Cardiovertor defibrillator

Sub-Saharan Africa is dominated by diseases of poverty. HIV/AIDS affects 28.5 out of a total of 600 million in the region. South Africa is the only country in sub-Saharan Africa in which implantable cardiovertor defibrillators (ICDs) are implanted (0.8/million in 2001). Only 3 of the 35 new ICDs were implanted in state-funded public hospitals. The pacemaker implantation rate for South Africa was 41/million in 2001. Approximately 20% of the population consume 56% of the health care expenditure, mainly funded by Medical Insurance...

All of the prospective multicenter trials that support the use of implantable defibrillators have used single chamber pacemakers/implantable cardiovertor defibrillators (ICDs). Despite the significantly increased cost of dual chamber pacemaker/ICD devices and the lack of outcome data, these devices accounted for approximately two-thirds of the ICDs implanted in the United States during the 12 months ending April 2001. Dual chamber pacemaker trials have not provided data that would support this trend, but the high incidence of atrial fibrillation, bradycardia, and congestive heart failure, as comorbid conditions, suggest that the situation could be different in the defibrillator patient population...

Based on data supplied by the centres that execute Interventional Electrophysiology in Portugal, the authors performed a survey of the electrophysiological studies, with or without associated catheter ablation. This report quantifies the experience of all centres, as well as with different classes of ablation techniques. Furthermore, the authors performed a survey of implanted cardiovertor defibrillators, distinguishing their distribution among the different centres. They conclude that the number of centres that practice Interventional Arrhythmias in Portugal is continuously increasing, as well as the number of catheter ablations performed, although these rates have somewhat stabilised in the last year...

OBJECTIVE: To identify the sources of electromagnetic interference (EMI) that may alter the performance of implanted cardiac devices and develop strategies to minimize their effects on patient hemodynamic status. SUMMARY BACKGROUND DATA: Since the development of the sensing demand pacemaker, EMI in the clinical setting has concerned physicians treating patients with such devices. Implanted cardiovertor defibrillators (ICDs) and ventricular assist devices (VADs) can also be affected by EMI...

Drug therapy has traditionally been the mainstay of treatment for both ventricular and supraventricular arrhythmias. However, increasing knowledge about the potentially significant adverse effects of these medications, together with the emergence of new, nonpharmacological approaches to the treatment of arrhythmias, has led some to question the future of antiarrhythmic drug therapy. Antiarrhythmic drugs are quite effective in terminating a variety of arrhythmias, including atrioventricular (AV) node re-entrant and AV tachycardias (particularly calcium antagonists and adenosine), atrial flutter (class III agents) and atrial fibrillation (class IA and IC drugs...

One of the main causes of cardiovascular death is the sudden death which is most frequently caused by malign arrhythmias: ventricular tachycardia (VT) and ventricular fibrillation (VF). These fatal disorders of rhythm are not manageable effectively by surgery, catheter ablation and pharmacology which cannot be thus widely used. Automatic implantable cardiovertors-defibrillators (AICD) have been used since 1980 in the therapy of malign ventricular disorders of rhythm. Modern AICD in more severe ventricular arrhyhmias have reduced the frequency of sudden death from 10-30% yearly to 1%...

The authors present a retrospective evaluation of the risk stratification and therapy of 53 patients with ventricular tachycardia. They present the diagnostical algorithm used for the detection of risk of sudden death. The most frequently used drug in the set of patients was amiodarone in monotherapy or in combination with other drugs. Sotalol was used for both, its antiarrhythmic nature, and for its ability to reduce the defibrillation threshold in patients with an implanted automatic implantable cardiovertor-defibrillator (AICD)...

The insertion of implantable cardioverter/defibrillators (ICD) requires induction of repeated episodes of ventricular fibrillation (VF). The neuropsychological repercussions associated with repeated inducement of hypotension and cerebral ischemia are unknown. In this prospective clinical trial, 1 day prior to ICD assessment/implantation and 5 days postprocedure, 14 patients underwent neurological and cognitive screening. Cognitive dysfunction was defined as impaired performance in one of four cognitive domains...

BACKGROUND: To determine the influence of left ventricular function on the long-term survival of patients with coronary artery disease and lethal ventricular arrhythmias, who undergo concomitant coronary artery bypass grafting (CABG) and implantable cardiovertor defibrillator (ICD) implantation, we studied survival in 54 consecutive patients who underwent CABG and ICD implantation. METHODS: Group I consisted of 35 patients with left ventricular ejection fraction (LVEF) < or = 35% (mean 25...

No abstract text is available yet for this article.

The experience acquired with the use of automatic ventricular cardiovertor-defibrillator led to the idea of developing an atrial device capable of automatically detecting and reducing atrial fibrillation. The large group of patients with paroxysmal atrial fibrillation not responding to pharmacological therapy makes this a particularly relevant question. The first problem is to define the need of this type of device. There is only one group of patients with resistant and/or poorly tolerated paroxysmal atrial fibrillation in whom non-pharmacological therapy is considered, for example ablation of the AV node with implantation of a pacemaker or surgery...

Ventricular tachycardia may be a serious complication of different forms of heart disease. It usually develops in later stages of the disease, with poor ventricular function and may lead to sudden death. Antiarrhythmic drug therapy is frequently unsuccessful. We report our experience with the first patient receiving an internal cardiovertor-defibrillator and anti-tachycardia pacemaker for treatment of drug refractory ventricular tachycardia. After 3 months of follow-up the patient is back to work with good tolerance to both devices...