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Biomedical subjects

H D Funke

Publications and source records attributed to H D Funke.

14 recordsLinked to original sources
PubMed1988

[Supraventricular tachycardia: therapy with a variable antitachycardia stimulation program].

Modern, microprocessor-controlled antitachycardia pacemakers are available with extended detection and termination programs for the treatment of supraventricular tachycardias. Using the "InterTach 262-12" we examined a universal antitachycardia pacing mode in the chronic state. Based on the individual electrophysiologic parameters, a defined burst stimulation mode was used for the first intervention and, consecutively, a determined scanning mode. The InterTach device was implanted in 17 patients with a mean age of 50 +/- 15 years: 10 with AV-nodal reentrant tachycardia, 6 with Wolff-Parkinson-White syndrome, 1 with reentrant tachycardia with Mahaim fibers. The mean tachycardia rate was 178 +/- 23/min and the follow-up 10 +/- 4 months. Every 3 months the efficacy of the termination mode was tested by programmed stimulation in supine and upright body position or during physical activity. In these tests, a rate of 95-100% successful terminations was observed. In the chronic state, 26 persistent tachycardias in 11 patients were noted; 21 episodes could be referred to an insufficient tachycardia detection. Only four persistent tachycardias were due to ineffective antitachycardia pacing. The introduction of extended variable termination programs, including consecutive, flexible pacing modes, can be considered as a marked advancement in the antitachycardia pacemaker therapy for supraventricular tachycardias.

Adult↗
PubMed1987

[Distribution of electric potentials in intra- and extracardiac defibrillation].

The implantable defibrillator is a device to treat refractory ventricular tachyarrhythmias. This study was done to evaluate the determinants of defibrillator performance which are not known completely. Different defibrillation electrodes were attached to beating and non-beating isolated pig-hearts (n = 15) and the electric field resulting from defibrillation measured over a distance of 3 mm. From 5 to 20 J a non-linear relation was found between delivered shock energies and the amplitudes of the recorded voltage waveforms. Using two patch electrodes maximal amplitudes were monitored apical in the right (4.6 +/- 0.5 V) and left ventricle (2.1 +/- 0.3 V). The atria only showed 10-25% of the maximal amplitudes. The combination of a patch and a catheter electrode showed similar efficiency. Two catheter electrodes reduced the apical (1.2 +/- 0.1 V) and increased the atrial amplitude (0.75 +/- 0.06 V). The recorded amplitudes in myocardium were half as much compared with blood-/sodium chloride indicating the twofold higher resistance of myocardial tissue. These experiments quantify the dependence of the efficiency of automatic implantable defibrillator systems on the sort and localization of the defibrillation electrodes.

Animals↗
PubMed1987

[Automatic implantable cardioverter-defibrillator (AICD) and antitachycardia pacemaker (Tachylog 651) in the treatment of ventricular tachyarrhythmias].

For the electrotherapy of refractory ventricular tachycardia the automatic implantable cardioverter-defibrillator (AICD) and antitachycardia pacemaker are available. The long-term use of antitachycardia pacing is still limited by the potential risk of acceleration to ventricular fibrillation. To combine the advantages of antitachycardia pacing with back-up defibrillation, we evaluated the use of an antitachycardia pacemaker with the automatic defibrillator. The AICD was implanted in 13 patients with a mean age of 62 years (from 46 to 75 years); six of them with recurrent ventricular tachycardia (170 +/- 16 per minute) which could reliably be terminated by overdrive pacing, received also an antitachycardia pacemaker (Tachylog 651). The underlying cardiac disease was coronary heart disease in 11 patients and cardiomyopathy in 2 cases. All patients had survived 1 to 6 cardiac arrests and had not responded to 6 +/- 1.5 antiarrhythmic drugs. For antitachycardia pacing we used burst stimulation with 4 to 6 stimuli and coupling intervals from 260 to 300 ms. During the follow-up period of 12 +/- 2 months, 83% of 744 tachycardias could be terminated by burst stimulation, according to the diagnostic data of the pulse generator. If the pacemaker failed to terminate or in case of acceleration (three patients), the automatic countershock of the AICD (5-42 per patient) restored sinus rhythm. In seven patients with high rate tachycardia, 2 to 69 AICD discharges occurred. No patient died suddenly, but three died due to underlying disease and one because of a pneumonia postoperatively. Future antitachycardia devices should be flexible with regard to detection and termination modes, combining antitachycardia pacing with back-up defibrillation.

Electric Countershock↗
PubMed1986

Combination of antitachycardia pacemaker and automatic implantable cardioverter/defibrillator for ventricular tachycardia.

Antitachycardia pacing for ventricular tachycardia (VT) is associated with the possibility of fibrillating the heart; on the other hand, the frequency of VT and patient discomfort can limit treatment with the automatic implantable cardioverter/defibrillator (AICD). To contribute to the further development of a universal pacemaker, we evaluated the combined use of the antitachycardia pacemaker ("tachylog") and the AICD in five patients with recurrent VT. In the automatic mode, the "tachylog" worked as a bipolar VVI pacemaker. For antitachycardia pacing, a burst of rapid ventricular pacing was delivered at about 80% of the cycle length. During a follow-up period of 5 +/- 2 months (range, 3 to 8) two to 291 successful interventions of antitachycardia pacing were counted from diagnostic data which had been collected by the pulse generator during the course of treatment. When the antitachycardia pacemaker failed to terminate VT, the AICD was activated. In the individual case, between 0 and 41 discharges of the AICD were delivered. The high pulse energy of the AICD did not damage the antitachycardia pacemaker; no interference of the two devices was observed. Future antitachycardia systems should be more flexible with regard to detection and termination modes, combining antitachycardia pacing with back-up defibrillation.

Aged↗
PubMed1977

[A simple and reliable atrial pacemaker electrode: technique of transvenous implantation and clinical results with a metal hook electrode (author's transl)].

At present only about 1% of all implanted pacemakers are atrial triggered ones, although an indication for them exists in about 77% of cases. This disproportion is due to an overestimate of the difficulties encountered in fixing the electrode. The electrode developed by Irnich has now been modified to provide good fixation for atrial stimulation, as well as recording of atrial potentials. Preliminary results in 20 patients have been favourable. Over a seven-month observation period there have been no instances of dislocation or loss of effective stimulation.

Electrocardiography↗
PubMed1977

[Surgical interventions in pacemaker patients (author's transl)].

In this paper 44 operations in patients with cardiac pacemakers have been reported. Electrosurgical instruments were used in almost all cases. It was noted, that neither a disturbance of the pacemaker nor of the heart stimulated by it occured during or after operation. A premature exhaustion of the battery was not observed.

Abdomen↗
PubMed1976

[Orthotopic saphena bypass in situ (author's transl)].

A procedure intended to restore the obliterated femoropopliteal arterial pathway is described. The vena saphena magna is canulated with a silicone tube, thus fixing the valves against the venous wall, the side vessels thrombose and close by secondary organization. After 6 to 8 weeks the transformed vein will be interposed instead of the obliterated arterial segment. The advantage of the operative procedure described consists in considerably reduced operative trauma compared with the well-known methods. Clinical results of 20 patients are presented.

Aged↗