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Biomedical subjects

M Mower

Publications and source records attributed to M Mower.

9 recordsLinked to original sources
PubMed1998

ICD trials: an extraordinary means of determining patient risk?

Extensive clinical experience with the implantable cardioverter defibrillator (ICD) combined with recently completed prospective, randomized trials like MADIT and AVID, have demonstrated the lifesaving efficacy of this therapy and its superiority compared to conventional medical management in treating patients at high risk of sudden arrhythmic death. This evidence has in turn spurred great interest in further ICD studies. Since the ability of the ICD to save lives is no longer in question, there is a need to reexamine the real objectives of these new studies.

Defibrillators, Implantable↗
PubMed1993

Time machine.

Explore the source record for details and available documents.

Methods↗
PubMed1991

Predictors of first discharge and subsequent survival in patients with automatic implantable cardioverter-defibrillators.

BACKGROUND: Two hundred eighteen patients were evaluated in a two-phase approach (time to first appropriate discharge, survival after discharge) to identify factors that may be related to maximal benefit derived from use of an automatic implantable cardioverter-defibrillator (AICD). METHODS AND RESULTS: One hundred ninety-seven patients survived implantation of AICD, with or without concomitant cardiac surgery. One hundred five patients had an AICD discharge associated with syncope, presyncope, documented sustained ventricular tachycardia or fibrillation, or sleep at 9.1 +/- 11.1 months after implantation. Patients survived 23.8 +/- 18.0 months after AICD discharge. Left ventricular dysfunction (p = 0.008 for ejection fraction less than 25%) was associated with earlier AICD discharge and shortened survival after AICD discharge (p = 0.008 for ejection fraction less than 25%; p = 0.01 for New York Heart Association functional class III and IV). beta-Blocker administration (p = 0.006) and coronary bypass surgery (p = 0.06) were associated with later AICD discharge. Coronary bypass surgery (p = 0.035) but not beta-blockers was associated with more prolonged survival after AICD discharge. CONCLUSIONS: These data suggest that a relatively easy algorithm can be applied to predict which patient will benefit most from AICD implantation.

Electric Countershock↗
PubMed1989

Use of the elective replacement indicator in predicting time of automatic implantable cardioverter-defibrillator battery depletion.

The elective replacement indicator (ERI) of an automatic implantable cardioverter-defibrillator (AICD) is intended to be utilized as strict criteria for the appropriate timing of pulse generator replacement. The manufacturer's newest recommendations suggest replacement within 3 months post-ERI attainment and this applies to both AID-B units and the latest Ventak models currently being implanted with expectations or increased battery longevity. Twelve patients with the AID-B model were prospectively evaluated in regard to (a) time from attainment of ERI to generator exchange and (b) total battery life with respect to the presence or absence of spontaneous discharges. In the overall group, the ERI was reached at 18.9 +/- 3.9 months (mean +/- standard deviation). The time from ERI attainment to generator exchange due to battery depletion was 8.1 +/- 5.1 months, and total battery life was 27.3 +/- 3.1 months. In the group with spontaneous discharges, the duration of time (months) post-ERI to generator exchange was 5.7 +/- 2.6 but was 11.4 +/- 6.1 in the others (P = 0.052); battery life was 25.7 +/- 2.4 and 29.4 +/- 2.7, respectively (P = 0.03). We conclude that the current ERI recommendation seems overly conservative in planning generator exchange for patients without the occurrence of spontaneous discharges and appropriate for patients with such discharges.

Electric Countershock↗
PubMed1988

Impending sudden cardiac death: treatment with myocardial revascularization and the automatic implantable cardioverter defibrillator.

Myocardial revascularization and implantation of the automatic implantable cardioverter defibrillator (AICD) have individually been shown to improve survival in patients after sudden cardiac death. Their combined role has not been well defined. Twenty-three survivors of sudden death underwent revascularization and AICD implantation at an average age of 59 years. The initial arrest was caused by ventricular fibrillation in 15 and ventricular tachycardia in 8. Exercise stress tests, ambulatory ECGs, and electrophysiological monitoring with programmed electrical stimulation were done preoperatively and postoperatively. Follow-up averaged 24 months with a two-year survival of 91%. Eight patients (35%) required AICD resuscitation an average of 8 months postoperatively, and electrophysiological testing did not accurately predict arrhythmia recurrence. The addition of AICD implantation to revascularization substantially improves survival of patients with sudden cardiac death.

Adult↗
PubMed1988

Implantation of the automatic implantable cardioverter defibrillator.

Since February 1980 the automatic implantable cardioverter defibrillator has been implanted in over 1,500 patients. Sudden death rates have been reduced to 2%-4% annually. This report reviews the implantation techniques, their indications, and our clinical experience in 200 patients.

Arrhythmias, Cardiac↗
PubMedDate not supplied

Automatic implantable defibrillator for the patient with recurrent refractory malignant ventricular arrhythmias: case report.

Clinically, the first line of treatment for patients experiencing potentially lethal arrhythmias includes antiarrhythmic medications and/or treatment of underlying causes such as ischemia or congestive heart failure. However, if the treatment is not successful in controlling the arrhythmia, the automatic implantable defibrillator is a viable alternative for the prevention of sudden death in these patients. The case report presents one example of how the automatic implantable defibrillator can supplement conventional medical therapy when success in suppressing recurrent arrhythmias cannot be obtained. This concept has been demonstrated in this 59-year-old woman who underwent several medication trials in an attempt to control her life-threatening arrhythmias.

Electric Countershock↗