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PubMedDate not supplied

The psychosocial and physiological experiences of patients with an implantable cardioverter defibrillator.

This article describes the relationships between anxiety, self-efficacy, as well as the psychosocial and physiological experiences of patients with an internal cardioverter defibrillator (ICD). Although survival rates with ICDs are impressive, patients experience psychological and physiological responses to their lifesaving devices. Thirty-nine patients completed questionnaires during outpatient clinic visits. Patients' anxiety levels were correlated with fears about ICD malfunction, fear of death, fear of being shocked, loss of control, trouble related to sleeping, inability to concentrate, overprotective family members, and depression. Patients with physical symptoms had higher anxiety levels than those without physical symptoms. There was not a significant relationship between anxiety and discomfort associated with discharge, the number of discharges, or ejection fractions. Low self-efficacy was significantly related to fears about ICD malfunction as well as patients' inability to work, engage in hobbies, and drive a car. Patients with low self-efficacy had more physical symptoms and lower ejection fractions. There were no significant relationships between self-efficacy and frequency of ICD discharge or patients' discomfort during ICD discharge.

Aged↗
PubMed2005

New-onset ventricular tachycardia after cardiac resynchronization therapy.

It is well established that coronary artery disease with healed myocardial infarction is the most common backdrop for ventricular tachycardia (VT). Although the clinical benefits of biventricular pacing (BivP) in the treatment of severe heart failure are well documented, exact relation with ventricular arrhythmias remains still unclear. We describe a case of a patient, whitout a previous history of arrhythmic episodes, in which the onset of several episodes of VT presented immediatly after cardiac resynchronization therapy (CRT) and did not occur after BivP discontinuation.

Cardiac Pacing, Artificial↗
PubMed1994

The role of cardioversion therapy in patients with implanted cardioverter defibrillators.

Stable ventricular tachycardias can be treated with pacing or electrical countershock. Use of pacing includes several advantages, but it is not always effective; when pacing is not effective, shocks can be used for cardioversion of the arrhythmia. Use of such shocks includes advantages and disadvantages, but generally they are well tolerated and form an important part of the treatment of patients with sustained ventricular arrhythmias.

Cardiac Pacing, Artificial↗
PubMedDate not supplied

Engineering considerations in the development of the automatic implantable cardioverter defibrillator.

Each of the authors played a significant role in the design and development of one or more of the Medrad/Intec/Cardiac Pacemakers Inc defibrillators. In so doing, each has contributed to the realization of Dr Mirowski's dream. That tens of thousands of patients have now benefitted from his leadership and that many AICDs will soon be competing in the marketplace is testimony to his truly remarkable vision and persistence.

Animals↗
PubMedDate not supplied

Future developments in implantable cardioverter defibrillators: the optimal device.

Despite recent therapeutic advances, SCD remains the leading cause of mortality in industralized nations. The most frequent cause of SCD is ventricular tachyarrhythmias in the setting of advanced structural heart disease due to chronic coronary heart disease or idiopathic dilated cardiomyopathy. Although high-risk groups can be prospectively identified, attempts at primary prevention have been largely unsuccessful. Effective treatment strategies for SCD survivors include antiarrhythmic drug therapy guided by programmed stimulation, endocardial resection, and ICDs. Device therapy has proven extremely effective in preventing recurrent sudden death from ventricular tachyarrhythmias. Widespread application of ICD therapy, perhaps even to include members of high-risk populations that have not experienced cardiac arrest, will depend on many factors including the demonstration that device therapy improves total mortality, not just arrhythmia-related mortality, reduction in cost, and improvements in the devices themselves. Some of the important characteristics of the optimal ICD of the future are nonthoracotomy lead placement; subpectoral generator placement; multiprogrammable, tiered therapy; improved diagnostic specificity, whether based on electrogram or hemodynamic-sensing algorithms; improved integration of brady- and tachy-sensing systems; and enhanced electrogram storage capability with trans-telephonic retrieval of electrogram recordings. The creation of this ideal ICD will obviously require continued technological advances; however, given the tremendous improvements realized over the first three generations of ICD systems, optimism for the future seems warranted.

Anti-Arrhythmia Agents↗