Biomedical subjects

M P Combs

Publications and source records attributed to M P Combs.

3 recordsLinked to original sources

PubMed1995

Improved defibrillation threshold with a new epicardial carbon electrode compared with a standard epicardial titanium patch.

BACKGROUND: Recent studies show that depending on the type of shock morphology used, 5% to 15% of patients requiring implantable defibrillators cannot be treated with a nonthoracotomy system. In these cases, an epicardial patch-based system becomes necessary. In this study, we investigated a newly developed epicardial carbon electrode as an alternative to a standard epicardial titanium patch. METHODS AND RESULTS: A tubular epicardial braided carbon electrode of 7F diameter and 14-cm length applied in a U-shape to the epicardium was compared with a standard left ventricular epicardial 15-cm2 titanium mesh patch (CPI Inc). As cathode, a CPI endocardial lead, a Medtronic lead, or a carbon-platinum-iridium prototype electrode was used. Ventricular fibrillation was induced with a 60-Hz generator and allowed to continue for 10 seconds before a shock was given. Two different biphasic shock waveforms (3.2/2- and 6/6-millisecond) were delivered by the six electrode configurations. Eight dogs (weight, 24.5 +/- 1.3 kg) underwent an up-down defibrillation protocol. The order of testing the epicardial electrodes, the endocardial cathodes, and the waveform was randomized. With the epicardial carbon electrode, the mean defibrillation threshold (DFT) energy decreased 39% to 56% and the voltage decreased 24% to 35% compared with the titanium patch: from 8.3 +/- 2.5 to 4.9 +/- 3.6 J with the CPI lead and the 3.2/2-millisecond waveform, from 6.2 +/- 2.5 to 2.9 +/- 2.1 J with the carbon-platinum-iridium prototype, and from 6.4 +/- 3.4 J to 3.5 +/- 2.6 J with the Medtronic lead (P < or = .05). The DFT determinations with the 6/6-millisecond biphasic waveform showed a similar trend with slightly higher values. CONCLUSIONS: Compared with a titanium patch, the new braided epicardial electrode significantly decreases the defibrillation energy requirements. This effect can be maximized by using an endocardial carbon-platinum-iridium prototype as cathode and a short duration biphasic waveform.

Animals↗

PubMed1995

Characterization of a sudden expansion flow chamber to study the response of endothelium to flow recirculation.

In order to simulate regions of flow separation observed in vivo, a conventional parallel plate flow chamber was modified to produce an asymmetric sudden expansion. The flow field was visualized using light reflecting particles and the size of the recirculation zone was measured by image analysis of the particles. Finite element numerical solutions of the two and three-dimensional forms of the Navier-Stokes equation were used to determine the wall shear stress distribution and predict the location of reattachment. For two different size expansions, numerical estimates of the reattachment point along the centerline of the flow chamber agreed well with experimental values for Reynolds numbers below 473. Even at a Reynolds number of 473, the flow could be approximated as two-dimensional for 80 percent of the chamber width. Peak shear stresses in the recirculation zone as high as 80 dyne/cm2 and shear stress gradients of 2500 (dyne/cm2)/cm were produced. As an application of this flow chamber, subconfluent bovine aortic endothelial cell shape and orientation were examined in the zone of recirculation during a 24 h exposure to flow at a Reynolds number of 267. After 24 h, gradients in cell orientation and shape were observed within the recirculation zone. At the location of reattachment, where the wall shear stress was zero but the shear stress gradients were large, cells plated at low density were still aligned with the direction of flow. No preferred orientation was observed at the gasket edge where the wall shear stress and shear stress gradients were zero. At higher cell densities, no alignment was observed at the separation point.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1994

Improved cardiac anthropomorphic phantom.

An improved cardiac sonographic phantom is described that simulates the anatomy of the human heart for applications as a low cost quality assurance and training tool in echocardiography. The major new feature in the phantom is the development of a polyurethane sponge left ventricle, which mimics the myocardium during sonographic imaging while undergoing hydraulic pumping. The left ventricle, including prosthetic mechanical mitral and aortic valves, is housed in an optically transparent Lexan chamber or in a tissue mimicking polyurethane rubber torso. Additional new features include a port for transesophageal imaging, and an adjustable calibrated stroke volume on the piston pump, which can serve as a standard for echocardiographic stroke volume measurement. B-scans of the phantom show excellent image quality in all three standard echocardiographic views as well as in transesophageal scanning.

Echocardiography↗