading technologies in the field of medical sensor systems is on low power consumption and robust data transmission. For example, the implantable cardioverter-defibrillator (ICD), which is used to maintain the heart in a healthy state, requires a reliable wireless communication scheme with an extremely low duty-cycle, high bit rate, and energy-efficient media access protocols. Because such devices must be sustained for over 5 years without access to battery replacement, the...

  3. Induction of atrial fibrillation with rapid high voltage ventricular pacing for ventricular fibrillation conversion testing

    OpenAIRE

    Schuchert, A; Kuhl, M; Ruppel, R; Meinertz, T

    2000-01-01

    OBJECTIVE—To assess whether rapid high voltage ventricular pacing can also induce atrial fibrillation, and whether the induction of atrial fibrillation during ventricular fibrillation conversion testing is related to the patient's heart disease.
DESIGN—Prospective study of 50 patients who received the dual chamber implantable cardioverter-defibrillator (ICD) Ventak AV II DR (Guidant) as a first implant. This device can record atrial activity even during a ventricular fibrillation episode and ...

  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. ICD 10 Based Medical Expert System Using Fuzzy Temporal Logic

    OpenAIRE

    Chinniah, P.; Dr. S.Muttan

    2010-01-01

    Medical diagnosis process involves many levels and considerable amount of time and money are invariably spent for the first level of diagnosis usually made by the physician for all the patients every time. Hence there is a need for a computer based system which not only asks relevant questions to the patients but also aids the physician by giving a set of possible diseases from the symptoms obtained using logic at inference. In this work, an ICD10 based Medical Expert System that provides adv...

  6. Tourette and tic disorders in ICD-11: standing at the diagnostic crossroads

    OpenAIRE

    Woods, Douglas W; Thomsen, Per H.

    2014-01-01

    This article reflects discussion by the WHO ICD-11 Working Group on the Classification of Obsessive-Compulsive and Related Disorders. After reviewing the historical classification of tic disorders, this article discusses their placement in ICD-11. Existing problems with diagnostic labels and criteria, appropriate placement of the tic disorders category within the ICD-11 system, and pragmatic factors affecting classification are reviewed. The article ends with recommendations to (a) maintain c...

  7. 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

  8. ICD 10 Based Medical Expert System Using Fuzzy Temporal Logic

    Directory of Open Access Journals (Sweden)

    P.Chinniah

    2009-12-01

    Full Text Available Medical diagnosis process involves many levels and considerable amount of time and money are invariably spent for the first level of diagnosis usually made by the physician for all the patients every time. Hence there is a need for a computer based system which not only asks relevant questions to the patients but also aids the physician by giving a set of possible diseases from the symptoms obtained using logic at inference. In this work, an ICD10 based Medical Expert System that provides advice, information and recommendation to the physician using fuzzy temporal logic. The knowledge base used in this system consists of facts of symptoms and rules on diseases. It also provides fuzzy severity scale and weight factor for symptom and disease and can vary with respect to time. The system generates the possible disease conditions based on modified Euclidean metric using Elder’s algorithm for effective clustering. The minimum similarity value is used as the decision parameter to identify a disease. Keywords -Fuzzy clustering, symptoms, fuzzy severity scale, weight factor, Minkowski distance, ICD, WHO, Rules Base, TSQL

  9. Anatomy of the ICDS series: A bibliometric analysis

    Energy Technology Data Exchange (ETDEWEB)

    Cardona, Manuel [Max Planck Institute for Solid State Research, Heisenbergstrasse 1, D-70569 Stuttgart (Germany)], E-mail: m.cardona@fkf.mpg.de; Marx, Werner [Max Planck Institute for Solid State Research, Heisenbergstrasse 1, D-70569 Stuttgart (Germany)

    2007-12-15

    In this article, the proceedings of the International Conferences on Defects in Semiconductors (ICDS) have been analyzed by bibliometric methods. The papers of these conferences have been published as articles in regular journals or special proceedings journals and in books with diverse publishers. The conference name/title changed several times. Many of the proceedings did not appear in the so-called 'source journals' covered by the Thomson/ISI citation databases, in particular by the Science Citation Index (SCI). But the number of citations within these source journals can be determined using the Cited Reference Search mode under the Web of Science (WoS) and the SCI offered by the host STN International. The search functions of both systems were needed to select the papers published as different document types and to cover the full time span of the series. The most cited ICDS papers were identified, and the overall numbers of citations as well as the time-dependent impact of these papers, of single conferences, and of the complete series, was established. The complete of citing papers was analyzed with respect to the countries of the citing authors, the citing journals, and the ISI subject categories.

  10. Anatomy of the ICDS series: A bibliometric analysis

    Science.gov (United States)

    Cardona, Manuel; Marxa, Werner

    2007-12-01

    In this article, the proceedings of the International Conferences on Defects in Semiconductors (ICDS) have been analyzed by bibliometric methods. The papers of these conferences have been published as articles in regular journals or special proceedings journals and in books with diverse publishers. The conference name/title changed several times. Many of the proceedings did not appear in the so-called “source journals” covered by the Thomson/ISI citation databases, in particular by the Science Citation Index (SCI). But the number of citations within these source journals can be determined using the Cited Reference Search mode under the Web of Science (WoS) and the SCI offered by the host STN International. The search functions of both systems were needed to select the papers published as different document types and to cover the full time span of the series. The most cited ICDS papers were identified, and the overall numbers of citations as well as the time-dependent impact of these papers, of single conferences, and of the complete series, was established. The complete of citing papers was analyzed with respect to the countries of the citing authors, the citing journals, and the ISI subject categories.

  11. Anatomy of the ICDS series: A bibliometric analysis

    International Nuclear Information System (INIS)

    In this article, the proceedings of the International Conferences on Defects in Semiconductors (ICDS) have been analyzed by bibliometric methods. The papers of these conferences have been published as articles in regular journals or special proceedings journals and in books with diverse publishers. The conference name/title changed several times. Many of the proceedings did not appear in the so-called 'source journals' covered by the Thomson/ISI citation databases, in particular by the Science Citation Index (SCI). But the number of citations within these source journals can be determined using the Cited Reference Search mode under the Web of Science (WoS) and the SCI offered by the host STN International. The search functions of both systems were needed to select the papers published as different document types and to cover the full time span of the series. The most cited ICDS papers were identified, and the overall numbers of citations as well as the time-dependent impact of these papers, of single conferences, and of the complete series, was established. The complete of citing papers was analyzed with respect to the countries of the citing authors, the citing journals, and the ISI subject categories

  12. Potential demographic and baselines variables for risk stratification of high-risk post-myocardial infarction patients in the era of implantable cardioverter-defibrillator - a prognostic indicator

    DEFF Research Database (Denmark)

    Yap, Yee Guan; Duong, Trinh; Bland, Martin; Malik, M.; Torp-Pedersen, Christian Tobias; Køber, Lars Valeur; Connolly, S.J.; Gallagher, M.M.; Camm, A.J.

    2008-01-01

    BACKGROUND: Risk stratification after myocardial infarction (MI) remains expensive and disappointing. We designed a prognostic indicator using demographic information to select patients at risk of dying after MI. METHOD AND RESULTS: We combined individual patient data from the placebo arms of EMIAT...... containing only significant variables. The prognostic index was the sum of the individual contribution from the risk factors. 2707 patients were pooled (age: 66 (23-92) years, 78.8% M) with 480 deaths at 2-years (44% arrhythmic and 35.6% non-arrhythmic cardiac deaths). Variables predicting mortality were age...

  13. Bleeding complications after pacemaker or cardioverter-defibrillator implantation in patients receiving dual antiplatelet therapy: Results of a prospective, two-centre registry

    OpenAIRE

    Przybylski, A; Derejko, P.; Kwaśniewski, W.; Urbańczyk-Świć, D.; Zakrzewska, J.; Orszulak, W.; Orczykowski, M.; Filipecki, A.; Szumowski, Ł; Walczak, F.; Trusz-Gluza, M.

    2010-01-01

    Introduction. The aim of the study was to define the prevalence of bleeding events in patients treated with dual antiplatelet therapy (DAT) in comparison with patients receiving only acetylsalicylic acid (ASA).

  14. 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

    NARCIS (Netherlands)

    Brouwer, I.A.; Zock, P.L.; Camm, A.J.; Bocker, D.; Hauer, R.N.W.; Wever, E.F.D.; Dullemeijer, C.; Ronden, J.E.; Katan, M.B.; Lubinski, A.; Buschler, H.; Schouten, E.G.

    2006-01-01

    Context Very-long-chain n-3 polyunsaturated fatty acids (omega-3 PUFAs) from fish are thought to reduce risk of sudden death, possibly by reducing susceptibility to cardiac arrhythmia. Objective To study the effect of supplemental fish oil vs placebo on ventricular tachyarrhythmia or death. Design,

  15. The CopenHeartSF trial--comprehensive sexual rehabilitation programme for male patients with implantable cardioverter defibrillator or ischaemic heart disease and impaired sexual function

    DEFF Research Database (Denmark)

    Johansen, Pernille Palm; Zwisler, Ann-Dorthe; Hastrup-Svendsen, Jesper;

    2013-01-01

    Sexuality is an important part of people's physical and mental health. Patients with heart disease often suffer from sexual dysfunction. Sexual dysfunction has a negative impact on quality of life and well-being in persons with heart disease, and sexual dysfunction is associated with anxiety and...... depression. Treatment and care possibilities seem to be lacking. Studies indicate that non-pharmacological interventions such as exercise training and psychoeducation possess the potential of reducing sexual dysfunction in patients with heart disease. The CopenHeartSF trial will investigate the effect of a...

  16. 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...

  17. 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...

  18. 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...

  19. 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.

  20. 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.

  1. Trends in Gastroenteritis-associated Mortality in the United States 1985-2005: Variations by ICD-9 and ICD-10 Codes

    Science.gov (United States)

    BackgroundTrends in gastroenteritis-associated mortality are changing over time with development of antibiotic resistant strains of certain pathogens, improved diagnostic methods, and changing healthcare. In 1999, ICD-10 coding was introduced for mortality records which can also ...

  2. Estimation of the Alpha Factor Parameters Using the ICDE Database

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Dae Il; Hwang, M. J.; Han, S. H

    2007-04-15

    Detailed common cause failure (CCF) analysis generally need for the data for CCF events of other nuclear power plants because the CCF events rarely occur. KAERI has been participated at the international common cause failure data exchange (ICDE) project to get the data for the CCF events. The operation office of the ICDE project sent the CCF event data for EDG to the KAERI at December 2006. As a pilot study, we performed the detailed CCF analysis of EDGs for Yonggwang Units 3 and 4 and Ulchin Units 3 and 4 using the ICDE database. There are two onsite EDGs for each NPP. When an offsite power and the two onsite EDGs are not available, one alternate AC (AAC) diesel generator (hereafter AAC) is provided. Two onsite EDGs and the AAC are manufactured by the same company, but they are designed differently. We estimated the Alpha Factor and the CCF probability for the cases where three EDGs were assumed to be identically designed, and for those were assumed to be not identically designed. For the cases where three EDGs were assumed to be identically designed, double CCF probabilities of Yonggwang Units 3/4 and Ulchin Units 3/4 for 'fails to start' were estimated as 2.20E-4 and 2.10E-4, respectively. Triple CCF probabilities of those were estimated as 2.39E-4 and 2.42E-4, respectively. As each NPP has no experience for 'fails to run', Yonggwang Units 3/4 and Ulchin Units 3/4 have the same CCF probability. The estimated double and triple CCF probabilities for 'fails to run' are 4.21E-4 and 4.61E-4, respectively. Quantification results show that the system unavailability for the cases where the three EDGs are identical is higher than that where the three EDGs are different. The estimated system unavailability of the former case was increased by 3.4% comparing with that of the latter. As a future study, a computerization work for the estimations of the CCF parameters will be performed.

  3. 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

  4. ICD-10-GM 2006: Endgültige Fassungen beim DIMDI veröffentlicht

    OpenAIRE

    DIMDI, P

    2005-01-01

    Das DIMDI hat die endgültige Fassung der Internationalen Klassifikation der Krankheiten (deutsche Modifikation: ICD-10-GM) Version 2006 auf seinen Internetseiten veröffentlicht. Wichtige Erkrankungen werden in der neuen ICD-Version differenzierter als bisher verschlüsselt.

  5. Patient versus informant reporting of ICD symptoms in Parkinson's disease using the QUIP: validity and variability.

    Science.gov (United States)

    Papay, Kimberly; Mamikonyan, Eugenia; Siderowf, Andrew D; Duda, John E; Lyons, Kelly E; Pahwa, Rajesh; Driver-Dunckley, Erika D; Adler, Charles H; Weintraub, Daniel

    2011-03-01

    Questions exist regarding the validity of patient-reporting of psychiatric symptoms in Parkinson's disease (PD). We assessed observer variability and validity in reporting of impulse control disorder (ICD) symptoms in PD by using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP). PD patients and their informants (71 pairs) completed the QUIP to assess four ICDs (compulsive gambling, buying, sexual behavior, and eating) in patients. Trained raters then administered a diagnostic interview. Sensitivity of the QUIP for a diagnosed ICD was 100% for both patient- and informant-completed instruments, and specificity was 75% for both raters. Approximately 40% of patients without an ICD diagnosis had a positive QUIP, suggesting that many PD patients experience subsyndromal ICD symptoms that require ongoing monitoring. Agreement between patient- and informant-reporting of any ICD behaviors on the QUIP was moderate (kappa=0.408), and for individual ICDs was highest for gambling (kappa=0.550). Overall, a negative QUIP from either the patient or informant rules out the possibility of an ICD, while a positive QUIP requires a follow-up diagnostic interview and ongoing monitoring to determine if symptoms currently are, or in the future become, clinically significant. PMID:21186135

  6. Bipolar and related disorders in DSM-5 and ICD-10.

    Science.gov (United States)

    Kaltenboeck, Alexander; Winkler, Dietmar; Kasper, Siegfried

    2016-08-01

    Bipolar disorders are a group of psychiatric disorders with profound negative impact on affected patients. Even if their symptomatology has long been recognized, diagnostic criteria have changed over time and diagnosis often remains difficult. The Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), issued in May 2013, comprises several changes regarding the diagnosis of bipolar disorders compared to the previous edition. Diagnostic categories and criteria for bipolar disorders show some concordance with the internationally also widely used Tenth Edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). However, there are also major differences that are worth highlighting. The aim of the following text is to depict and discuss those. PMID:27378177

  7. ICD 10 Based Medical Expert System Using Fuzzy Temporal Logic

    CERN Document Server

    Chinniah, P

    2010-01-01

    Medical diagnosis process involves many levels and considerable amount of time and money are invariably spent for the first level of diagnosis usually made by the physician for all the patients every time. Hence there is a need for a computer based system which not only asks relevant questions to the patients but also aids the physician by giving a set of possible diseases from the symptoms obtained using logic at inference. In this work, an ICD10 based Medical Expert System that provides advice, information and recommendation to the physician using fuzzy temporal logic. The knowledge base used in this system consists of facts of symptoms and rules on diseases. It also provides fuzzy severity scale and weight factor for symptom and disease and can vary with respect to time. The system generates the possible disease conditions based on modified Euclidean metric using Elders algorithm for effective clustering. The minimum similarity value is used as the decision parameter to identify a disease.

  8. Expanding the definition of addiction: DSM-5 vs. ICD-11.

    Science.gov (United States)

    Grant, Jon E; Chamberlain, Samuel R

    2016-08-01

    While considerable efforts have been made to understand the neurobiological basis of substance addiction, the potentially "addictive" qualities of repetitive behaviors, and whether such behaviors constitute "behavioral addictions," is relatively neglected. It has been suggested that some conditions, such as gambling disorder, compulsive stealing, compulsive buying, compulsive sexual behavior, and problem Internet use, have phenomenological and neurobiological parallels with substance use disorders. This review considers how the issue of "behavioral addictions" has been handled by latest revisions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD), leading to somewhat divergent approaches. We also consider key areas for future research in order to address optimal diagnostic classification and treatments for such repetitive, debilitating behaviors. PMID:27151528

  9. Systematic review of validated case definitions for diabetes in ICD-9-coded and ICD-10-coded data in adult populations

    Science.gov (United States)

    Khokhar, Bushra; Jette, Nathalie; Metcalfe, Amy; Cunningham, Ceara Tess; Kaplan, Gilaad G; Butalia, Sonia; Rabi, Doreen

    2016-01-01

    Objectives With steady increases in ‘big data’ and data analytics over the past two decades, administrative health databases have become more accessible and are now used regularly for diabetes surveillance. The objective of this study is to systematically review validated International Classification of Diseases (ICD)-based case definitions for diabetes in the adult population. Setting, participants and outcome measures Electronic databases, MEDLINE and Embase, were searched for validation studies where an administrative case definition (using ICD codes) for diabetes in adults was validated against a reference and statistical measures of the performance reported. Results The search yielded 2895 abstracts, and of the 193 potentially relevant studies, 16 met criteria. Diabetes definition for adults varied by data source, including physician claims (sensitivity ranged from 26.9% to 97%, specificity ranged from 94.3% to 99.4%, positive predictive value (PPV) ranged from 71.4% to 96.2%, negative predictive value (NPV) ranged from 95% to 99.6% and κ ranged from 0.8 to 0.9), hospital discharge data (sensitivity ranged from 59.1% to 92.6%, specificity ranged from 95.5% to 99%, PPV ranged from 62.5% to 96%, NPV ranged from 90.8% to 99% and κ ranged from 0.6 to 0.9) and a combination of both (sensitivity ranged from 57% to 95.6%, specificity ranged from 88% to 98.5%, PPV ranged from 54% to 80%, NPV ranged from 98% to 99.6% and κ ranged from 0.7 to 0.8). Conclusions Overall, administrative health databases are useful for undertaking diabetes surveillance, but an awareness of the variation in performance being affected by case definition is essential. The performance characteristics of these case definitions depend on the variations in the definition of primary diagnosis in ICD-coded discharge data and/or the methodology adopted by the healthcare facility to extract information from patient records. PMID:27496226

  10. The impact of proposed changes to ICD-11 on estimates of PTSD prevalence and comorbidity.

    Science.gov (United States)

    Wisco, Blair E; Miller, Mark W; Wolf, Erika J; Kilpatrick, Dean; Resnick, Heidi S; Badour, Christal L; Marx, Brian P; Keane, Terence M; Rosen, Raymond C; Friedman, Matthew J

    2016-06-30

    The World Health Organization's posttraumatic stress disorder (PTSD) work group has published a proposal for the forthcoming edition of the International Classification of Diseases (ICD-11) that would yield a very different diagnosis relative to DSM-5. This study examined the impact of the proposed ICD-11 changes on PTSD prevalence relative to the ICD-10 and DSM-5 definitions and also evaluated the extent to which these changes would accomplish the stated aim of reducing the comorbidity associated with PTSD. Diagnostic prevalence estimates were compared using a U.S. national community sample and two U.S. Department of Veterans Affairs clinical samples. The ICD-11 definition yielded prevalence estimates 10-30% lower than DSM-5 and 25% and 50% lower than ICD-10 with no reduction in the prevalence of common comorbidities. Findings suggest that by constraining the diagnosis to a narrower set of symptoms, the proposed ICD-11 criteria set would substantially reduce the number of individuals with the disorder. These findings raise doubt about the extent to which the ICD-11 proposal would achieve the aim of reducing comorbidity associated with PTSD and highlight the public health and policy implications of such a redefinition. PMID:27124207

  11. Obsessive-compulsive disorder for ICD-11: proposed changes to the diagnostic guidelines and specifiers

    Directory of Open Access Journals (Sweden)

    Helen Blair Simpson

    2014-01-01

    Full Text Available Since the approval of the ICD-10 by the World Health Organization (WHO in 1990, global research on obsessive-compulsive disorder (OCD has expanded dramatically. This article evaluates what changes may be needed to enhance the scientific validity, clinical utility, and global applicability of OCD diagnostic guidelines in preparation for ICD-11. Existing diagnostic guidelines for OCD were compared. Key issues pertaining to clinical description, differential diagnosis, and specifiers were identified and critically reviewed on the basis of the current literature. Specific modifications to ICD guidelines are recommended, including: clarifying the definition of obsessions (i.e., that obsessions can be thoughts, images, or impulses/urges and compulsions (i.e., clarifying that these can be behaviors or mental acts and not calling these “stereotyped”; stating that compulsions are often associated with obsessions; and removing the ICD-10 duration requirement of at least 2 weeks. In addition, a diagnosis of OCD should no longer be excluded if comorbid with Tourette syndrome, schizophrenia, or depressive disorders. Moreover, the ICD-10 specifiers (i.e., predominantly obsessional thoughts, compulsive acts, or mixed should be replaced with a specifier for insight. Based on new research, modifications to the ICD-10 diagnostic guidelines for OCD are recommended for ICD-11.

  12. Body dysmorphic disorder and olfactory reference disorder: proposals for ICD-11

    Directory of Open Access Journals (Sweden)

    David Veale

    2014-01-01

    Full Text Available The article reviews the historical background and symptoms of body dysmorphic disorder (BDD and olfactory reference disorder, and describes the proposals of the WHO ICD-11 Working Group on the Classification of Obsessive-Compulsive and Related Disorders related to these categories. This paper examines the possible classification of BDD symptoms in ICD-10. Four different possible diagnoses are found (hypochondriacal disorder, schizotypal disorder, delusional disorder, or other persistent delusional disorder. This has led to significant confusion and lack of clear identification in ICD-10. Olfactory reference disorder can also be classified as a delusional disorder in ICD-10, but there is no diagnosis for non-delusional cases. The Working Group reviewed the classification and diagnostic criteria of BDD in DSM-5, as well as cultural variations of BDD and olfactory reference disorder that include Taijin Kyofusho. The Working Group has proposed the inclusion of both BDD and olfactory reference disorder in ICD-11, and has provided diagnostic guidelines and guidance on differential diagnosis. The Working Group's proposals for ICD-11 related to BDD and olfactory reference disorder are consistent with available global evidence and current understanding of common mechanisms in obsessive-compulsive and related disorders, and resolve considerable confusion inherent in ICD-10. The proposals explicitly recognize cultural factors. They are intended to improve clinical utility related to appropriate identification, treatment, and resource allocation related to these disorders.

  13. Intracellular fragment of NLRR3 (NLRR3-ICD) stimulates ATRA-dependent neuroblastoma differentiation

    Energy Technology Data Exchange (ETDEWEB)

    Akter, Jesmin [Laboratory of Innovative Cancer Therapeutics, Chiba Cancer Center Research Institute, Chiba 260-8717 (Japan); Takatori, Atsushi, E-mail: atakatori@chiba-cc.jp [Laboratory of Cancer Genetics, Chiba Cancer Center Research Institute, Chiba 260-8717 (Japan); Islam, Md. Sazzadul [Laboratory of Innovative Cancer Therapeutics, Chiba Cancer Center Research Institute, Chiba 260-8717 (Japan); Nakazawa, Atsuko [Department of Pathology, National Center for Child Health and Development, Tokyo (Japan); Ozaki, Toshinori, E-mail: tozaki@chiba-cc.jp [Laboratory of DNA Damage Signaling, Chiba Cancer Center Research Institute, Chiba 260-8717 (Japan); Nagase, Hiroki [Laboratory of Cancer Genetics, Chiba Cancer Center Research Institute, Chiba 260-8717 (Japan); Nakagawara, Akira [Saga Medical Centre, 840-8571 (Japan)

    2014-10-10

    Highlights: • NLRR3 is a membrane protein highly expressed in favorable neuroblastoma. • NLRR3-ICD was produced through proteolytic processing by secretases. • NLRR3-ICD was induced to be translocated into cell nucleus following ATRA exposure. • NLRR3-ICD plays a pivotal role in ATRA-mediated neuroblastoma differentiation. - Abstract: We have previously identified neuronal leucine-rich repeat protein-3 (NLRR3) gene which is preferentially expressed in favorable human neuroblastomas as compared with unfavorable ones. In this study, we have found for the first time that NLRR3 is proteolytically processed by secretases and its intracellular domain (NLRR3-ICD) is then released to translocate into cell nucleus during ATRA-mediated neuroblastoma differentiation. According to our present observations, NLRR3-ICD was induced to accumulate in cell nucleus of neuroblastoma SH-SY5Y cells following ATRA treatment. Since the proteolytic cleavage of NLRR3 was blocked by α- or γ-secretase inhibitor, it is likely that NLRR3-ICD is produced through the secretase-mediated processing of NLRR3. Intriguingly, forced expression of NLRR3-ICD in neuroblastoma SK-N-BE cells significantly suppressed their proliferation as examined by a live-cell imaging system and colony formation assay. Similar results were also obtained in neuroblastoma TGW cells. Furthermore, overexpression of NLRR3-ICD stimulated ATRA-dependent neurite elongation in SK-N-BE cells. Together, our present results strongly suggest that NLRR3-ICD produced by the secretase-mediated proteolytic processing of NLRR3 plays a crucial role in ATRA-mediated neuronal differentiation, and provide a clue to develop a novel therapeutic strategy against aggressive neuroblastomas.

  14. 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.

  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. ICD-10-GM 2008: DIMDI veröffentlicht die endgültige Fassung

    OpenAIRE

    DIMDI-Pressestelle

    2007-01-01

    Das DIMDI hat die endgültige Fassung der ICD-10-GM Version 2008 (Internationale statistische Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, German Modification) auf seinen Internetseiten veröffentlicht.

  17. A Discussion on the Code of Brugada's Syndrome in ICD-10%Brugada综合征的ICD-10编码探讨

    Institute of Scientific and Technical Information of China (English)

    刘红云

    2008-01-01

    目的 探讨Brugada综合征的正确ICD-10编码.方法 通过分析了解Brugada综合征病因以及临床特征,找寻Brugada综合征对应的ICD-10疾病编码.结论 对于新生病种要通过多方面查找资料,以确保编码的准确性和唯一性.

  18. International common-cause failure data exchange. ICDE general coding guidelines - Technical note

    International Nuclear Information System (INIS)

    Several Member countries of the Nuclear Energy Agency of the Organisation for Economic Co-operation and Development (OECD/NEA) have established the International Common-Cause Failure Data Exchange Project (ICDE Project) to encourage multilateral co-operation in the collection and analysis of data relating to Common-Cause Failure (CCF) events. The objectives of the ICDE Project are to: a) Collect and analyse CCF events over the long term so as to better understand such events, their causes, and their prevention; b) Generate qualitative insights into the root causes of CCF events which can then be used to derive approaches or mechanisms for their prevention or for mitigating their consequences; c) Establish a mechanism for the efficient feedback of experience gained in connection with CCF phenomena, including the development of defences against their occurrence, such as indicators for risk based inspections; and d) Record event attributes to facilitate quantification of CCF frequencies when so decided by the Project Working Group. The ICDE Project is envisaged to comprise all possible events of interest, including both complete and partial ICDE events. The ICDE Project will cover the key components of the main safety systems. Presently, the components listed below are included in the ICDE Project. Data have been collected for the six first components in the list: Centrifugal pumps, Diesel generators, Motor operated valves, Safety relief valves/power operated relief valves, Check valves, Batteries, Level measurement, Breakers, Control rod drive assemblies. Others will be added to this list later on. In this component coding guidelines, explanations on the ICDE General coding format are given. The guide reflects present experience with the data format and with the collected data. Further interpretations and clarifications will be added, should they become necessary. For each component analysed in the ICDE project, separate coding guidance is provided in the appendices

  19. Women Literacy and Infant Feeding Practices in Rural Integrated Child Development Scheme (ICDS) Block of Delhi

    OpenAIRE

    Davey Sanjeev , Davey Anuradha

    2012-01-01

    Background: Infant feeding practices have significant effect on the child nutrition, which largely dependent upon the mothers correct knowledge and awareness for the same. Objective: To find out effect of rural women empowerment through literacy on infant feeding practices in an ICDS block. Material and Methodology: Interview of the mothers of registered children up to 6 years in the rural ICDS block for the feeding practices and recording of the weight of those registered children by the sal...

  20. Nuclear Ep-ICD expression is a predictor of poor prognosis in "low risk" prostate adenocarcinomas.

    Directory of Open Access Journals (Sweden)

    Jasmeet Assi

    Full Text Available Molecular markers for predicting prostate cancer (PCa that would have poor prognosis are urgently needed for a more personalized treatment for patients. Regulated intramembrane proteolysis of Epithelial cell adhesion molecule results in shedding of the extracellular domain (EpEx and release of its intracellular domain (Ep-ICD which triggers oncogenic signaling and might correlate to tumor aggressiveness. This study aimed to explore the potential of Ep-ICD and EpEx to identify PCa that have poor prognosis.Immunohistochemical analysis of Ep-ICD and EpEx was carried out in normal prostate tissues (n = 100, benign prostate hyperplasia (BPH, n = 83, and prostate cancer (n = 249 using domain specific antibodies. The expression of Ep-ICD and EpEx was correlated with clinico- pathological parameters and disease free survival (DFS.Reduced expression of nuclear Ep-ICD and membrane EpEx was observed in PCa in comparison with BPH and normal prostate tissues (p = 0.006, p < 0.001 respectively. For patients who had PCa with Gleason Score less than 7, preserved nuclear Ep-ICD emerged as the most significant marker in multivariate analysis for prolonged DFS, where these patients did not have recurrence during follow up of up to 12 years (p = 0.001.Reduced expression of nuclear Ep-ICD was associated with shorter disease free survival in patients with a Gleason Score less than 7 and may be useful in identifying patients likely to have aggressive tumors with poor prognosis. Furthermore, nuclear Ep-ICD can differentiate between normal and prostate cancer tissues for ambiguous cases.

  1. Validation of ICD-9 Codes for Stable Miscarriage in the Emergency Department

    OpenAIRE

    Quinley, Kelly E.; Falck, Ailsa; Kallan, Michael J.; Datner, Elizabeth M.; Carr, Brendan G.; Schreiber, Courtney A.

    2015-01-01

    Introduction: International Classification of Disease, Ninth Revision (ICD-9) diagnosis codes have not been validated for identifying cases of missed abortion where a pregnancy is no longer viable but the cervical os remains closed. Our goal was to assess whether ICD-9 code “632” for missed abortion has high sensitivity and positive predictive value (PPV) in identifying patients in the emergency department (ED) with cases of stable early pregnancy failure (EPF). Methods:...

  2. Validation of ICD-9 Codes for Stable Miscarriage in the Emergency Department

    OpenAIRE

    Quinley, Kelly E.; Falck, Ailsa; Kallan, Michael J.; Datner, Elizabeth M.; Carr, Brendan G.; Schreiber, Courtney A.

    2015-01-01

    Introduction International Classification of Disease, Ninth Revision (ICD-9) diagnosis codes have not been validated for identifying cases of missed abortion where a pregnancy is no longer viable but the cervical os remains closed. Our goal was to assess whether ICD-9 code “632” for missed abortion has high sensitivity and positive predictive value (PPV) in identifying patients in the emergency department (ED) with cases of stable early pregnancy failure (EPF). Methods We studied females ages...

  3. Validation of ICD-9-CM coding algorithm for improved identification of hypoglycemia visits

    OpenAIRE

    Lieberman Rebecca M; Blanc Phillip G; Ginde Adit A; Camargo Carlos A

    2008-01-01

    Abstract Background Accurate identification of hypoglycemia cases by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes will help to describe epidemiology, monitor trends, and propose interventions for this important complication in patients with diabetes. Prior hypoglycemia studies utilized incomplete search strategies and may be methodologically flawed. We sought to validate a new ICD-9-CM coding algorithm for accurate identification of hypoglyc...

  4. Body dysmorphic disorder and olfactory reference disorder: proposals for ICD-11

    OpenAIRE

    David Veale; Hisato Matsunaga

    2014-01-01

    The article reviews the historical background and symptoms of body dysmorphic disorder (BDD) and olfactory reference disorder, and describes the proposals of the WHO ICD-11 Working Group on the Classification of Obsessive-Compulsive and Related Disorders related to these categories. This paper examines the possible classification of BDD symptoms in ICD-10. Four different possible diagnoses are found (hypochondriacal disorder, schizotypal disorder, delusional disorder, or other persistent delu...

  5. Sikkerhed af magnetisk resonans-skanning hos patienter med pacemaker og implanterbar defibrillator

    DEFF Research Database (Denmark)

    Al-Sabagh, Kifah Hekmat; Christensen, Britta Ege; Thøgersen, Anna Margrethe;

    2010-01-01

    INTRODUCTION: The presence of a cardiac implantable device is ICD considered an absolute contraindication to magnetic resonance imaging (MRI). The purpose of this study was to evaluate the safety of performing MRI in patients with cardiac pacemakers and ICDs that had a compelling clinical need fo...... pacemakers with an acceptable risk-benefit ratio, while MRI of patients with ICDs must still be considered an experimental procedure. Udgivelsesdato: 2010-Jun...

  6. Using ICD for structural analysis of clusters: a case study on NeAr clusters

    International Nuclear Information System (INIS)

    We present a method to utilize interatomic Coulombic decay (ICD) to retrieve information about the mean geometric structures of heteronuclear clusters. It is based on observation and modelling of competing ICD channels, which involve the same initial vacancy, but energetically different final states with vacancies in different components of the cluster. Using binary rare gas clusters of Ne and Ar as an example, we measure the relative intensity of ICD into (Ne+)2 and Ne+Ar+ final states with spectroscopically well separated ICD peaks. We compare in detail the experimental ratios of the Ne–Ne and Ne–Ar ICD contributions and their positions and widths to values calculated for a diverse set of possible structures. We conclude that NeAr clusters exhibit a core–shell structure with an argon core surrounded by complete neon shells and, possibly, further an incomplete shell of neon atoms for the experimental conditions investigated. Our analysis allows one to differentiate between clusters of similar size and stochiometric Ar content, but different internal structure. We find evidence for ICD of Ne 2s−1, producing Ar+ vacancies in the second coordination shell of the initial site. (paper)

  7. 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...

  8. 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.

  9. 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...

  10. 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....

  11. COPE-ICD: a randomised clinical trial studying the effects and meaning of a comprehensive rehabilitation programme for ICD recipients -design, intervention and population

    DEFF Research Database (Denmark)

    Berg, Selina K; Svendsen, Jesper H; Zwisler, Ann-Dorthe;

    2011-01-01

    Growing evidence exists that living with an ICD can lead to fear and avoidance behaviour including the avoidance of physical activity. It has been suggested that psychological stress can increase the risk of shock and predict death. Small studies have indicated a beneficial effect arising from...

  12. COPE-ICD: a randomised clinical trial studying the effects and meaning of a comprehensive rehabilitation programme for ICD recipients -design, intervention and population

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Svendsen, Jesper H; Zwisler, Ann-Dorthe;

    2011-01-01

    Growing evidence exists that living with an ICD can lead to fear and avoidance behaviour including the avoidance of physical activity. It has been suggested that psychological stress can increase the risk of shock and predict death. Small studies have indicated a beneficial effect arising from...... exercise training and psychological intervention, therefore a large-scale rehabilitation programme was set up....

  13. Sikkerhed af magnetisk resonans-skanning hos patienter med pacemaker og implanterbar defibrillator

    DEFF Research Database (Denmark)

    Al-Sabagh, Kifah Hekmat; Christensen, Britta Ege; Thøgersen, Anna Margrethe;

    2010-01-01

    INTRODUCTION: The presence of a cardiac implantable device is ICD considered an absolute contraindication to magnetic resonance imaging (MRI). The purpose of this study was to evaluate the safety of performing MRI in patients with cardiac pacemakers and ICDs that had a compelling clinical need fo...

  14. Obsessive compulsive and related disorders: comparing DSM-5 and ICD-11.

    Science.gov (United States)

    Marras, Anna; Fineberg, Naomi; Pallanti, Stefano

    2016-08-01

    Obsessive-compulsive disorder (OCD) has been recognized as mainly characterized by compulsivity rather than anxiety and, therefore, was removed from the anxiety disorders chapter and given its own in both the American Psychiatric Association (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the Beta Draft Version of the 11th revision of the World Health Organization (WHO) International Classification of Diseases (ICD-11). This revised clustering is based on increasing evidence of common affected neurocircuits between disorders, differently from previous classification systems based on interrater agreement. In this article, we focus on the classification of obsessive-compulsive and related disorders (OCRDs), examining the differences in approach adopted by these 2 nosological systems, with particular attention to the proposed changes in the forthcoming ICD-11. At this stage, notable differences in the ICD classification are emerging from the previous revision, apparently converging toward a reformulation of OCRDs that is closer to the DSM-5. PMID:27401060

  15. Tourette and tic disorders in ICD-11: standing at the diagnostic crossroads.

    Science.gov (United States)

    Woods, Douglas W; Thomsen, Per H

    2014-01-01

    This article reflects discussion by the WHO ICD-11 Working Group on the Classification of Obsessive-Compulsive and Related Disorders. After reviewing the historical classification of tic disorders, this article discusses their placement in ICD-11. Existing problems with diagnostic labels and criteria, appropriate placement of the tic disorders category within the ICD-11 system, and pragmatic factors affecting classification are reviewed. The article ends with recommendations to (a) maintain consistency with the DSM-5 diagnostic labels for tic disorders, (b) add a minimum duration guideline for a provisional tic disorder diagnosis, (c) remove the multiple motor tic guideline for the diagnosis of Tourette disorder, and (d) co-parent the tic disorder diagnoses in the disorders of the nervous system and the mental and behavioral disorders categories, with secondary co-parenting in the obsessive-compulsive and related disorders and neurodevelopmental disorders sections. PMID:25388612

  16. Tourette and tic disorders in ICD-11: standing at the diagnostic crossroads

    Directory of Open Access Journals (Sweden)

    Douglas W. Woods

    2014-01-01

    Full Text Available This article reflects discussion by the WHO ICD-11 Working Group on the Classification of Obsessive-Compulsive and Related Disorders. After reviewing the historical classification of tic disorders, this article discusses their placement in ICD-11. Existing problems with diagnostic labels and criteria, appropriate placement of the tic disorders category within the ICD-11 system, and pragmatic factors affecting classification are reviewed. The article ends with recommendations to (a maintain consistency with the DSM-5 diagnostic labels for tic disorders, (b add a minimum duration guideline for a provisional tic disorder diagnosis, (c remove the multiple motor tic guideline for the diagnosis of Tourette disorder, and (d co-parent the tic disorder diagnoses in the disorders of the nervous system and the mental and behavioral disorders categories, with secondary co-parenting in the obsessive-compulsive and related disorders and neurodevelopmental disorders sections.

  17. Migration to the ICD-10 coding system: A primer for spine surgeons (Part 1

    Directory of Open Access Journals (Sweden)

    Gazanfar Rahmathulla

    2014-01-01

    Full Text Available Background: On 1 October 2015, a new federally mandated system goes into effect requiring the replacement of the International Classification of Disease-version 9-Clinical Modification (ICD-9-CM with ICD-10-CM. These codes are required to be used for reimbursement and to substantiate medical necessity. ICD-10 is composite with as many as 141,000 codes, an increase of 712% when compared to ICD-9. Methods: Execution of the ICD-10 system will require significant changes in the clinical administrative and hospital-based practices. Through the transition, diminished productivity and practice revenue can be anticipated, the impacts of which the spine surgeon can minimizeby appropriate education and planning. Results: The advantages of the new system include increased clarity and more accurate definitions reflecting patient condition, information relevant to ambulatory and managed care encounters, expanded injury codes, laterality, specificity, precise data for safety and compliance reporting, data mining for research, and finally, enabling pay-for-performance programs. The disadvantages include the cost per physician, training administrative staff, revenue loss during the learning curve, confusion, the need to upgrade hardware along with software, and overall expense to the healthcare system. Conclusions: With the deadline rapidly approaching, gaps in implementation result in delayed billing, delayed or diminished reimbursements, and absence of quality and outcomes data. It is thereby essential for spine surgeons to understand their role in transitioning to this new environment. Part I of this article discusses the background, coding changes, and costs as well as reviews the salient features of ICD-10 in spine surgery

  18. COPE-ICD: A randomised clinical trial studying the effects and meaning of a comprehensive rehabilitation programme for ICD recipients -design, intervention and population

    Directory of Open Access Journals (Sweden)

    Pedersen Birthe D

    2011-06-01

    Full Text Available Abstract Background Growing evidence exists that living with an ICD can lead to fear and avoidance behaviour including the avoidance of physical activity. It has been suggested that psychological stress can increase the risk of shock and predict death. Small studies have indicated a beneficial effect arising from exercise training and psychological intervention, therefore a large-scale rehabilitation programme was set up. Methods/Design A mixed methods embedded experimental design was chosen to include both quantitative and qualitative measures. A randomised clinical trial is its primary component. 196 patients (power-calculated were block randomised to either a control group or intervention group at a single centre. The intervention consists of a 1-year psycho-educational component provided by two nurses and a 12-week exercise training component provided by two physiotherapists. Our hypothesis is that the COPE-ICD programme will reduce avoidance behaviour, sexual dysfunction and increase quality of life, increase physical capability, reduce the number of treatment-demanding arrhythmias, reduce mortality and acute re-hospitalisation, reduce sickness leading to absence from work and be cost-effective. A blinded investigator will perform all physical tests and data collection. Discussion Most participants are men (79% with a mean age of 58 (range 20-85. Most ICD implantations are on primary prophylactic indication (66%. 44% is NYHA II. Mean walk capacity (6MWT is 417 m. Mean perception of General Health (SF-36 is PCS 42.6 and MCS 47.1. A large-scale ICD rehabilitation trial including psycho-educational intervention and exercise training has been initiated and will report findings starting in 2011. Trial Registration ClinicalTrials.gov: NCT00569478

  19. COPE-ICD: A randomised clinical trial studying the effects and meaning of a comprehensive rehabilitation programme for ICD recipients -design, intervention and population

    OpenAIRE

    Pedersen Birthe D; Zwisler Ann-Dorthe; Svendsen Jesper H; Berg Selina K; Preisler Pernille; Siersbæk-Hansen Lone; Hansen Mette B; Nielsen Rune H; Pedersen Preben U

    2011-01-01

    Abstract Background Growing evidence exists that living with an ICD can lead to fear and avoidance behaviour including the avoidance of physical activity. It has been suggested that psychological stress can increase the risk of shock and predict death. Small studies have indicated a beneficial effect arising from exercise training and psychological intervention, therefore a large-scale rehabilitation programme was set up. Methods/Design A mixed methods embedded experimental design was chosen ...

  20. Inter-atomic Coulombic Decay (ICD) of clusters upon electron impact

    International Nuclear Information System (INIS)

    Full text: ICD is proposed to be a universal ionization mechanism in clusters, where one atom absorbs energy, becomes inner valence ionized and the excess energy is transferred to a neighboring atom via a virtual photon, leading to its ionization. Thus the cluster ends up with two positively charged particles exploding due to the Coulombic force. In the present study mass spectrometry is used to investigate the presence of ICD relaxation mechanisms in neon clusters. This is done by measuring the initial kinetic energy of product ions after electron impact of the clusters. (author)

  1. 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....

  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. OPS und ICD-10-GM Versionen 2006: Redaktionsschluss für Änderungsvorschläge

    OpenAIRE

    Müller, W.

    2004-01-01

    Zur Weiterentwicklung des G-DRG-Systems werden die Klassifikationen OPS und ICD-10-GM kontinuierlich bearbeitet und angepasst. Änderungsvorschläge zu den Klassifikationen nimmt das DIMDI entgegen. Der Redaktionsschluss für Änderungsvorschläge zu den OPS- und ICD-10-Versionen des Jahres 2006 ist am 31. März 2005.

  4. Consequences of the Diagnostic Criteria Proposed for the ICD-11 on the Prevalence of PTSD in Children and Adolescents.

    Science.gov (United States)

    Sachser, Cedric; Goldbeck, Lutz

    2016-04-01

    In 2013, a working group of the World Health Organization (WHO) proposed a reformulation of the posttraumatic stress disorder (PTSD) diagnostic criteria for the upcoming 11(th) edition of the International Classification of Diseases (ICD-11; Maercker, Brewin, Bryant, Cloitre, van Ommeren, et al., 2013). This study investigated the consequences of the proposed ICD-11 PTSD symptom reduction on the prevalence of PTSD in children and adolescents. Prevalence rates of PTSD in a clinical sample of 159 traumatized children and adolescents were compared applying criteria according to the 4(th) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994), the ICD-10 (WHO, 1992), and the ICD-11. The prevalence rate was 76.1% using DSM-IV, 88.1% using ICD-10, and 61.0% using ICD-11. The use of the criteria proposed for ICD-11 resulted in 27.1% less positive cases compared with ICD-10 and 15.1% less positive cases compared with DSM-IV. Our results showed that in a clinical sample of children and adolescents the prevalence of PTSD was significantly affected by the use of different diagnostic systems. This will constitute a major challenge for research and practice because, depending on the algorithm used, different groups of patients will be included in studies and different groups of individuals will be able to access medical care and therapy. PMID:26915520

  5. 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。

  6. 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

  7. ICD-10-GM 2009: Vorabversion beim DIMDI veröffentlicht

    OpenAIRE

    DIMDI-Pressestelle

    2008-01-01

    Die vorläufige Fassung der ICD-10-GM 2009 steht als Vorabversion ab sofort auf den Internetseiten des DIMDI bereit. Bitte beachten Sie, dass es in der endgültigen amtlichen Fassung noch Änderungen gegenüber dieser Vorabversion geben kann.

  8. ICD-10-GM und OPS: Neue Versionen für das Jahr 2005

    OpenAIRE

    Müller, W.

    2004-01-01

    Das Deutsche Institut für Medizinische Dokumentation und Information (DIMDI) teilt mit: Für das DRG-Vergütungssystem beginnt am 1. Januar 2005 die Konvergenzphase. Zur Vorbereitung darauf hat das DIMDI die neuen Versionen 2005 der Internationalen Klassifikation der Krankheiten (ICD-10-GM) und des Operationen- und Prozedurenschlüssels (OPS) auf seinen Internetseiten veröffentlicht.

  9. ICD-10-GM 2008: Vorabversion beim DIMDI veröffentlicht

    OpenAIRE

    DIMDI-Pressestelle

    2007-01-01

    Die vorläufige Fassung der ICD-10-GM 2008 steht als Vorabversion ab sofort auf den Internetseiten des DIMDI bereit. Bitte beachten Sie, dass gegenüber der endgültigen Fassung noch Änderungen möglich sind.

  10. DIMDI veröffentlicht Vorabversionen von OPS Version 2010 und ICD-10-GM 2010

    OpenAIRE

    DIMDI-Pressestelle

    2009-01-01

    Die vorläufigen Fassungen des OPS 2010 und des ICD-10-GM werden ab sofort auf den Internetseiten des DIMDI publiziert. Bitte beachten Sie, dass es in der endgültigen amtlichen Fassung noch Änderungen gegenüber diesen Vorabversionen geben kann.

  11. DIMDI veröffentlicht Vorabversion der ICD-10-GM 2012

    OpenAIRE

    DIMDI-Pressestelle

    2011-01-01

    Die vorläufige Fassung der ICD-10-GM 2012 finden Sie ab sofort auf den Internetseiten des DIMDI. Bitte beachten Sie, dass es in der endgültigen amtlichen Fassung noch Änderungen gegenüber dieser Vorabversion geben kann.

  12. Reliability of clinical ICD-10 diagnoses among electroconvulsive therapy patients with chronic affective disorders

    DEFF Research Database (Denmark)

    Jakobsen, Klaus Damgaard; Hansen, Thomas Folkmann; Dam, Henrik;

    2008-01-01

    investigated. A standardized schema for basic anamnesis and the Operational Criteria Checklist for Psychotic and Affective Illness (OPCRIT) were used. The sensitivity, specificity, positive and negative predictive values of clinical affective disorder ICD-10 diagnoses and the formal agreement between clinical...

  13. Using Semantic Web technology to support icd-11 textual definitions authoring.

    Science.gov (United States)

    Jiang, Guoqian; Solbrig, Harold R; Chute, Christopher G

    2013-01-01

    The beta phase of the 11th revision of International Classification of Diseases (ICD-11) intends to accept public input through a distributed model of authoring. One of the core use cases is to create textual definitions for the ICD categories. The objective of the present study is to design, develop, and evaluate approaches to support ICD-11 textual definitions authoring using Semantic Web technology. We investigated a number of heterogeneous resources related to the definitions of diseases, including the linked open data (LOD) from DBpedia, the textual definitions from the Unified Medical Language System (UMLS) and the formal definitions of the Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT). We integrated them in a Semantic Web framework (i.e., the Linked Data in a Resource Description Framework [RDF] triple store), which is being proposed as a backend in a prototype platform for collaborative authoring of ICD-11 beta. We performed a preliminary evaluation on the usefulness of our approaches and discussed the potential challenges from both technical and clinical perspectives. PMID:23601451

  14. Metrics and tools for consistent cohort discovery and financial analyses post-transition to ICD-10-CM.

    Science.gov (United States)

    Boyd, Andrew D; Li, Jianrong John; Kenost, Colleen; Joese, Binoy; Yang, Young Min; Kalagidis, Olympia A; Zenku, Ilir; Saner, Donald; Bahroos, Neil; Lussier, Yves A

    2015-05-01

    In the United States, International Classification of Disease Clinical Modification (ICD-9-CM, the ninth revision) diagnosis codes are commonly used to identify patient cohorts and to conduct financial analyses related to disease. In October 2015, the healthcare system of the United States will transition to ICD-10-CM (the tenth revision) diagnosis codes. One challenge posed to clinical researchers and other analysts is conducting diagnosis-related queries across datasets containing both coding schemes. Further, healthcare administrators will manage growth, trends, and strategic planning with these dually-coded datasets. The majority of the ICD-9-CM to ICD-10-CM translations are complex and nonreciprocal, creating convoluted representations and meanings. Similarly, mapping back from ICD-10-CM to ICD-9-CM is equally complex, yet different from mapping forward, as relationships are likewise nonreciprocal. Indeed, 10 of the 21 top clinical categories are complex as 78% of their diagnosis codes are labeled as "convoluted" by our analyses. Analysis and research related to external causes of morbidity, injury, and poisoning will face the greatest challenges due to 41 745 (90%) convolutions and a decrease in the number of codes. We created a web portal tool and translation tables to list all ICD-9-CM diagnosis codes related to the specific input of ICD-10-CM diagnosis codes and their level of complexity: "identity" (reciprocal), "class-to-subclass," "subclass-to-class," "convoluted," or "no mapping." These tools provide guidance on ambiguous and complex translations to reveal where reports or analyses may be challenging to impossible.Web portal: http://www.lussierlab.org/transition-to-ICD9CM/Tables annotated with levels of translation complexity: http://www.lussierlab.org/publications/ICD10to9. PMID:25681260

  15. Less is more? Assessing the validity of the ICD-11 model of PTSD across multiple trauma samples

    Directory of Open Access Journals (Sweden)

    Maj Hansen

    2015-10-01

    Full Text Available Background: In the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, the symptom profile of posttraumatic stress disorder (PTSD was expanded to include 20 symptoms. An alternative model of PTSD is outlined in the proposed 11th edition of the International Classification of Diseases (ICD-11 that includes just six symptoms. Objectives and method: The objectives of the current study are: 1 to independently investigate the fit of the ICD-11 model of PTSD, and three DSM-5-based models of PTSD, across seven different trauma samples (N=3,746 using confirmatory factor analysis; 2 to assess the concurrent validity of the ICD-11 model of PTSD; and 3 to determine if there are significant differences in diagnostic rates between the ICD-11 guidelines and the DSM-5 criteria. Results: The ICD-11 model of PTSD was found to provide excellent model fit in six of the seven trauma samples, and tests of factorial invariance showed that the model performs equally well for males and females. DSM-5 models provided poor fit of the data. Concurrent validity was established as the ICD-11 PTSD factors were all moderately to strongly correlated with scores of depression, anxiety, dissociation, and aggression. Levels of association were similar for ICD-11 and DSM-5 suggesting that explanatory power is not affected due to the limited number of items included in the ICD-11 model. Diagnostic rates were significantly lower according to ICD-11 guidelines compared to the DSM-5 criteria. Conclusions: The proposed factor structure of the ICD-11 model of PTSD appears valid across multiple trauma types, possesses good concurrent validity, and is more stringent in terms of diagnosis compared to the DSM-5 criteria.

  16. Minding the body: situating gender identity diagnoses in the ICD-11.

    Science.gov (United States)

    Drescher, Jack; Cohen-Kettenis, Peggy; Winter, Sam

    2012-12-01

    The World Health Organization (WHO) is in the process of revising the International Statistical Classification of Diseases and Related Health Problems (ICD) and ICD-11 has an anticipated publication date of 2015. The Working Group on the Classification of Sexual Disorders and Sexual Health (WGSDSH) is charged with evaluating clinical and research data to inform the revision of diagnostic categories related to sexuality and gender identity that are currently included in the mental and behavioural disorders chapter of ICD-10, and making initial recommendations regarding whether and how these categories should be represented in the ICD-11. The diagnostic classification of disorders related to (trans)gender identity is an area long characterized by lack of knowledge, misconceptions and controversy. The placement of these categories has shifted over time within both the ICD and the American Psychiatric Association's Diagnostic and Statistical Manual (DSM), reflecting developing views about what to call these diagnoses, what they mean and where to place them. This article reviews several controversies generated by gender identity diagnoses in recent years. In both the ICD-11 and DSM-5 development processes, one challenge has been to find a balance between concerns related to the stigmatization of mental disorders and the need for diagnostic categories that facilitate access to healthcare. In this connection, this article discusses several human rights issues related to gender identity diagnoses, and explores the question of whether affected populations are best served by placement of these categories within the mental disorders section of the classification. The combined stigmatization of being transgender and of having a mental disorder diagnosis creates a doubly burdensome situation for this group, which may contribute adversely to health status and to the attainment and enjoyment of human rights. The ICD-11 Working Group on the Classification of Sexual Disorders and

  17. The relationship of reactive psychosis and ICD-10 acute and transient psychotic disorders: evidence from a case register-based comparison

    DEFF Research Database (Denmark)

    Castagnini, Augusto; Bertelsen, Aksel; Munk-Jørgensen, Povl;

    2006-01-01

    relationship between the concept of reactive psychosis (RP), equivalent to the ICD-8 298 category of 'other psychoses', and ATPD. SAMPLING AND METHOD: Since January 1, 1994, ICD-10 has replaced ICD-8 as official classification in Denmark. Patients given an ICD-8 298 diagnosis on their last admission in 1992...... accounted for 8.7% of those with non-organic psychotic and affective disorders in 1994-1995. Thirty-eight per cent of patients with an ICD-8 298 diagnosis were readmitted during the years 1994-1995. Schizophrenia and related disorders (F2) and affective disorders (F3) accounted for three quarters of ICD-10......-1993 were identified from the Danish Psychiatric Central Register, and the ICD-8 diagnoses assigned were compared with their ICD-10 diagnoses when readmitted in 1994-1995. RESULTS: Diagnosis of RP was recorded in 19.2% of patients with functional psychoses in 1992-1993, whereas ATPD overall prevalence...

  18. 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...

  19. OECD/NEA International Common Cause Failure Data Exchange (ICDE) project - insights and lessons learnt

    International Nuclear Information System (INIS)

    Events initiated by common-cause-failure (CCF) can significantly affect the availability and reliability of nuclear power plant safety systems. In recognition of this, CCF data are systematically collected and analysed in the International Common-Cause Data Exchange (ICDE) Project, which was initiated in August 1994. Since April 1998, the NEA has formally operated the project. Currently eleven countries participate in the project. The ICDE collects all events where two or more identical, redundant components of a group, fulfilling the same function, have failed or were impaired due to a shared cause (ICDE events). Complete CCFs, i. e. failure of all identical, redundant components in the group due to a shared cause are an important subset of the collected data. Currently, data exchange and analysis covers the following components: centrifugal pumps, diesel generators, motor-operated valves, safety and relief valves, check valves, reactor protection system components (level measurement, control rod drives, etc), circuit breakers, and batteries. The main findings of the ICDE reports issued by 2005 show averaged over all components that about two thirds of all complete CCF events involve faulty actions by plant personnel and contractors. The single largest contribution is from faulty testing and maintenance work due to deficient and/or incomplete procedures. Other important causes are insufficient testing and requalification of components or systems after maintenance, repair, modifications or backfitting work, as well as operator errors of commission. The probability that a reported ICDE event is a complete CCF decreases strongly with increasing number of redundant components, demonstrating the effectiveness of redundancy as a powerful defence against CCFs. However, complete CCFs cannot be completely prevented by high redundancy only. (orig.)

  20. [The trends of mood disorders in ICD-11: bipolar and depressive disorders].

    Science.gov (United States)

    Kurumaji, Akeo

    2013-01-01

    The international classification of diseases 11th (ICD-11) revision is due by 2015. The ICD-11 beta draft has recently been released, which includes a prospective change in the content of mood disorders. The ICD-11 may separate the disorders into bipolar and depressive disorders as a consequence of an evaluation for the feasibility of a meta-structure for mental and behavioral disorders. In addition, the bipolar disorders may be divided into type I and II disorders. The depressive disorders may include new diseases, i. e., disruptive mood dysregulation disorder, mixed depressive anxiety, and premenstrual dysphoric disorder. Our epidemiological data from patients with mood disorders diagnosed using the ICD-10 or DSM-IV have proven their utility in clinical use, and suggested a required revision for the criteria of the diagnosis. A part of persistent mood disorders, such as cyclothymia and dysthymia, seem to be the prodromal state of bipolar disorders. For an accurate assessment of manic and hypomanic episodes, a precise estimation of the physiological effects of antidepressants as well as a sufficient review of clinical information from family members of patients are mandatory. The mixed affective episode may be deleted in the new version, because our data also indicate that this episode is a very rare clinical state. Moreover, it appears that inpatients with bipolar II disorder diagnosed by the DSM-IV in our hospital showed heterogeneous clinical properties, such as the onset age and interval between the first depressive and first hypomanic episode. After a worldwide and intensive discussion, it appears that the newly revised ICD-11 will be an advanced scientific tool for psychiatry. PMID:23691796

  1. The ERα coactivator, HER4/4ICD, regulates progesterone receptor expression in normal and malignant breast epithelium

    Directory of Open Access Journals (Sweden)

    Howard Beatrice A

    2010-06-01

    Full Text Available Abstract The HER4 intracellular domain (4ICD is a potent estrogen receptor (ERα coactivator with activities in breast cancer and the developing mammary gland that appear to overlap with progesterone receptor (PgR. In fact, 4ICD has recently emerged as an important regulator and predictor of tamoxifen response, a role previously thought to be fulfilled by PgR. Here we investigated the possibility that the 4ICD coactivator regulates PgR expression thereby providing a mechanistic explanation for their partially overlapping activities in breast cancer. We show that 4ICD is both sufficient and necessary to potentiate estrogen stimulation of gene expression. Suppression of HER4/4ICD expression in the MCF-7 breast tumor cell line completely eliminated estrogen stimulated expression of PgR. In addition, the HER4/4ICD negative MCF-7 variant, TamR, failed to express PgR in response to estrogen. Reintroduction of wild-type HER4 but not the γ-secretase processing mutant HER4V673I into the TamR cell line restored PgR expression indicating that 4ICD is an essential PgR coactivator in breast tumor cells. These results were substantiated in vivo using two different physiologically relevant experimental systems. In the mouse mammary gland estrogen regulates expression of PgR-A whereas expression of PgR-B is estrogen independent. Consistent with a role for 4ICD in estrogen regulated PgR expression in vivo, PgR-A, but not PgR-B, expression was abolished in HER4-null mouse mammary glands during pregnancy. Coexpression of PgR and 4ICD is also commonly observed in ERα positive breast carcinomas. Using quantitative AQUA IHC technology we found that 4ICD potentiated PgR expression in primary breast tumors and the highest levels of PgR expression required coexpression of ERα and the 4ICD coactivator. In summary, our results provide compelling evidence that 4ICD is a physiologically important ERα coactivator and 4ICD cooperates with ERα to potentiate PgR expression

  2. Arrhythmia risk stratification of patients after myocardial infarction using personalized heart models.

    Science.gov (United States)

    Arevalo, Hermenegild J; Vadakkumpadan, Fijoy; Guallar, Eliseo; Jebb, Alexander; Malamas, Peter; Wu, Katherine C; Trayanova, Natalia A

    2016-01-01

    Sudden cardiac death (SCD) from arrhythmias is a leading cause of mortality. For patients at high SCD risk, prophylactic insertion of implantable cardioverter defibrillators (ICDs) reduces mortality. Current approaches to identify patients at risk for arrhythmia are, however, of low sensitivity and specificity, which results in a low rate of appropriate ICD therapy. Here, we develop a personalized approach to assess SCD risk in post-infarction patients based on cardiac imaging and computational modelling. We construct personalized three-dimensional computer models of post-infarction hearts from patients' clinical magnetic resonance imaging data and assess the propensity of each model to develop arrhythmia. In a proof-of-concept retrospective study, the virtual heart test significantly outperformed several existing clinical metrics in predicting future arrhythmic events. The robust and non-invasive personalized virtual heart risk assessment may have the potential to prevent SCD and avoid unnecessary ICD implantations. PMID:27164184

  3. [Ventricular tachyarrhythmias. A retrospective analysis of etiology, demography and treatment

    DEFF Research Database (Denmark)

    Christensen, A.H.; Henningsen, K.; Svendsen, Jesper Hastrup

    2008-01-01

    INTRODUCTION: The aim of this study was to investigate the age, sex, etiology, frequency of implantable cardioverter-defibrillator (ICD) and previous cardiac arrest among patients discharged from the Department of Cardiology, Rigshospitalet (Copenhagen University Hospital), Denmark, due to...... average age of 59 years (ranging 15-95 years) with a majority of males (76%). Among the patients with known etiology ischemic heart disease (60%), dilated cardiomyopathy (6%) and arrhythmogenic right ventricular cardiomyopathy (6%) were the most frequent. A substantial number of the patients (15%) had...... unknown etiology; 492 (50%) of the patients overall had an ICD implanted, the majority of whom had been categorized as having ventricular tachycardia (92%); 168 patients had previous cardiac arrest, 127 of whom did not have a potential reversible cause. Of this group 75 (59%) had an ICD implanted...

  4. Stratification of the Risk of Sudden Death in Nonischemic Heart Failure

    Directory of Open Access Journals (Sweden)

    Maurício Pimentel

    2014-10-01

    Full Text Available Despite significant therapeutic advancements, heart failure remains a highly prevalent clinical condition associated with significant morbidity and mortality. In 30%-40% patients, the etiology of heart failure is nonischemic. The implantable cardioverter-defibrillator (ICD is capable of preventing sudden death and decreasing total mortality in patients with nonischemic heart failure. However, a significant number of patients receiving ICD do not receive any kind of therapy during follow-up. Moreover, considering the situation in Brazil and several other countries, ICD cannot be implanted in all patients with nonischemic heart failure. Therefore, there is an urgent need to identify patients at an increased risk of sudden death because these would benefit more than patients at a lower risk, despite the presence of heart failure in both risk groups. In this study, the authors review the primary available methods for the stratification of the risk of sudden death in patients with nonischemic heart failure.

  5. 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.

  6. Prognostic value of tissue Doppler imaging for predicting ventricular arrhythmias and cardiovascular mortality in ischaemic cardiomyopathy

    DEFF Research Database (Denmark)

    Biering-Sørensen, Tor; Olsen, Flemming Javier; Storm, Katrine;

    2016-01-01

    .0 vs. 5.7 ± 1.8 cm/s, P = 0.020). Global a' remained an independent predictor of VT/VF/CVD after multivariable adjustment for age, gender, β-blocker therapy, and deceleration time (HR = 1.25 [1.02, 1.54], P = 0.032). Regional analysis revealed that a depressed a' in the inferior wall drives the......AIMS: Only 30% of patients receiving an implantable cardioverter defibrillator (ICD) for primary prevention receive appropriately therapy. We sought to investigate the value of tissue Doppler imaging (TDI) to predict ventricular tachycardia (VT), ventricular fibrillation (VF), and cardiovascular...

  7. Loeffler endocarditis: silent right ventricular myocardium!

    Science.gov (United States)

    Çetin, Süha; Heper, Gülümser; Gökhan Vural, Mustafa; Hazirolan, Tuncay

    2016-07-01

    We present the case of a 54-year-old male patient with Loeffler endocarditis. It is a rare disorder characterized by fibrous thickening of the endocardium leading to apical obliteration and restrictive cardiomyopathy resulting in heart failure, thromboembolic events or atrial fibrillation. To the best of our knowledge, this is the first case reporting the electrical silence of the right ventricular (RV) apex caused by fibrothrombotic thickening of this area. Under these circumstances RV apical implantation of an implantable cardioverter defibrillator (ICD) or pacemaker electrode may lead to unsuccessful stimulation of these devices. PMID:26980214

  8. 033 移动电话对ICD的影响

    Institute of Scientific and Technical Information of China (English)

    陈元秀; 黄从新

    2000-01-01

    @@ Eraldo测试了移动电话(手机)对30例植入除颤器(implantable cardioverter defibrillator;ICD)患者的影响.30例患者中男26例,女4例.ICD型号包括Telectronics7例;CPI 7例,Medtronic 7例,Ventritex 5例;Ela medical 4例.测试过程中连续监测体表心电图改变.

  9. Transient loss of consciousness in a patient with a Brugada like ECG

    Directory of Open Access Journals (Sweden)

    Belinda Sandler

    2011-11-01

    Full Text Available Syncope in a patient with a Brugada syndrome channelopathy carries significant prognostic implications and warrants consideration of implantable cardioverter defibrillator (ICD implantation. We report a case of a 62- year-old gentleman who presented with a transient loss of consciousness and an electrocardiogram (ECG suggestive of type 1 Brugada syndrome. Further investigation revealed evidence of a silent myocardial infarction and negative ventricular tachycardia stimulation and Ajmaline testing. Careful review of the ECG’s subsequently showed the type 1 pattern was present in only V1.

  10. 心脏自动复律除颤器的临床应用

    Institute of Scientific and Technical Information of China (English)

    李爱国

    2005-01-01

    @@ 心脏性猝死是目前世界上尚未解决的医学难题.美国每年约有45万人死于该病,几乎每分钟死亡1人,而恶性室性快速性心律失常为其主要原因,约占心脏性猝死的87%.植入型心律转复除颤器(Implantable cardioverter defibrillator,ICD)的应用为恶性室性心律失常的治疗开辟了一个新领域.

  11. Designing Shared Electronic Records for Chronic Care

    DEFF Research Database (Denmark)

    Bansler, Jørgen Peter; Havn, Erling C.; Mønsted, Troels

    This paper reports preliminary findings from an ongoing research project on the development of IT support for communication and information sharing across institutional and professional boundaries within the Danish healthcare system. The project focuses on the treatment of patients with implanted...... ICDs (implantable cardioverter-defibrillator). These are chronic patients who usually see several different healthcare providers on a regular basis. The main findings so far are: (1) Most of the data produced and recorded as part of the care process are context-specific and often difficult to interpret...

  12. Concordance of ICD-11 and DSM-5 definitions of alcohol and cannabis use disorders: a population survey.

    Science.gov (United States)

    Lago, Luise; Bruno, Raimondo; Degenhardt, Louisa

    2016-07-01

    The proposed criteria for alcohol and cannabis use disorders in the 11th edition of ICD (ICD-11) will be presented to the World Health Assembly in 2017, but the beta-phase descriptions have been released. We compared them with those in the tenth edition (ICD-10) and the American Psychiatric Association's DSM fourth edition (DSM-IV) and fifth edition (DSM-5), in a nationally representative sample of adult Australians. Disorders were assessed with the WHO World Mental Health Composite International Diagnostic Interview. The proportions classified as being dependent on alcohol and cannabis were similar with ICD-10, ICD-11, and DSM-IV, whereas for DSM-5, the proportion of lifetime users meeting the criteria for moderate to severe use (most comparable to dependence in the other systems) was far higher. We assessed whether criteria for alcohol and cannabis use described unidimensional syndromes for each, and all definitions seemed to do so. Classification of alcohol and cannabis use disorders, although simplified in ICD-11, was in almost perfect agreement with the classifications of ICD-10 and DSM-IV. With DSM-5, use disorder seemed to capture a different aspect of problematic use and selected a different group of individuals from the other systems. How the newest definitions will become used remains to be seen. The choice of classification might depend on the clinical population of interest. PMID:27371989

  13. 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

  14. 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...

  15. 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...

  16. 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...

  17. 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.

  18. Psychopathy in childhood: Toward better informing the DSM-5 and ICD-11 conduct disorder specifiers.

    Science.gov (United States)

    Salekin, Randall T

    2016-04-01

    Callous unemotional traits have been incorporated into the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) and are being considered for the International Classification of Diseases 11th Revision (ICD-11). Despite the centrality of callous-unemotional (CU) traits it is only 1 of 3 dimensions of child psychopathy. It is proposed that the grandiose-manipulative (GM) and daring-impulsive (DI) traits also be considered and potentially incorporated as specifiers for conduct disorder (CD) in future versions of the DSM and ICD. Such an addition would make a larger contribution to our understanding of youth with CD allowing clinicians to better describe and treat individuals with conduct problems (CP). However, before such specifiers are adopted, future research is needed to test the proposed specifiers interaction with CD. (PsycINFO Database Record PMID:26389622

  19. ICDE project report: collection and analysis of common-cause failures of batteries

    International Nuclear Information System (INIS)

    This report documents a study performed on the set of Common Cause Failure (CCF) events of batteries (BT). the events studied here were derived from the International CCF Data Exchange (ICDE) database, with contributions from organizations from several countries. 50 events in the ICDE database were studied by tabulating the data and observing the trends. The data span a period from 1980 through 2000. The database contains general information about event attributes such as root cause, coupling factor, common cause component group (CCCG) size, and corrective action. The objective of the report was also to develop the failure mechanisms and phenomena involved in the events, their relationship to the root causes, and possibilities for improvement

  20. ICD-10-GM 2011: DIMDI veröffentlicht endgültige Fassung

    OpenAIRE

    Müller, W.; DIMDI-Pressestelle

    2010-01-01

    Das DIMDI hat die endgültige Fassung der ICD-10-GM Version 2011 (Internationale Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, German Modification) auf seinen Internetseiten veröffentlicht. In die neue Version flossen knapp 60 Vorschläge aus Fachgesellschaften und von Fachleuten aus Ärzteschaft, Krankenkassen und Kliniken ein sowie zahlreiche Änderungen der Weltgesundheitsorganisation (WHO). Die Klassifikation bildet die Basis für das pauschalierende Vergütungssystem G-DRG...

  1. ICD-10-GM 2012: DIMDI veröffentlicht endgültige Fassung

    OpenAIRE

    Müller, W.; DIMDI-Pressestelle

    2011-01-01

    Das DIMDI hat die endgültige Fassung der ICD-10-GM Version 2012 (Internationale Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, German Modification) auf seinen Internetseiten veröffentlicht. In die neue Version flossen knapp 80 Vorschläge aus Fachgesellschaften und von Fachleuten aus Ärzteschaft, Krankenkassen und Kliniken sowie Änderungen der Weltgesundheitsorganisation (WHO) ein. Die Klassifikation bildet die Basis für das pauschalierende Vergütungssystem G-DRG (German Di...

  2. An Ensemble Learning Based Framework for Traditional Chinese Medicine Data Analysis with ICD-10 Labels

    OpenAIRE

    Gang Zhang; Yonghui Huang; Ling Zhong; Shanxing Ou; Yi Zhang; Ziping Li

    2015-01-01

    Objective. This study aims to establish a model to analyze clinical experience of TCM veteran doctors. We propose an ensemble learning based framework to analyze clinical records with ICD-10 labels information for effective diagnosis and acupoints recommendation. Methods. We propose an ensemble learning framework for the analysis task. A set of base learners composed of decision tree (DT) and support vector machine (SVM) are trained by bootstrapping the training dataset. The base learners are...

  3. Classification of feeding and eating disorders: review of evidence and proposals for ICD-11

    OpenAIRE

    Uher, Rudolf; Rutter, Michael,

    2012-01-01

    Current classification of eating disorders is failing to classify most clinical presentations; ignores continuities between child, adolescent and adult manifestations; and requires frequent changes of diagnosis to accommodate the natural course of these disorders. The classification is divorced from clinical practice, and investigators of clinical trials have felt compelled to introduce unsystematic modifications. Classification of feeding and eating disorders in ICD-11 requires substantial c...

  4. DSM-III DIAGNOSTIC CATEGORIES FOR ICD-9 HYSTERIA: A STUDY ON 103 CASES

    OpenAIRE

    Saxena, Shekhar; Pachauri, Ravindra; Wig, Narendra N.

    1986-01-01

    SUMMARY Rediagnosing 103 ICD-9 Hysteria cases on DSM-III, the authors found Conversion Disorder and Atypical Dissociative Disorder to be the most common diagnosis. Somatization Disorder was diagnosed only in 8.7 per ant of cases. Twenty-nine per cent cases received double diagnoses. Limitations of using DSM-III on Hysteria patients are mentioned and a suggestion is made to include a new category of ‘Simple Dissociative Disorder’ in the DSM-III.

  5. Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis

    OpenAIRE

    Cloitre, Marylène; Garvert, Donn W.; Brewin, Chris R; Bryant, Richard A.; Maercker, Andreas

    2013-01-01

    Background: The WHO International Classification of Diseases, 11th version (ICD-11), has proposed two related diagnoses, posttraumatic stress disorder (PTSD) and complex PTSD within the spectrum of trauma and stress-related disorders.Objective: To use latent profile analysis (LPA) to determine whether there are classes of individuals that are distinguishable according to the PTSD and complex PTSD symptom profiles and to identify potential differences in the type of stressor and severity of im...

  6. Obsessive-compulsive (anankastic) personality disorder: toward the ICD-11 classification

    OpenAIRE

    Fineberg, Naomi A.; Samar Reghunandanan; Sangeetha Kolli; Murad Atmaca

    2014-01-01

    Obsessive-compulsive personality disorder (OCPD) is an early-onset disorder characterized by perfectionism, need for control, and cognitive rigidity. Its nosological status is currently under review. Historically, OCPD has been conceptualized as bearing a close relationship with obsessive-compulsive disorder (OCD). In this article, we discuss the diagnosis of OCPD in anticipation of its review for the ICD-11, from the perspective of clinical utility, global applicability, and research plannin...

  7. ICD-10 and the clinical features of depressions: data of the CIRCADIAN-I program

    OpenAIRE

    O V Serdyuk; Ovchinnikov, A.; Kutuzova, N. A.; M Y Drobizhev; K Y Retyunsky

    2011-01-01

    The data of the CIRCADIAN-I trial suggest that depressions are unsatisfactorily diagnosed in psychiatric practice. Thus, some of the ICD-10 diagnoses used to denote depressive states (dysthymia, cyclothymia) are made extremely rarely. Only comparatively short-term and reversible vital depressions are considered to be preferred for the categories of affective disorders (F.30-F.33). Any clinical deviations from this clinical presentation (sensitive, anxiety symptoms, a prolonged course, and no ...

  8. ICDE project report: collection and analysis of common-cause failures of motor operated valves

    International Nuclear Information System (INIS)

    This report documents a study performed on the set of common cause failures (CCF) of motor operated valves (MOV). The data studied here were derived from the International CCF Data Exchange (ICDE) database, to which several countries have submitted CCF event data. The purpose of the ICDE is to allow multiple countries to collaborate and exchange CCF data to enhance the quality of risk analyses that include CCF modeling. Because CCF events are typically rare events, most countries do not experience enough CCF events to perform meaningful analyses. Data combined from several countries, however, yields sufficient data for more rigorous analyses. This report is the result of an in-depth review of the MOV events and presents several insights about them. The objective of this document is to look beyond the CCF parameter estimates that can be obtained from the CCF data, to gain further understanding of why CCF events occur and what measures may be taken to prevent, or at least mitigate the effect of MOV CCF events. The report presents details of the ICDE project, a quantitative presentation of the MOV events, and a discussion of some engineering aspects of the events. (authors)

  9. Typical Versus Atypical Anorexia Nervosa Among Adolescents: Clinical Characteristics and Implications for ICD-11.

    Science.gov (United States)

    Silén, Yasmina; Raevuori, Anu; Jüriloo, Elisabeth; Tainio, Veli-Matti; Marttunen, Mauri; Keski-Rahkonen, Anna

    2015-09-01

    There is scant research on the clinical utility of differentiating International Classification of Diseases (ICD) 10 diagnoses F50.0 anorexia nervosa (typical AN) and F50.1 atypical anorexia. We reviewed systematically records of 47 adolescents who fulfilled criteria for ICD-10 F50.0 (n = 34) or F50.1 (n = 13), assessing the impact of diagnostic subtype, comorbidity, background factors and treatment choices on recovery. Atypical AN patients were significantly older (p = 0.03), heavier (minimum body mass index 16.7 vs 15.1 kg/m(2) , p = 0.003) and less prone to comorbidities (38% vs 71%, p = 0.04) and had shorter, less intensive and less costly treatments than typical AN patients. The diagnosis of typical versus atypical AN was the sole significant predictor of treatment success: recovery from atypical AN was 4.3 times (95% confidence interval [1.1, 17.5]) as likely as recovery from typical AN. Overall, our findings indicate that a broader definition of AN may dilute the prognostic value of the diagnosis, and therefore, ICD-11 should retain its distinction between typical and atypical AN. PMID:26010207

  10. ICDE project report on collection and analysis of common-cause failures of emergency diesel generators

    International Nuclear Information System (INIS)

    This report documents a study performed on the set of common cause failures (CCF) of emergency diesel generators (EDG). The data studied here were derived from the International CCF Data Exchange (ICDE) database, to which several countries have submitted CCF event data. The data span a period from 1982 through 1997. The purpose of the ICDE is to allow multiple countries to collaborate and exchange CCF data to enhance the quality of risk analyses that include CCF modeling. Because CCF events are typically rare events, most countries do not experience enough CCF events to perform meaningful analyses. Data combined from several countries, however, yields sufficient data for more rigorous analyses. This report is the result of an in-depth review of the EDG events and presents several insights about them. The objective of this document is to look beyond the CCF parameter estimates that can be obtained from the CCF data, to gain further understanding of why CCF events occur and what measures may be taken to prevent, or at least mitigate the effect of, EDG CCF events. The report presents details of the ICDE project, a quantitative presentation of the EDG events, and a discussion of some engineering aspects of the events. (authors)

  11. DIMDI veröffentlicht endgültige Fassungen von ICD-10-GM 2010 und OPS Version 2010

    OpenAIRE

    Müller, W.

    2009-01-01

    Das DIMDI hat die endgültigen Fassungen der ICD-10-GM Version 2010 (Internationale Klassifikation der Krankheiten, German Modification) und des Operationen- und Prozedurenschlüssels (OPS) Version 2010 online veröffentlicht.

  12. An evaluation of ICD-11 PTSD and complex PTSD criteria in a sample of adult survivors of childhood institutional abuse

    Directory of Open Access Journals (Sweden)

    Matthias Knefel

    2013-12-01

    Full Text Available Background : The WHO recently launched the proposal for the 11th version of the International Classification of Diseases (ICD-11 that also includes two diagnoses related to traumatic stress. In contrast to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5, ICD-11 will probably, in addition to posttraumatic stress disorder (PTSD, also define a new diagnosis termed “complex posttraumatic stress disorder” (CPTSD. Objective : We aimed to apply the proposed ICD-11 criteria for PTSD and CPTSD and to compare their prevalence to the ICD-10 (International Classification of Diseases [10th revision] PTSD prevalence. In addition, we compiled a list of symptoms for CPTSD based on subthreshold PTSD so as to include a wider group of individuals. Methods : To evaluate the appropriateness of the WHO ICD-11 proposal compared to the criteria of ICD-10, we applied the newly introduced criteria for PTSD and CPTSD deriving from the Posttraumatic Stress Disorder Checklist – Civilian Version (PCL-C and the Brief Symptom Inventory (BSI scales, to a sample of adult survivors (N=229 of childhood institutional abuse. We evaluated the construct validity of CPTSD using confirmatory factor analysis (CFA. Results : More individuals fulfilled the criteria for PTSD according to ICD-10 (52.8% than the ICD-11 proposal (17% for PTSD only; 38.4% if combined with complex PTSD. The new version of PTSD neutralized the gender effects. The prevalence of CPTSD was 21.4%, and women had a significantly higher rate of CPTSD than men (40.4 and 15.8%, respectively. Those survivors who were diagnosed with CPTSD experienced institutional abuse for a longer time. CFA showed a strong model fit. Conclusion : CPTSD is a highly relevant classification for individuals with complex trauma history, but surprisingly, effects of gender were apparent. Further research should thus address gender effects.

  13. Comparison of ICD-10R, DSM-IV-TR and DSM-5 in an Adult Autism Spectrum Disorder Diagnostic Clinic

    Science.gov (United States)

    Wilson, C. Ellie; Gillan, Nicola; Spain, Deborah; Robertson, Dene; Roberts, Gedeon; Murphy, Clodagh M.; Maltezos, Stefanos; Zinkstok, Janneke; Johnston, Katie; Dardani, Christina; Ohlsen, Chris; Deeley, P. Quinton; Craig, Michael; Mendez, Maria A.; Happé, Francesca; Murphy, Declan G. M.

    2013-01-01

    An Autism Spectrum Disorder (ASD) diagnosis is often used to access services. We investigated whether ASD diagnostic outcome varied when DSM-5 was used compared to ICD-10R and DSM-IV-TR in a clinical sample of 150 intellectually able adults. Of those diagnosed with an ASD using ICD-10R, 56% met DSM-5 ASD criteria. A further 19% met DSM-5 (draft)…

  14. 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

  15. Concordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence

    Directory of Open Access Journals (Sweden)

    Adornetto Carmen

    2012-12-01

    Full Text Available Abstract Background Mental disorders are classified by two major nosological systems, the ICD-10 and the DSM-IV-TR, consisting of different diagnostic criteria. The present study investigated the diagnostic concordance between the two systems for anxiety disorders in childhood and adolescence, in particular for separation anxiety disorder (SAD, specific phobia, social phobia, and generalized anxiety disorder (GAD. Methods A structured clinical interview, the Kinder-DIPS, was administered to 210 children and 258 parents. The percentage of agreement, kappa, and Yule’s Y coefficients were calculated for all diagnoses. Specific criteria causing discrepancies between the two classification systems were identified. Results DSM-IV-TR consistently classified more children than ICD-10 with an anxiety disorder, with a higher concordance between DSM-IV-TR and the ICD-10 child section (F9 than with the adult section (F4 of the ICD-10. This result was found for all four investigated anxiety disorders. The results revealed low to high levels of concordance and poor to good agreement between the classification systems, depending on the anxiety disorder. Conclusions The two classification systems identify different children with an anxiety disorder. However, it remains an open question, whether the research results can be generalized to clinical practice since DSM-IV-TR is mainly used in research while ICD-10 is widely established in clinical practice in Europe. Therefore, the population investigated by the DSM (research population is not identical with the population examined using the ICD (clinical population.

  16. 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

  17. ICDE project report on collection and analysis of common-cause failures of centrifugal pumps

    International Nuclear Information System (INIS)

    Several member countries of OECD/NEA decided to establish the International Common-Cause Failure Data Exchange (ICDE) Project to encourage multilateral co-operation in the collection and analysis of data relating to Common-Cause Failure (CCF) events. The project was initiated in August 1994 in Sweden and was discussed at meetings in both Sweden and France in 1995. A coding benchmark exercise was defined which was evaluated at meetings held in Germany and in the US in 1996. Subsequently, the exchange of centrifugal pump data was defined; the first phase of this exchange was evaluated at meetings in Switzerland and in France in 1997. The objectives of the ICDE Project are: - to collect and analyse CCF events in the long term so as to better understand such events, their causes, and their prevention, - to generate qualitative insights into the root causes of CCF events which can then be used to derive approaches or mechanisms for their prevention or for mitigating their consequences, - to establish a mechanism for the efficient feedback of experience gained on CCF phenomena, including the development of defences against their occurrence, such as indicators for risk based inspections. The ICDE Project is envisaged as including all possible events of interest, comprising complete, partial and incipient CCF events, called 'ICDE events' in the following. The Project covers the key components of the main safety systems, like centrifugal pumps, diesel generators, motor operated valves, power operated relief valves, safety relief valves, check valves, RPS circuit breakers, batteries and transmitters. Data are collected in an MS ACCESS based databank implemented and maintained at ES-Konsult, Sweden, by NEA appointed clearinghouse. The databank is regularly updated. The clearinghouse and the project group operate it. In the modelling of common-cause failures in systems consisting of several redundant components, two kinds of events are distinguished: a) Unavailability of a

  18. 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...

  19. Heart pacemaker

    Science.gov (United States)

    ... Elsevier Saunders; 2015:chap 36. Read More Arrhythmias Atrial fibrillation or flutter Cardiac ablation procedures Heart failure - overview Implantable cardioverter-defibrillator Sick sinus syndrome Wolff- ...

  20. ICDE project report: collection and analysis of common-cause failure of check valves

    International Nuclear Information System (INIS)

    This report documents a study performed on the set of Common Cause Failure (CCF) events of Check Valves (CVs). The events studied here were derived from the International CCF Data Exchange (ICDE) database. Organizations from Canada, Finland, France, Germany, Netherlands, Sweden, Switzerland and the United States contributed with data to this data exchange. This study examines 94 CCF events of CVs reported in the ICDE database by tabulating the data and observing trends. The database contains general information about event attributes like root cause, coupling factor, detection method and corrective action taken. As part of this study, most of these events were reviewed in more detail and characterized by failure cause and failure symptom categories. The study itself begins with an overview of the entire data set in chapter 5. Charts are provided for each of the above-mentioned event attributes. This chapter forms the baseline for chapter 6. The intention of chapter 6 is to give the reader a deeper qualitative insight in the database content beyond that obtained from using the event coding only. Chapter 7 contains the summary of the study results and the conclusions derived from. Approximately 8% of all ICDE events of CVs were complete CCFs (all redundant components had failed). The number of partial CCF events (at least two of the redundant components failed) accounted for 24%. In the remaining 68% of the ICDE events, less than two components had failed completely, and the other components of the observed group only suffered from small defects, incipient degradation or were not affected at all. However, it was found that for more than 75% of the ICDE events the causal factors had a high probability to be shared by all the redundant components. 88 of the 94 reported ICDE events were reviewed in some more detail in Section 6 of this report with respect to failure causes, failure symptoms and failure mechanism. All events classified with a low 'shared cause factor

  1. 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

  2. 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...

  3. 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...

  4. 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...

  5. RELIABILITY OF THE ICD-10 INTERNATIONAL PERSONALITY DISORDER EXAMINATION (IPDE) (HINDI VERSION): A PRELIMINARY STUDY

    OpenAIRE

    Sharan, Pratap; Kulhara, P.; Verma, S. K.; Mohanty, Manju

    2002-01-01

    The study was aimed at estimating the joint-rater reliability and applicability of Hindi version of ICD-10 IPDE that was obtained following a standard translation protocol. The instrument was administered to 22 non-psychotic patients by two raters. The average intraclass correlation for each item (0.89), number of criteria met per disorder (0.92) and dimensional scores (0.98) was high. Kappa for definite (0.65-0.78) and probaole personality disorder (PD) (0.78-1.00) and for presence/absence o...

  6. Immunohistochemical analysis based Ep-ICD subcellular localization index (ESLI) is a novel marker for metastatic papillary thyroid microcarcinoma

    International Nuclear Information System (INIS)

    Thyroid cancer is among the fastest growing malignancies; almost fifty-percent of these rapidly increasing incidence tumors are less than or equal to 1cm in size, termed papillary thyroid microcarcinoma (PTMC). The management of PTMC remains a controversy due to differing natural history of these patients. Epithelial cell adhesion molecule (EpCAM) is comprised of an extracellular domain (EpEx), a single transmembrane domain and an intracellular domain (Ep-ICD). Our group reported nuclear Ep-ICD correlated with poor prognosis in thyroid cancer (Ralhan et al., BMC Cancer 2010,10:331). Here in, we hypothesized nuclear and cytoplasmic accumulation of Ep-ICD and loss of membranous EpEx may aid in distinguishing metastatic from non-metastatic PTMC, which is an important current clinical challenge. To test our hypothesis, Ep-ICD and EpEx expression levels were analyzed in PTMC and the staining was correlated with metastatic potential of these carcinomas. Thirty-six PTMC patients (tumor size 0.5 - 1cm; metastatic 8 cases and non-metastatic 28 cases) who underwent total thyroidectomy were selected. The metastatic group consisted of patients who developed lymph node or distant metastasis at diagnosis or during follow up. The patients’ tissues were stained for Ep-ICD and EpEx using domain specific antibodies by immunohistochemistry and evaluated. PTMC patients with metastasis had higher scores for nuclear and cytoplasmic Ep-ICD immunostaining than the patients without metastasis (1.96 ± 0.86 vs. 1.22 ± 0.45; p = 0.007 and 5.37 ± 0.33 vs. 4.72 ± 1.07; p = 0.016, respectively). Concomitantly, the former had lower scores for membrane EpEx than the non-metastatic group (4.64 ± 1.08 vs. 5.64 ± 1.51; p = 0.026). An index of aggressiveness, Ep-ICD subcellular localization index (ESLI), was defined as sum of the IHC scores for accumulation of nuclear and cytoplasmic Ep-ICD and loss of membranous EpEx; ESLI = [Ep − ICDnuc + Ep − ICDcyt + loss of membranous EpEx]. Notably

  7. Atmospheric, Magnetospheric and Plasmas in Space (AMPS) spacelab payload definition study. Volume 3: Interface control documents. Part 2: AMPS payload to spacelab ICD

    Science.gov (United States)

    1976-01-01

    The AMPS to Spacelab Interface Control Document which is to be used as a guide for format and information content in generating specific AMPS Mission ICDs is presented. This document is meant to supplement the Spacelab Payload Accommodations Handbook in that it only defines interfaces which are not discussed in the handbook to the level required for design purposes. The AMPS Top Level Requirements Tree, illustrates this ICD by a shaded area and its relationship to the other AMPS technical documents. Other interface documents shown are the Level II, AMPS to Space Shuttle Vehicle ICD and the Level III, AMPS to Instruments ICD.

  8. 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

  9. Polymorphisms associated with ventricular tachyarrhythmias: rationale, design, and endpoints of the 'diagnostic data influence on disease management and relation of genomics to ventricular tachyarrhythmias in implantable cardioverter/defibrillator patients (DISCOVERY)' study

    DEFF Research Database (Denmark)

    Garcia, Javier; Wieneke, Heinrich; Spencker, Sebastian; Svendsen, Jesper Hastrup; Martinez, Juan Gabriel; Strohmer, Bernhard; Toivonen, Lauri; Le Marec, Hervé; Garcia Bizzio, Javier Eduardo; Kaup, Bernd; Soykan, Orhan; Corrado, Domenico; Siffert, Winfried

    2010-01-01

    variants contributing to ventricular arrhythmias, a genome-wide association study will be conducted if sufficient a priori evidence can be gathered. In the second part of the study, associations of SNPs with ventricular arrhythmias will be sought and a search for potential new biological arrhythmic...... pathways will be investigated. As it is a diagnostic study, DISCOVERY will also investigate the impact of long-term device diagnostic data on the management of patients suffering from chronic cardiac disease as well as medical decisions made regarding their treatment....... modulate the risk for arrhythmias and sudden cardiac death, and identification of common variants could help to better identify patients at risk. The DISCOVERY study is an interventional, longitudinal, prospective, multi-centre diagnostic study that will enrol 1287 patients in approximately 80 European...

  10. PERCEPTION ABOUT ICDS SERVICES IN A RURAL POPULATION OF LUCKNOW, UTTAR PRADESH

    Directory of Open Access Journals (Sweden)

    Vandana Pandey

    2013-12-01

    Full Text Available Objective: To assess the perception of mother/fathers about the Anganwadicentres in a rural block of Lucknow district. Study design:Cross-sectional study.Study site: Kakori Block of Lucknow district, UP.Study subjects:Mothers/fathers whose children were attending the Anganwadicentre to receive the ICDS scheme.Results: A total of 453 mothers/fathers were interviewed. Majority (86.8% belonged to Hindu community and scheduled caste (62.8%.More than half(63.8% of the respondents viewed that their children received cooked food item as one full glass measure (80 grams per day. About half (53.9% of the respondents viewed that their children consumed food items at the AWCs itself, while 24.2% viewed that children brought it partially at home. However, 21.9% of them viewed that they brought all the food items at home whatever they received.  About one third (33.8% of the respondents perceived that the purpose of enrolment at AWCs of their children was learning.Majority (81.9% of the respondents viewed that there were the benefits of AWC in the village.Conclusions: The ICDS scheme may be very attractive but beneficiaries do not realize its importance.  Proper and sufficient nutritional supplementation provided to beneficiaries may help children towards leading a nutritionally sound and healthy life and combat malnutrition.

  11. Sexual health in the International Classification of Diseases (ICD): implications for measurement and beyond.

    Science.gov (United States)

    Chou, Doris; Cottler, Sara; Khosla, Rajat; Reed, Geoffrey M; Say, Lale

    2015-11-01

    This paper examines different dimensions of sexual health as related to the measurement of sexual health indicators and the proposed changes in the International Classification of Diseases to address issues related to sexuality and sexual health with an aim of informing health policy-making and programming. The lack of mechanisms for monitoring and evaluating sexual health outcomes has impeded the development of policies and programmes that support sexual health. The potential impact of changes to the ICD-11 is major and far-reaching given that the ICD is used by countries to define eligibility and access to health services and to formulate relevant policies and laws, and is used by health professionals as a basis for conceptualizing health conditions, treatments and outcomes. Improving the measurement of sexual health-related indicators builds the evidence base on scientific knowledge of sex, sexuality, sexual health and rights. As we stand on the cusp of the post-2015 era and the development agenda transitions to the Sustainable Development Goals, a unique opportunity presents itself to further consider how sexual health is defined, conceptualized, and monitored. PMID:26719010

  12. The exploration of relationship between the surgery grading management and the ICD-9-CM-3 coding

    Directory of Open Access Journals (Sweden)

    Xin-yu FAN

    2014-09-01

    Full Text Available Surgery grading management is one of the key aspects of medical technology access and medical quality management. Surgical classification is graded by risk level, the degree of difficulty of the process and the technology; however, surgery coding is mainly classified by the surgical site. Therefore, the grading of the ICD coding surgical name encounters some difficulties. Our hospital uses the “Jiangsu Province set of medical information classification and coding standards” and “Jiangsu Province surgery hierarchical directory”, which is issued by Jiangsu Provincial Commission of Health and Family Planning, as the basis. We are practicing and exploring about the correspondence between the surgery which has graded and ICD-9-CM-3 encoding, including six categories problems, such as different types of the same operation, different surgeries of the same parts. We carry out the surgical grading and coding intelligent management into hospital management, which will regulate the management of hospital surgery more effectively, ensure the safety of medical quality, and reduce the incidence of adverse events in health care.

  13. 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。

  14. 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

  15. DSM-5 AND ICD-11 DEFINITIONS OF POSTTRAUMATIC STRESS DISORDER: INVESTIGATING “NARROW” AND “BROAD” APPROACHES

    Science.gov (United States)

    Stein, Dan J.; McLaughlin, Katie A.; Koenen, Karestan C.; Atwoli, Lukoye; Friedman, Matthew J.; Hill, Eric D.; Maercker, Andreas; Petukhova, Maria; Shahly, Victoria; van Ommeren, Mark; Alonso, Jordi; Borges, Guilherme; de Girolamo, Giovanni; de Jonge, Peter; Demyttenaere, Koen; Florescu, Silvia; Karam, Elie G.; Kawakami, Norito; Matschinger, Herbert; Okoliyski, Michail; Posada-Villa, Jose; Scott, Kate M.; Viana, Maria Carmen; Kessler, Ronald C.

    2014-01-01

    Background The development of the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) and ICD-11 has led to reconsideration of diagnostic criteria for posttraumatic stress disorder (PTSD). The World Mental Health (WMH) Surveys allow investigation of the implications of the changing criteria compared to DSM-IV and ICD-10. Methods WMH Surveys in 13 countries asked respondents to enumerate all their lifetime traumatic events (TEs) and randomly selected one TE per respondent for PTSD assessment. DSMIV and ICD-10 PTSD were assessed for the 23,936 respondents who reported lifetime TEs in these surveys with the fully structured Composite International Diagnostic Interview (CIDI). DSM-5 and proposed ICD-11 criteria were approximated. Associations of the different criteria sets with indicators of clinical severity (distress-impairment, suicidality, comorbid fear-distress disorders, PTSD symptom duration) were examined to investigate the implications of using the different systems. Results A total of 5.6% of respondents met criteria for “broadly defined” PTSD (i.e., full criteria in at least one diagnostic system), with prevalence ranging from 3.0% with DSM-5 to 4.4% with ICD-10. Only one-third of broadly defined cases met criteria in all four systems and another one third in only one system (narrowly defined cases). Between-system differences in indicators of clinical severity suggest that ICD-10 criteria are least strict and DSM-IV criteria most strict. The more striking result, though, is that significantly elevated indicators of clinical significance were found even for narrowly defined cases for each of the four diagnostic systems. Conclusions These results argue for a broad definition of PTSD defined by any one of the different systems to capture all clinically significant cases of PTSD in future studies. PMID:24894802

  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. Primary cardiac lymphoma: diagnostic tools and treatment challenges.

    LENUS (Irish Health Repository)

    Bambury, R

    2011-03-01

    Primary cardiac lymphoma (PCL) is a rare malignancy and the optimal treatment strategy remains uncertain. It appears to respond much better to systemic chemotherapy than to surgery and it should be considered in the differential diagnosis of all cardiac tumours before definitive management is undertaken. We report a case of this rare disorder treated successfully with a combination of rituximab and cyclophosphamide, adriamycin, vincristine and prednisolone. The patient developed recurrent unstable ventricular tachycardia (VT) post-chemotherapy secondary to extensive scarring at the tumour site. The tumour as well as the post-treatment scarring is well illustrated by cardiac magnetic resonance imaging highlighting its usefulness in this setting. An implantable cardioverter defibrillator (ICD) was placed. This is only the second case in the literature of PCL to have an ICD placed for recurrent VT. A brief literature review is included.

  18. High-dose daptomycin and fosfomycin treatment of a patient with endocarditis caused by daptomycin-nonsusceptible Staphylococcus aureus: Case report

    Directory of Open Access Journals (Sweden)

    Hsiao Chen-Yuan

    2011-05-01

    Full Text Available Abstract Background Emergence of daptomycin-nonsusceptible (DNS Staphylococcus aureus is a dreadful problem in the treatment of endocarditis. Few current therapeutic agents are effective for treating infections caused by DNS S. aureus. Case presentation We describe the emergence of DNS S. aureus. in a patient with implantable cardioverter-defibrillator (ICD device -related endocarditis who was priorily treated with daptomycin. Metastatic dissemination as osteomyelitis further complicated the management of endocarditis. The dilemma was successfully managed by surgical removal of the ICD device and combination antimicrobial therapy with high-dose daptomycin and fosfomycin. Conclusions Surgical removal of intracardiac devices remains an important adjunctive measure in the treatment of endocarditis. Our case suggests that combination therapy is more favorable than single-agent therapy for infections caused by DNS S. aureus.

  19. Sudden cardiac death – what do we know and how do we prevent it?

    Directory of Open Access Journals (Sweden)

    Łukasz Zandecki

    2013-12-01

    Full Text Available Sudden cardiac death (SCD is an important clinical problem with a complex and multifactor background. Trends in its prevention have been dynamically developing over the last decades. Patients with ischemic heart disease, especially after myocardial infarction, represent the largest group at an elevated risk of SCD. Many congenital and hereditary diseases are associated with an increased risk of SCD, particularly among young people. Although far from perfect, left ventricular ejection fraction remains the only widely recognized, relatively objective and credible method of assessing the risk of SCD among patients with heart failure. Other methods for assessing the risk are waiting for the final confirmation of their usefulness in clinical trials. The implantable cardioverter-defibrillator (ICD and its newer version – totally subcutaneous S-ICD – remain the most effective methods of SCD prevention. The only class of drugs with well-proven efficiency in most patients at risk of SCD is β-blockers.

  20. INTEGRATING CLINICAL LABORATORY MEASURES AND ICD-9 CODE DIAGNOSES IN PHENOME-WIDE ASSOCIATION STUDIES

    Science.gov (United States)

    Verma, Anurag; Leader, Joseph B.; Verma, Shefali S.; Frase, Alex; Wallace, John; Dudek, Scott; Lavage, Daniel R.; Van Hout, Cristopher V.; Dewey, Frederick E.; Penn, John; Lopez, Alex; Overton, John D.; Carey, David J.; Ledbetter, David H.; Kirchner, H. Lester; Ritchie, Marylyn D.; Pendergrass, Sarah A.

    2016-01-01

    Electronic health records (EHR) provide a comprehensive resource for discovery, allowing unprecedented exploration of the impact of genetic architecture on health and disease. The data of EHRs also allow for exploration of the complex interactions between health measures across health and disease. The discoveries arising from EHR based research provide important information for the identification of genetic variation for clinical decision-making. Due to the breadth of information collected within the EHR, a challenge for discovery using EHR based data is the development of high-throughput tools that expose important areas of further research, from genetic variants to phenotypes. Phenome-Wide Association studies (PheWAS) provide a way to explore the association between genetic variants and comprehensive phenotypic measurements, generating new hypotheses and also exposing the complex relationships between genetic architecture and outcomes, including pleiotropy. EHR based PheWAS have mainly evaluated associations with case/control status from International Classification of Disease, Ninth Edition (ICD-9) codes. While these studies have highlighted discovery through PheWAS, the rich resource of clinical lab measures collected within the EHR can be better utilized for high-throughput PheWAS analyses and discovery. To better use these resources and enrich PheWAS association results we have developed a sound methodology for extracting a wide range of clinical lab measures from EHR data. We have extracted a first set of 21 clinical lab measures from the de-identified EHR of participants of the Geisinger MyCode™ biorepository, and calculated the median of these lab measures for 12,039 subjects. Next we evaluated the association between these 21 clinical lab median values and 635,525 genetic variants, performing a genome-wide association study (GWAS) for each of 21 clinical lab measures. We then calculated the association between SNPs from these GWAS passing our Bonferroni

  1. 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。

  2. The data quality of splenomegaly ICD-10 diagnoses in a population-based hospital discharge registry

    DEFF Research Database (Denmark)

    Rotbain, E. C.; Lund Hansen, Dennis; Frederiksen, H.

    2015-01-01

    months; distribution can be seen in figure 1. The most common method for determining enlarged spleen, as seen in table 1, was ultrasonic imaging. Table 2 shows that hematological diseases was the most common underlying causal disease group (50%), followed by hepatic diseases (25%), other diseases (12......Background Splenomegaly is a common finding in general medical patients. The cause of splenomegaly is often found outside the spleen and therefore an extensive diagnostic medical work-up is frequently required. There is very little data on the distribution of causal diagnoses and, to the best of...... nationwide registry study of the above stated risks can be undertaken, and to investigate which causal diagnoses are most common. Method The study was conducted as a cohort with data from the Danish health care system. Patients with an ICD-10 diagnosis of splenomegaly at Odense University Hospital (OUH) from...

  3. Prolonged grief disorder: Psychometric validation of criteria proposed for DSM-V and ICD-11.

    Directory of Open Access Journals (Sweden)

    Holly G Prigerson

    2009-08-01

    Full Text Available BACKGROUND: Bereavement is a universal experience, and its association with excess morbidity and mortality is well established. Nevertheless, grief becomes a serious health concern for a relative few. For such individuals, intense grief persists, is distressing and disabling, and may meet criteria as a distinct mental disorder. At present, grief is not recognized as a mental disorder in the DSM-IV or ICD-10. The goal of this study was to determine the psychometric validity of criteria for prolonged grief disorder (PGD to enhance the detection and potential treatment of bereaved individuals at heightened risk of persistent distress and dysfunction. METHODS AND FINDINGS: A total of 291 bereaved respondents were interviewed three times, grouped as 0-6, 6-12, and 12-24 mo post-loss. Item response theory (IRT analyses derived the most informative, unbiased PGD symptoms. Combinatoric analyses identified the most sensitive and specific PGD algorithm that was then tested to evaluate its psychometric validity. Criteria require reactions to a significant loss that involve the experience of yearning (e.g., physical or emotional suffering as a result of the desired, but unfulfilled, reunion with the deceased and at least five of the following nine symptoms experienced at least daily or to a disabling degree: feeling emotionally numb, stunned, or that life is meaningless; experiencing mistrust; bitterness over the loss; difficulty accepting the loss; identity confusion; avoidance of the reality of the loss; or difficulty moving on with life. Symptoms must be present at sufficiently high levels at least six mo from the death and be associated with functional impairment. CONCLUSIONS: The criteria set for PGD appear able to identify bereaved persons at heightened risk for enduring distress and dysfunction. The results support the psychometric validity of the criteria for PGD that we propose for inclusion in DSM-V and ICD-11. Please see later in the article for

  4. Women Literacy and Infant Feeding Practices in Rural Integrated Child Development Scheme (ICDS Block of Delhi

    Directory of Open Access Journals (Sweden)

    Davey Sanjeev , Davey Anuradha

    2012-09-01

    Full Text Available Background: Infant feeding practices have significant effect on the child nutrition, which largely dependent upon the mothers correct knowledge and awareness for the same. Objective: To find out effect of rural women empowerment through literacy on infant feeding practices in an ICDS block. Material and Methodology: Interview of the mothers of registered children up to 6 years in the rural ICDS block for the feeding practices and recording of the weight of those registered children by the salter weighing scale for their nutritional status. Results: Three fourth of the children had received ceremonial feed in the form of honey or gutti and 40 percent of the mothers in our study has discarded colostrums, considering it as ‘bad milk’. Exclusive breast feeding was received by 34.6% children. As literacy level of mothers increased the nutritional status of children was better. This could be because most of the women who are middle school passed or above are non working, so are able to give more time for care and feeding practices. The Severe malnutrition (grade III and IV was evident only in illiterate category of mothers, where 58.7% women were working in unskilled or semiskilled job outside home. Conclusion: Women living in chronic hunger are forced to unskilled jobs for income generation for the family, thereby influencing the feeding practices of their children. In such scenario AWCs and AWWs can be a unique opportunity with their focused approach to take care of severe and moderate malnutrition.

  5. An evaluation of expert human and automated Abbreviated Injury Scale and ICD-9-CM injury coding.

    Science.gov (United States)

    Long, W B; Sacco, W J; Copes, W S; Lawnick, M M; Proctor, S M; Sacco, J B

    1994-04-01

    Two hundred ninety-five injury descriptions from 135 consecutive patients treated at a level-I trauma center were coded by three human coders (H1, H2, H3) and by TRI-CODE (T), a PC-based artificial intelligence software program. Two study coders are nationally recognized experts who teach AIS coding for its developers (the Association for the Advancement of Automotive Medicine); the third has 5 years experience in ICD and AIS coding. A "correct coding" (CC) was established for the study injury descriptions. Coding results were obtained for each coder relative to the CC. The correct ICD codes were selected in 96% of cases for H2, 92% for H1, 91% for T, and 86% for H3. The three human coders agreed on 222 (75%) injuries. The correct 7 digit AIS codes (six identifying digits and the severity digit) were selected in 93% of cases for H2, 87% for T, 77% for H3, and 73% for H1. The correct AIS severity codes (seventh digit only) were selected in 98.3% of cases for H2, 96.3% for T, 93.9% for H3, and 90.8% for H1. On the basis of the weighted kappa statistic TRI-CODE had excellent agreement with the correct coding (CC) of AIS severities. Each human coder had excellent agreement with CC and with TRI-CODE. Coders H1 and H2 were in excellent agreement. Coder H3 was in good agreement with H1 and H2. However, errors among the human coders often occur for different codes, accentuating the variability.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8158710

  6. Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis

    Directory of Open Access Journals (Sweden)

    Marylène Cloitre

    2013-05-01

    Full Text Available Background: The WHO International Classification of Diseases, 11th version (ICD-11, has proposed two related diagnoses, posttraumatic stress disorder (PTSD and complex PTSD within the spectrum of trauma and stress-related disorders. Objective: To use latent profile analysis (LPA to determine whether there are classes of individuals that are distinguishable according to the PTSD and complex PTSD symptom profiles and to identify potential differences in the type of stressor and severity of impairment associated with each profile. Method: An LPA and related analyses were conducted on 302 individuals who had sought treatment for interpersonal traumas ranging from chronic trauma (e.g., childhood abuse to single-incident events (e.g., exposure to 9/11 attacks. Results: The LPA revealed three classes of individuals: (1 a complex PTSD class defined by elevated PTSD symptoms as well as disturbances in three domains of self-organization: affective dysregulation, negative self-concept, and interpersonal problems; (2 a PTSD class defined by elevated PTSD symptoms but low scores on the three self-organization symptom domains; and (3 a low symptom class defined by low scores on all symptoms and problems. Chronic trauma was more strongly predictive of complex PTSD than PTSD and, conversely, single-event trauma was more strongly predictive of PTSD. In addition, complex PTSD was associated with greater impairment than PTSD. The LPA analysis was completed both with and without individuals with borderline personality disorder (BPD yielding identical results, suggesting the stability of these classes regardless of BPD comorbidity. Conclusion: Preliminary data support the proposed ICD-11 distinction between PTSD and complex PTSD and support the value of testing the clinical utility of this distinction in field trials. Replication of results is necessary.For the abstract or full text in other languages, please see Supplementary files under Article Tools online

  7. 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...

  8. 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...

  9. 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.

  10. Asperger's Syndrome: A Comparison of Clinical Diagnoses and Those Made According to the ICD-10 and DSM-IV

    Science.gov (United States)

    Woodbury-Smith, Marc; Klin, Ami; Volkmar, Fred

    2005-01-01

    The diagnostic criteria for Asperger Syndrome (AS) according to ICD-10 and DSM-IV have been criticized as being too narrow in view of the rules of onset and precedence, whereby autism takes precedence over AS in a diagnostic hierarchy. In order to investigate this further, cases from the DSM-IV multicenter study who had been diagnosed clinically…

  11. Comparison of DSM-IV and proposed ICD-11 formulations of PTSD among civilian survivors of war and war veterans

    NARCIS (Netherlands)

    N. Morina; A.A.P. van Emmerik; B. Andrews; C.R. Brewin

    2014-01-01

    The World Health Organization recently proposed a reformulation of posttraumatic stress disorder (PTSD) for the 11th edition of the International Classification of Diseases (ICD-11), employing only 6 symptoms. The aim of this study was to investigate the impact of this reformulation of PTSD as compa

  12. Differences in the ICD-10 diagnostic subtype of depression in bipolar disorder compared to recurrent depressive disorder

    DEFF Research Database (Denmark)

    Jensen, H.M.; Christensen, E.M.; Kessing, Lars Vedel

    2008-01-01

    Background: The aim of the study was to investigate whether patients with bipolar depression and patients with recurrent depressive disorder present with different subtypes of depressive episode as according to ICD-10. Sampling and Methods: All patients who got a diagnosis of bipolar affective di...

  13. AN EVALUATION OF PRIMARY IMMUNIZATION COVERAGE AMONG ICDS CHILDREN UNDER URBAN FIELD PRACTICE AREA OF OSMANIA MEDICAL COLLEGE, HYDERABAD

    Directory of Open Access Journals (Sweden)

    Mohd

    2014-01-01

    Full Text Available Research question : What is the Primary Immunization Coverage of Anganwadi children (12 - 72 months under Urban Field Practice area of Osmania Medical College? BACKGROUND: Vaccine - preventable diseases are responsible for about 25%of the 10 million deaths occurring annually among children under 5 years of age. Immunization is a proven tool for controlling and eliminating life - threatening infectious diseases and it is estimated that more than 2 million child deaths were averted through immunization in 2003.Immunization is one of the important services which is being provided under ICDS (Integrated Child Development Scheme projects. OBJECTIVES: 1. To Estimate Primar y Immunization Coverage of Anganwadi children (12 - 72 months age group under Urban ICDS project.2. To Estimate Gender inequality ratio (GIR among Study group. METHODOLOGY: It’s a Community based cross sectional Study conducted in Anganwadi Centre of Urban ICDS Project among 340 children (12 - 72 months age group. RESULTS : Children in the age group of 12 - 23 months are more fully immunized when compared to any other age group of children. Males are comparatively more immunized than females. Mother’s education had significant impact on immunization of their children (P˂ 0.05.Primary Immunization coverage is over 85% among study groups. CONCLUSION : The present study showed that there is a better immunization coverage in Urban ICDS project areas. The study also showed that there has been an improvement over few years about immunization taking place in Urban ICDS projects. There is Gender inequality still exist in our country. Maternal Education had positive relation with immunization of their children.

  14. 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.

  15. 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

  16. 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.

  17. 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...

  18. 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

  19. 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.

  20. Comparison of ICD code-based diagnosis of obesity with measured obesity in children and the implications for health care cost estimates

    Directory of Open Access Journals (Sweden)

    Kuhle Stefan

    2011-12-01

    Full Text Available Abstract Background Administrative health databases are a valuable research tool to assess health care utilization at the population level. However, their use in obesity research limited due to the lack of data on body weight. A potential workaround is to use the ICD code of obesity to identify obese individuals. The objective of the current study was to investigate the sensitivity and specificity of an ICD code-based diagnosis of obesity from administrative health data relative to the gold standard measured BMI. Methods Linkage of a population-based survey with anthropometric measures in elementary school children in 2003 with longitudinal administrative health data (physician visits and hospital discharges 1992-2006 from the Canadian province of Nova Scotia. Measured obesity was defined based on the CDC cut-offs applied to the measured BMI. An ICD code-based diagnosis obesity was defined as one or more ICD-9 (278 or ICD-10 code (E66-E68 of obesity from a physician visit or a hospital stay. Sensitivity and specificity were calculated and health care cost estimates based on measured obesity and ICD-based obesity were compared. Results The sensitivity of an ICD code-based obesity diagnosis was 7.4% using ICD codes between 2002 and 2004. Those correctly identified had a higher BMI and had higher health care utilization and costs. Conclusions An ICD diagnosis of obesity in Canadian administrative health data grossly underestimates the true prevalence of childhood obesity and overestimates the health care cost differential between obese and non-obese children.

  1. Long Term Impact Of The Non Formal Pre School Education Component Of Icds On The Mental Status Of School Going Children

    OpenAIRE

    Sachar R.K; Krishnan J; Bhatia R C; Raizada N; Dhot Ramnik; Soni R.K; Gill P J S

    1996-01-01

    Research Question: What is the long term impact of non formal pre-school education component of ICDS on the mental status of school children? Objective: To assess and compare the long-term impact of the preschool education component of ICDS on the mental development in rural and urban children in the school going age group (6-12 yrs). Study design: With and without non-formal education exposure. Setting: Two ICDS blocks one urban and one rural in Ludhiana district. Participants: School going ...

  2. 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

  3. Diagnosis and classification of disorders specifically associated with stress: proposals for ICD-11.

    Science.gov (United States)

    Maercker, Andreas; Brewin, Chris R; Bryant, Richard A; Cloitre, Marylene; van Ommeren, Mark; Jones, Lynne M; Humayan, Asma; Kagee, Ashraf; Llosa, Augusto E; Rousseau, Cécile; Somasundaram, Daya J; Souza, Renato; Suzuki, Yuriko; Weissbecker, Inka; Wessely, Simon C; First, Michael B; Reed, Geoffrey M

    2013-10-01

    The diagnostic concepts of post-traumatic stress disorder (PTSD) and other disorders specifically associated with stress have been intensively discussed among neuro- and social scientists, clinicians, epidemiologists, public health planners and humanitarian aid workers around the world. PTSD and adjustment disorder are among the most widely used diagnoses in mental health care worldwide. This paper describes proposals that aim to maximize clinical utility for the classification and grouping of disorders specifically associated with stress in the forthcoming 11th revision of the International Classification of Diseases (ICD-11). Proposals include a narrower concept for PTSD that does not allow the diagnosis to be made based entirely on non-specific symptoms; a new complex PTSD category that comprises three clusters of intra- and interpersonal symptoms in addition to core PTSD symptoms; a new diagnosis of prolonged grief disorder, used to describe patients that undergo an intensely painful, disabling, and abnormally persistent response to bereavement; a major revision of "adjustment disorder" involving increased specification of symptoms; and a conceptualization of "acute stress reaction" as a normal phenomenon that still may require clinical intervention. These proposals were developed with specific considerations given to clinical utility and global applicability in both low- and high-income countries. PMID:24096776

  4. Classifying aging as a disease in the context of ICD-11.

    Science.gov (United States)

    Zhavoronkov, Alex; Bhullar, Bhupinder

    2015-01-01

    Aging is a complex continuous multifactorial process leading to loss of function and crystalizing into the many age-related diseases. Here, we explore the arguments for classifying aging as a disease in the context of the upcoming World Health Organization's 11th International Statistical Classification of Diseases and Related Health Problems (ICD-11), expected to be finalized in 2018. We hypothesize that classifying aging as a disease with a "non-garbage" set of codes will result in new approaches and business models for addressing aging as a treatable condition, which will lead to both economic and healthcare benefits for all stakeholders. Actionable classification of aging as a disease may lead to more efficient allocation of resources by enabling funding bodies and other stakeholders to use quality-adjusted life years (QALYs) and healthy-years equivalent (HYE) as metrics when evaluating both research and clinical programs. We propose forming a Task Force to interface the WHO in order to develop a multidisciplinary framework for classifying aging as a disease with multiple disease codes facilitating for therapeutic interventions and preventative strategies. PMID:26583032

  5. Obsessive-compulsive (anankastic personality disorder: toward the ICD-11 classification

    Directory of Open Access Journals (Sweden)

    Naomi A. Fineberg

    2014-01-01

    Full Text Available Obsessive-compulsive personality disorder (OCPD is an early-onset disorder characterized by perfectionism, need for control, and cognitive rigidity. Its nosological status is currently under review. Historically, OCPD has been conceptualized as bearing a close relationship with obsessive-compulsive disorder (OCD. In this article, we discuss the diagnosis of OCPD in anticipation of its review for the ICD-11, from the perspective of clinical utility, global applicability, and research planning. Considering the recent establishment of an obsessive-compulsive and related disorders (OCRD category in DSM-5, we focus on the relationship between OCPD and the disorders that are currently thought to bear a close relationship with OCD, including DSM-5 OCRD, and other compulsive disorders such as eating disorder and autistic spectrum disorder (that were not included in the DSM-5 OCRD category, as well as with the personality disorders, focusing on nosological determinants such as phenomenology, course of illness, heritability, environmental risk factors, comorbidity, neurocognitive endophenotypes, and treatment response. Based on this analysis, we attempt to draw conclusions as to its optimal placement in diagnostic systems and draw attention to key research questions that could be explored in field trials.

  6. Obsessive-compulsive (anankastic) personality disorder: toward the ICD-11 classification.

    Science.gov (United States)

    Fineberg, Naomi A; Reghunandanan, Samar; Kolli, Sangeetha; Atmaca, Murad

    2014-01-01

    Obsessive-compulsive personality disorder (OCPD) is an early-onset disorder characterized by perfectionism, need for control, and cognitive rigidity. Its nosological status is currently under review. Historically, OCPD has been conceptualized as bearing a close relationship with obsessive-compulsive disorder (OCD). In this article, we discuss the diagnosis of OCPD in anticipation of its review for the ICD-11, from the perspective of clinical utility, global applicability, and research planning. Considering the recent establishment of an obsessive-compulsive and related disorders (OCRD) category in DSM-5, we focus on the relationship between OCPD and the disorders that are currently thought to bear a close relationship with OCD, including DSM-5 OCRD, and other compulsive disorders such as eating disorder and autistic spectrum disorder (that were not included in the DSM-5 OCRD category), as well as with the personality disorders, focusing on nosological determinants such as phenomenology, course of illness, heritability, environmental risk factors, comorbidity, neurocognitive endophenotypes, and treatment response. Based on this analysis, we attempt to draw conclusions as to its optimal placement in diagnostic systems and draw attention to key research questions that could be explored in field trials. PMID:25388611

  7. 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.

  8. ICD-10-GM: DIMDI veröffentlicht die endgültige Fassung für 2007

    OpenAIRE

    Müller, W.; DIMDI Pressestelle

    2006-01-01

    Das DIMDI hat die endgültige Fassung der ICD-10-GM Version 2007 (Internationale statistische Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, German Modification) auf seinen Internetseiten veröffentlicht. In die neue Version flossen über 50 Vorschläge aus Fachgesellschaften und von Fachleuten aus Ärzteschaft, Krankenkassen und Kliniken ein. Die Krankheiten-Klassifikation bildet zusammen mit dem Operationen- und Prozedurenschlüssel (OPS) die Basis für das pauschalierende Verg...

  9. The Evaluation Of Effectiveness Of ICDS In 7 Anganwadi Centres On The Health Status Of Pre-School Children

    OpenAIRE

    Kulkarni M.N; Pattabhi Y.N

    1988-01-01

    Impact of Integrated child Development Services (ICDS) scheme in 7 Anganwadi centers of Davangere Block on the health status of pre-school children were studied for a period of one year. Total of 547 children, who were enrolled for supplementary nutrition and non-formal education, formed the study group. Impact of the programme on nutritional status was seen only in severely malnourished children (Grade III & IV). Severely malnourished children constituted 9.3% of total initially a...

  10. Concordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence

    OpenAIRE

    Adornetto Carmen; Suppiger Andrea; In-Albon Tina; Neuschwander Murielle; Schneider Silvia

    2012-01-01

    Abstract Background Mental disorders are classified by two major nosological systems, the ICD-10 and the DSM-IV-TR, consisting of different diagnostic criteria. The present study investigated the diagnostic concordance between the two systems for anxiety disorders in childhood and adolescence, in particular for separation anxiety disorder (SAD), specific phobia, social phobia, and generalized anxiety disorder (GAD). Methods A structured clinical interview, the Kinder-DIPS, was administered to...

  11. Comparing ICD9-Encoded Diagnoses and NLP-Processed Discharge Summaries for Clinical Trials Pre-Screening: A Case Study

    OpenAIRE

    Li, Li; Chase, Herbert S.; Patel, Chintan O.; Friedman, Carol; Weng, Chunhua

    2008-01-01

    The prevalence of electronic medical record (EMR) systems has made mass-screening for clinical trials viable through secondary uses of clinical data, which often exist in both structured and free text formats. The tradeoffs of using information in either data format for clinical trials screening are understudied. This paper compares the results of clinical trial eligibility queries over ICD9-encoded diagnoses and NLP-processed textual discharge summaries. The strengths and weaknesses of both ...

  12. Chiari malformation Type I surgery in pediatric patients. Part 1: validation of an ICD-9-CM code search algorithm.

    Science.gov (United States)

    Ladner, Travis R; Greenberg, Jacob K; Guerrero, Nicole; Olsen, Margaret A; Shannon, Chevis N; Yarbrough, Chester K; Piccirillo, Jay F; Anderson, Richard C E; Feldstein, Neil A; Wellons, John C; Smyth, Matthew D; Park, Tae Sung; Limbrick, David D

    2016-05-01

    OBJECTIVE Administrative billing data may facilitate large-scale assessments of treatment outcomes for pediatric Chiari malformation Type I (CM-I). Validated International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code algorithms for identifying CM-I surgery are critical prerequisites for such studies but are currently only available for adults. The objective of this study was to validate two ICD-9-CM code algorithms using hospital billing data to identify pediatric patients undergoing CM-I decompression surgery. METHODS The authors retrospectively analyzed the validity of two ICD-9-CM code algorithms for identifying pediatric CM-I decompression surgery performed at 3 academic medical centers between 2001 and 2013. Algorithm 1 included any discharge diagnosis code of 348.4 (CM-I), as well as a procedure code of 01.24 (cranial decompression) or 03.09 (spinal decompression or laminectomy). Algorithm 2 restricted this group to the subset of patients with a primary discharge diagnosis of 348.4. The positive predictive value (PPV) and sensitivity of each algorithm were calculated. RESULTS Among 625 first-time admissions identified by Algorithm 1, the overall PPV for CM-I decompression was 92%. Among the 581 admissions identified by Algorithm 2, the PPV was 97%. The PPV for Algorithm 1 was lower in one center (84%) compared with the other centers (93%-94%), whereas the PPV of Algorithm 2 remained high (96%-98%) across all subgroups. The sensitivity of Algorithms 1 (91%) and 2 (89%) was very good and remained so across subgroups (82%-97%). CONCLUSIONS An ICD-9-CM algorithm requiring a primary diagnosis of CM-I has excellent PPV and very good sensitivity for identifying CM-I decompression surgery in pediatric patients. These results establish a basis for utilizing administrative billing data to assess pediatric CM-I treatment outcomes. PMID:26799412

  13. Anthropometric Profile of Children Attending Anganwadi Centers under Integrated Child Development Sevices (ICDS) Scheme in Doiwala Block

    OpenAIRE

    Gagan Deep Kaur; Pradeep Aggarwal; Rakesh Kakkar

    2014-01-01

    Introduction In any community, Mothers and Children constitutes not only priority group, but they are also a “Vulnerable” or “Special-risk Group”. Similarly in India our biggest problem is malnutrition among under five year old children. To break the vicious cycle of malnutrition, morbidity reduced learning capacity and mortality India launched the Integrated Child Development Services (ICDS) Scheme in 1975. It is the foremost symbol of India’s commitment to her children Rationale: Forty perc...

  14. Enhancing research and treatment of mental disorders with dimensional concepts: toward DSM-V and ICD-11.

    Science.gov (United States)

    Krueger, Robert F; Bezdjian, Serena

    2009-02-01

    The current versions of the DSM (DSM-IV-TR) and ICD (ICD-10) describe all mental disorders as polythetic-categorical concepts. Lists of symptoms are presented, and diagnostic category labels are assigned to patients based on observing specific patterns of symptoms. A number of notable conceptual problems emerge when using this strictly categorical system in research and in the clinic. When thorough structured diagnostic interviews are used, typical patients meet criteria for more than one specific diagnosis (a phenomenon termed "comorbidity"). In addition, groups of patients with the same putative categorical label are often heterogeneous with respect to key clinical features, such as severity and prognosis, and patients with symptomatology below diagnostic thresholds are often significantly impaired. Although categorical concepts will always be essential in official nosologies (e.g., in providing diagnostic labels for reimbursement purposes), many of the conceptual problems of a strictly categorical diagnostic system can be overcome by enhancing official nosologies with dimensional concepts. Specific dimensional approaches and directions that may be considered for upcoming revisions of both the DSM and ICD are discussed. PMID:19293948

  15. Evaluation of functioning of ICDS project areas under Indore and Ujjain divisions of the state of Madhya Pradesh

    Directory of Open Access Journals (Sweden)

    Sanjay Dixit

    2010-07-01

    Full Text Available Background: Integrated Child Development Services (ICDS is recognized worldwide as one of the most efficient community based programmes promoting early childhood care. Regular evaluations of the programme have been conducted to make it more effective and adequate for the beneficiaries. Objectives: To evaluate the functioning of the Anganwadi Centers under different project areas of Indore and Ujjain Divisions. Methods: Under the present evaluation system one ICDS project and five Anganwadi Centers under the project area (AWCs were visited on a monthly basis and services provided reviewed. Findings reported are from nine project areas under Indore and Ujjain Divisions in the state of Madhya Pradesh from October 2008 – June 2009. Results: A total of 45 centers were evaluated. 29 centers were operating from rented buildings and storage facilities were lacking at 19 of the centers. Though the quality of food was acceptable to the beneficiaries shortage of food was a problem at the centers. Absence of Pre-School Education (PSE and Nutrition and Health Education (NHED Kits compromised PSE and NHED activities at the centers. Unavailability of medicine kits, lack of regular visits by the ANMs to the centers and absence of routine health check up of beneficiaries were other problems encountered under the project areas surveyed. Availability of a doctor under each project area was stated as a major need by the workers. Conclusion: Coordinated steps catering to different services provided at the centers are needed to optimize the functioning of the ICDS scheme.

  16. Intellectual developmental disorders: towards a new name, definition and framework for "mental retardation/intellectual disability" in ICD-11.

    Science.gov (United States)

    Salvador-Carulla, Luis; Reed, Geoffrey M; Vaez-Azizi, Leila M; Cooper, Sally-Ann; Martinez-Leal, Rafael; Bertelli, Marco; Adnams, Colleen; Cooray, Sherva; Deb, Shoumitro; Akoury-Dirani, Leyla; Girimaji, Satish Chandra; Katz, Gregorio; Kwok, Henry; Luckasson, Ruth; Simeonsson, Rune; Walsh, Carolyn; Munir, Kemir; Saxena, Shekhar

    2011-10-01

    Although "intellectual disability" has widely replaced the term "mental retardation", the debate as to whether this entity should be conceptualized as a health condition or as a disability has intensified as the revision of the World Health Organization (WHO)'s International Classification of Diseases (ICD) advances. Defining intellectual disability as a health condition is central to retaining it in ICD, with significant implications for health policy and access to health services. This paper presents the consensus reached to date by the WHO ICD Working Group on the Classification of Intellectual Disabilities. Literature reviews were conducted and a mixed qualitative approach was followed in a series of meetings to produce consensus-based recommendations combining prior expert knowledge and available evidence. The Working Group proposes replacing mental retardation with intellectual developmental disorders, defined as "a group of developmental conditions characterized by significant impairment of cognitive functions, which are associated with limitations of learning, adaptive behaviour and skills". The Working Group further advises that intellectual developmental disorders be incorporated in the larger grouping (parent category) of neurodevelopmental disorders, that current subcategories based on clinical severity (i.e., mild, moderate, severe, profound) be continued, and that problem behaviours be removed from the core classification structure of intellectual developmental disorders and instead described as associated features. PMID:21991267

  17. 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

  18. 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

  19. Harmonizing WHO’s International Classification of Diseases (ICD) and International Classification of Functioning, Disability and Health (ICF): importance and methods to link disease and functioning

    Science.gov (United States)

    2013-01-01

    Background To understand the full burden of a health condition, we need the information on the disease and the information on how that disease impacts the functioning of an individual. The ongoing revision of the International Classification of Diseases (ICD) provides an opportunity to integrate functioning information through the International Classification of Functioning, Disability and Health (ICF). Discussion Part of the ICD revision process includes adding information from the ICF by way of “functioning properties” to capture the impact of the disease on functioning. The ICD content model was developed to provide the structure of information required for each ICD-11 disease entity and one component of this content model is functioning properties. The activities and participation domains from ICF are to be included as the value set for functioning properties in the ICD revision process. Summary The joint use of ICD and ICF could create an integrated health information system that would benefit the implementation of a standard language-based electronic health record to better capture and understand disease and functioning in healthcare. PMID:23938048

  20. Long Term Impact Of The Non Formal Pre School Education Component Of Icds On The Mental Status Of School Going Children

    Directory of Open Access Journals (Sweden)

    Sachar R K

    1996-01-01

    Full Text Available Research Question: What is the long term impact of non formal pre-school education component of ICDS on the mental status of school children? Objective: To assess and compare the long-term impact of the preschool education component of ICDS on the mental development in rural and urban children in the school going age group (6-12 yrs. Study design: With and without non-formal education exposure. Setting: Two ICDS blocks one urban and one rural in Ludhiana district. Participants: School going children in age group 6-12 yrs. Sample Size: 360 children, (180 each from urban and rural school going children from 30 schools. Study Variables: Age, Sex. Place of residence, previous ICDS attendance. Outcome Variable: present mental status by Raven Colored Progressive Matrices Test. Statistical Analysis: Mean and Standard Error of difference between means. Results: The children exposed to non-formal pre-school education through ICDS in younger life had better mental status than those who did not receive such stimulation. Urban children of higher age groups i.e, 8-10yrs, had better mental status than similar group of rural children. No sex difference was noted in between similar groups. Recommendation: Non-formal pre-school education component of ICDS is highly cost-effective measure in promoting mental development and serves very useful purpose in our present situation.