Document Detail


Assessment of a prototype implantable cardioverter for ventricular tachycardia. Relation between synchronisation of sensing and origin of the tachycardia.
MedLine Citation:
PMID:  6477777     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The feasibility of internal cardioversion for ventricular tachycardia using a prototype of an implantable cardioverter which delivers a low energy discharge via an intracardiac lead and its acceptability to the patient were studied. The cardioverting discharge was synchronised to the apical right ventricular electrogram. In 29 episodes of ventricular tachycardia (RR interval 250-700 ms) the apical electrogram was reliably sensed. The interval from the onset of the QRS complex to the marker of sensing of the electrogram was significantly greater in the 15 episodes arising from the left ventricle than in the 14 episodes arising from the right ventricle; in three cases of ventricular tachycardia arising from the left ventricle the interval exceeded 100 ms. In all cases except one, however, sensing occurred within the first 80% of the QRS complex. In two episodes (RR interval 150 and 190 ms--that is, less than the refractory period of the unit) sensing of the electrogram was unreliable. The unit successfully terminated 10 of 15 episodes of ventricular tachycardia using energies ranging between 0.01 and 1.0 J, but 19 of the 23 discharges delivered to conscious patients caused varying degrees of discomfort. Sensing within 100 ms of the onset of the QRS complex (-20% to 83% of QRS) permitted effective and safe termination of ventricular tachycardia. Although there was neither acceleration of tachycardia nor ventricular fibrillation, subthreshold discharges advanced the next local ventricular electrogram in seven instances. An external low energy cardioverter connected to an intracardiac lead is a useful alternative to repeated external direct current shocks.
Authors:
M S Perelman; E Rowland; D M Krikler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British heart journal     Volume:  52     ISSN:  0007-0769     ISO Abbreviation:  Br Heart J     Publication Date:  1984 Oct 
Date Detail:
Created Date:  1984-11-09     Completed Date:  1984-11-09     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0370634     Medline TA:  Br Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  385-91     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Electric Countershock / instrumentation*
Electrocardiography
Evaluation Studies as Topic
Feasibility Studies
Female
Heart Ventricles
Humans
Male
Middle Aged
Patient Acceptance of Health Care
Prostheses and Implants
Recurrence
Tachycardia / therapy*
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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