Search results for "Defibrillator"

Comparative analysis in terms of computational cost for different discrimination algorithms in implantable defibrillators

2005

Implantable defibrillators (ICDs) use very low computational cost criteria (rate, stability and onset) offering good sensitivity for arrhythmia detection. Although, the specificity of these combined criteria decreases in difficult arrhythmia discrimination as in case of discrimination between ventricular tachycardia (VT) and supraventricular tachycardia (SVT). Several morphological published algorithms enhance arrhythmia discrimination but most algorithms are developed in personal computers and cannot be used in ICDs because of computational cost requirements compared with limited ICD capabilities. A general method to determine the possibility of ICD implementation for a discrimination algo…

Managed ventricular pacing vs. conventional dual-chamber pacing for elective replacements: the PreFER MVP study: clinical background, rationale, and …

2008

Udgivelsesdato: 2008-Mar AIMS: Several clinical studies have shown that, in patients with intact atrioventricular (AV) conduction, unnecessary chronic right ventricular (RV) pacing can be detrimental. The managed ventricular pacing (MVP) algorithm is designed to give preference to spontaneous AV conduction, thus minimizing RV pacing. The clinical outcomes of MVP are being studied in several ongoing trials in patients undergoing a first device implantation, but it is unknown to what extent MVP is beneficial in patients with a history of ventricular pacing. The purpose of the Prefer for Elective Replacement MVP (PreFER MVP) study is to assess the superiority of the MVP algorithm to convention…

Sacubitril/valsartan reduces indications for arrhythmic primary prevention in heart failure with reduced ejection fraction: insights from DISCOVER-AR…

2021

Abstract Aims This sub-study deriving from a multicentre Italian register [Deformation Imaging by Strain in Chronic Heart Failure Over Sacubitril-Valsartan: A Multicenter Echocardiographic Registry (DISCOVER)-ARNI] investigated whether sacubitril/valsartan in addition to optimal medical therapy (OMT) could reduce the rate of implantable cardioverter-defibrillator (ICD) indications for primary prevention in heart failure with reduced ejection fraction (HFrEF) according to European guidelines indications, and its potential predictors. Methods and results In this observational study, consecutive patients with HFrEF eligible for sacubitril/valsartan from 13 Italian centres were included. Lack o…

Implantation of a biventricular defibrillator in a borderline case of arrhythmogenic right ventricular dysplasia/cardiomyopathy

2014

European Clinical Experience with a Dual Chamber Single Pass Sensing and Pacing Defibrillation Lead

2002

Dual chamber ICDs are increasingly implanted nowadays, mainly to improve discrimination between supraventricular and ventricular arrhythmias but also to maintain AV synchrony in patients with bradycardia. The aim of this study was to investigate a new single pass right ventricular defibrillation lead capable of true bipolar sensing and pacing in the right atrium and integrated bipolar sensing and pacing in the right ventricle. The performance of the lead was evaluated in 57 patients (age 61 +/- 12 years; New York Heart Association 1.9 +/- 0.6, left ventricular ejection fraction 0.38 +/- 0.15) at implant, at prehospital discharge, and during a 1-year follow-up. Sensing and pacing behavior of…

Patient Alert to detect ICD lead failure: efficacy, limitations, and implications for future algorithms.

2006

Aims An algorithm that alerts implantable cardioverter-defibrillator (ICD) patients, in case of abnormal lead impedance (Patient Alert™, Medtronic), may help to recognize lead dysfunction. We aimed to determine the utility of Patient Alert for ICD lead-failure detection in a prospective study. Methods and results Three hundred and sixty ICD patients were followed for 22±14 months. Patient Alert was active for pacing impedance 2000–3000 Ω, and high-voltage conductor impedance 200 Ω. Ten alert events and a total of 29 severe system complications occurred. Patient Alert detected three of 10 ICD lead failures, with a positive predictive value (PPV) of 77.8% for any severe system complication. R…

Is there a right place to pace the right ventricle? Evaluation of apical and septal positions in a pacemaker population: Study protocol for a prospec…

2014

Abstract Introduction The main objective of research in pacemaker therapy has been to provide the best physiologic way to pace the heart. Despite the good results provided by right ventricular pacing minimization and by biventricular pacing in specific subsets of heart failure patients, these options present many limitations for standard pacemaker recipients. In these patients, pacing the right ventricle at alternative sites could result in a lower degree of left intraventricular dyssynchrony. Despite the lack of strong evidence and the difficulty in placing and accurately classifying the final lead position, pacing at alternative right ventricular sites seems to have become a standard proc…

Prophylactic Implantable Cardioverter Defibrillator Placement in a Sporadic Desmin Related Myopathy and Cardiomyopathy

2004

Desminopathy is a neuromuscular disorder associated with the accumulation of the protein desmin. This article reports a case of a man with a mutation in the desmin gene suffering from cardiomyopathy and skeletal myopathy. This patient underwent implantable cardioverter defibrillator (ICD) implantation for prognostic considerations and subsequently developed a sustained ventricular tachycardia (SVT). While nonsustained VTs (NSVT) have previously been reported, this is the first time that a SVT could be seen in a patient with this disease.

ICD Implantation in infants and small children: the extracardiac technique.

2007

There is no clear methodology for implantation of an internal cardioverter-defibrillator (ICD) in infants and small children. The aim of this study was to assess efficacy and safety of an extracardiac ICD implantation technique in pediatric patients.An extracardiac ICD system was implanted in eight patients (age: 0.3-8 years; body weight: 4-29 kg). Under fluoroscopic guidance a defibrillator lead was tunneled subcutaneously starting from the anterior axillar line along the course of the 6th rib until almost reaching the vertebral column. After a partial inferior sternotomy, bipolar steroid-eluting sensing and pacing leads were sutured to the atrial wall (n = 2) and to the anterior wall of t…

Clinical Benefit of Cardiac Resynchronization Therapy With a Defibrillator in Patients With an Ejection Fraction > 35% Estimated by Cardiac Magnet…

2014

A B S T R A C T Introduction and objectives: Cardiac resynchronization therapy with a defibrillator prolongs survival and improves quality of life in advanced heart failure. Traditionally, patients with ejection fraction > 35 estimated by echocardiography have been excluded. We assessed the prognostic impact of this therapy in a group of patients with severely depressed systolic function as assessed by echocardiography but with an ejection fraction > 35% as assessed by cardiac magnetic resonance. Methods: We analyzed consecutive patients admitted for decompensated heart failure between 2004 and 2011. The patients were in functional class II-IV, with a QRS to 120 ms, ejection fraction 35% es…