INAPPROPRIATE S-ICD PATIENT RECEIVES FALSE POSITIVE SHOCKS

Subcutaneous implantable cardioverter defibrillator (S-ICD) protects the patients at risk for sudden cardiac death while leaving the heart and vasculature untouched. It provides life-saving therapy, but may also deliver inappropriate therapy. Presented case demonstrates a possibility of S-ICD therapy induction due to double-counting. It was original caused by lack of suitable sensing vectors and the solution was possible just particularly. As the inter-individual variability of subcutaneous cardiac signal is considerable, the patient screening should be necessary for identification of such patients, which have an unsuitable subcutaneous sensing signals

THE USE OF PACEMAKER DIAGNOSTICS FOR SUPPORTING THE ANTICOAGULATION TREATMENT MANAGEMENT

In this work, the analysis of data on atrial fibrillation (AF) burden from dual chamber pacemakers is used for supporting the anticoagulation treatment management. The aim is to evaluate the benefit of basic diagnostic functions to support oral anticoagulation therapy in patients with atrial fibrillation. These patients have increased risk of thromboembolism. If patients have an implanted pacemaker, the device’s diagnostic features monitor the frequency and duration of atrial fibrillation episodes. This data can then be used for further decisions. Statistical data processing was performed on a group of 117 patients with an implanted dual chamber pacemaker. From these results, we evaluated the benefits of the algorithms. In the whole group, a trend was observed in increase of the AF burden between the two monitored periods. The increase of AF burden occurred in 17 patients, while the decrease occurred in 6 patients only. Using simple logic functions, the numbers of patients with different binary values of the presence of AF, the presence of oral anticoagulation therapy, the risk CHA2DS2-VASc score and the values of AF burden were determined. Thus, in the whole group of patients, the diagnostic functions of the implanted devices contributed to the change in oral anticoagulation therapy for 24% of patients

Pomiar parametrów elektrycznych i testowanie implantowanych cardio-stymulatorów

The aim of the work was measurement and testing of implantable cardioverter - defibrillator (ICDs) device. There was realised electronic measuring circuit which substitutes human body tissue during the device accuracy testing. This circuit enables to measure defibrillation shock discharge in the whole energy range (0.1- 41J). The presented measuring and testing procedures can easy check-up precision of parameters and functionality of embedded electronic device circuit’s part of the ICDs. Presented suggestion and results of this work can be implemented as verification procedure in various types of ICDs and also pacemakers before their implantation as well.W artykule przedstawiono wpływ indukcji i częstotliwości na straty w żelazie w blachach elektrotechnicznych wykorzystywanych w dławikach pracujących w filtrach wyższych harmonicznych. Podano uogólnioną zależność pozwalającą na obliczenie strat histerezowych i wiroprądowych z uwzględnieniem zastępczej eliptycznej pętli histerezy. Otrzymane wyniki porównano z pomiarami. Wprowadzony do rozważań współczynnik An zależy w praktyce od średniej wartości indukcji występującej w przekroju poprzecznym rdzenia. Uogólniona zależność zawierająca współczynnik An może być stosowana w szerokim zakresie częstotliwości

RESPIRATORY ARRHYTHMIA AS AN ENCOURAGEMENT OF INAPPROPRIATE ICD THERAPY

Implantable cardioverter-defibrillators (ICDs) are active cardiac implants for immediate treatment of ventricular arrhythmias. They provide life-saving therapy, but may also deliver inappropriate therapy. These two cases demonstrate a possibility of ICD therapy detection or induction encouraged by physiological patient breathing. The cases of 64-year-old and 30-year-old women patients are reported. The first one has received some therapy, the second one has not. The devices records did not show any abnormalities in trends or electrical parameters. As a solution, the detection parameters of the devices were optimized, with reference to individual physiologically reachable heart rates of the patients

Monitoring of CRT-D devices during radiation therapy in vitro

Background: Using of active cardiac medical devices increases steadily. In Europe, there were 183 implants of ICD and 944 implants of PM, 119 of biventricular ICD and 41 of biventricular PM, all per million inhabitants in 2014. Healthcare environments, including radiotherapy treatment rooms, are considered challenging for these implantable devices. Exposure to radiation may cause the device to experience premature elective replacement indicator, decreased pacing amplitude or pacing inhibition, inappropriate shocks or inhibition of tachyarrhythmia therapy and loss of device function. These impacts may be temporary or permanent. The aim of this study was to evaluate the influence of linear accelerator ionizing radiation dose of 10 Gy on the activity of the biventricular cardioverter-defibrillator in different position in radiation beam. Methods: Two identical wireless communication devices with all three leads were used for the measurement. Both systems were soused into solution saline and exposed in different position in the beam of linear accelerator per 10 Gy fractions. In comparison of usually used maximum recommended dose of 2 Gy, the radiation doses used in test were five times higher. Using the simultaneous monitoring wireless communication between device and its programmer allowed watching of the devices activities, noise occurrence or drop of biventricular pacing on the programmer screen, observed by local television loop camera. Results: At any device position in radiation beam, there were no influences of the device activity at dose of 10 Gy neither a significant increase of a solution saline temperature in any of the measured positions of CRT-D systems in linear accelerator. Conclusions: The results of the study indicated, that the recommendation dose for treating the patients with implantable devices are too conservative and the risk of device failure is not so high. The systems can easily withstand the dose fractions of tens Gy, which would allow current single-dose-procedure treatment in radiation therapy. Even though the process of the random alteration of device memory and electrical components by scatter particles not allowed to specify a safe dose during ionizing radiation, this study showed that the safe limit are above the today used dose fractions.Web of Science15art. no. 2

Pomiary i analiza kompatybilności elektromagnetycznej stymulatora serca

This paper deals with problematic of Electromagnetic Compatibility of Implantable Pacemaker. The ambient electromagnetic field can negatively influence the pacemaker functionality and also the wireless communication between its programmer and device. Electromagnetic compatibility parameters are tested by direct induction of interference signal to the inputs of cardiac pacemaker according to technical specification. The experimental tests were also made by generating of interference radio frequency signals to disturb the wireless telemetry communication.Przeanalizowano problem kompatybilności elektromagnetycznej przy pracy stymulatora serca. Zewnętrzne pole elektromagnetyczne może negatywnie wpływać na pracę stymulatora i na komunikację bezprzewodową z programatorem. Przeprowadzono eksperymenty z bez[pośrednim zakłóceniem pracy zewnętrzną falą elektromagnetyczną

Advanced Intracardial Biosignal Processing

Part 4: Biometric ApplicationsInternational audienceIn this work deals about the efficient intracardial ECG analysis algorithm. The main focus was design an optimal detection method for intracardial signals based on essential intracardial measuring methods and basic principles of gathering and processing data from invasive catheters. Intracardial ECG analysis is further important step in heart behavior understanding, especially it’s electric manners. Detailed signal description generated in heart,together with heart function knowledge can provide us with an useful information about heart’s condition or it’s diseases. Designed detection methodis able to mark significant points in intracardial records, compute it‘s elemental parameters and important time intervals. Incurred algorithm was designed and tested on intracardial records provided by Cardiology Clinic of Hospital IKEM – Praha, and Electrophysiology Laboratory of Hospital Podlesi – Trinec