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Development in a majority of medicine branches today is based on technological advancement. This is the case in cardiology, where medical devices designed to correct heart rhythm – pacemakers, cardioverters-defibrillators and biventricular systems – are implanted in order to help a sick heart. Medical pacing devices today are only developed and produced globally by a several producers who make different technical solutions, algorithms, system parameters etc. The book Implantable Cardiac Devices Technology is targeted at biomedical, clinical engineers, technicians in practice, students of biomedical disciplines, and all medical staff who are required to understand the basics of pacing technology. The book is comprised of fourteen chapters that are further subdivided according to specific topics. Chapters dealing with basic heart anatomy, physiology and arythmology are included for the sake of comprehensiveness. Chapters avoid the description of special functions, but cover general procedures and parameters common for the systems of all producers. The book is intended to serve as a monothematic textbook. In order to make the text comprehensible and well arranged for a reader, references to professional literature are only provided once in a respective chapter.
Today hundreds of thousands of Americans carry pacemakers and implantable cardioverter-defibrillators (ICDs) within their bodies. These battery-powered machines—small computers, in fact—deliver electricity to the heart to correct dangerous disorders of the heartbeat. But few doctors, patients, or scholars know the history of these devices or how "heart-rhythm management" evolved into a multi-billion-dollar manufacturing and service industry. Machines in Our Hearts tells the story of these two implantable medical devices. Kirk Jeffrey, a historian of science and technology, traces the development of knowledge about the human heartbeat and follows surgeons, cardiologists, and engineers as they invent and test a variety of electronic devices. Numerous small manufacturing firms jumped into pacemaker production but eventually fell by the wayside, leaving only three American companies in the business today. Jeffrey profiles pioneering heart surgeons, inventors from the realms of engineering and medical research, and business leaders who built heart-rhythm management into an industry with thousands of employees and annual revenues in the hundreds of millions. As Jeffrey shows, the pacemaker (first implanted in 1958) and the ICD (1980) embody a paradox of high-tech health care: these technologies are effective and reliable but add billions to the nation's medical bill because of the huge growth in the number of patients who depend on implanted devices to manage their heartbeats.
Different artificial tools, such as heart-pacing devices, wearable and implantable monitors, engineered heart valves and stents, and many other cardiac devices, are in use in medical practice. Recent developments in the methods of cardiac pacing along with appropriate selection of equipment are the purpose of this book. Implantable heart rate management devices and wearable cardiac monitors are discussed. Indications for using specific types of cardiac pacemakers, cardiac resynchronization therapy devices, and implantable cardioverter defibrillators (ICDs) are of interest and their contraindications are considered. Special attention is paid to using leadless devices. The subcutaneous ICD obviates the need for transvenous leads and leadless pacemakers are entirely implantable into the right ventricle. Finally, applications of user-friendly wearable devices for the detection of atrial arrhythmia are debated.
Unique in the field, Surgical Implantation of Cardiac Rhythm Devices provides complete, easy-to-follow guidance for safe, effective surgical implantation of pacemakers, ICDs, and other devices. Beginning with surgical anatomy and surgical principles, expert authors provide thorough coverage of surgical technique and procedures – everything from sutures to special circumstances and complications. Detailed, high-quality illustrations show you exactly how to proceed, and each procedure includes an accompanying video clip online. - Outlines relevant anatomic structures and landmarks, as well as various types of sutures and instruments. - Provides authoritative, detailed guidance on transvenous lead placement, including novel or alternative placements, as well as implantation of subcutaneous ICDs. - Covers tools and techniques, anesthesia, radiation safety, pitfalls and complications, tips and pearls, patient preparation, postoperative patient management, and follow-up care. - Offers expert coverage of pediatric considerations and other special circumstances. - Allows you to view surgical procedures and relevant anatomy in video clips online, as well as through extensive, high-quality illustrations in the text. - Ideal for EP fellows, practicing electrophysiologists, and cardiologists who perform surgical procedures to implant pacemakers, ICDs, and other devices.
A significant medical event is expected in 1992: the first human use of a fully implantable, long-term cardiac assist device. This timely volume reviews the artificial heart program-and in particular, the National Institutes of Health's major investment-raising important questions. The volume includes: Consideration of the artificial heart versus heart transplantation and other approaches to treating end-stage heart disease, keeping in mind the different outcomes and costs of these treatments. A look at human issues, including the number of people who may require the artificial heart, patient quality of life, and other ethical and societal questions. Examination of how this technology's use can be targeted most appropriately. Attention to achieving access to this technology for all those who can benefit from it. The committee also offers three mechanisms to aid in allocating research and development funds.
In the last years, indications for defibrillators and cardiac resynchronization therapy have expanded enormously; for this reason, and also due to the extension of human life length, the number of patients with implanted cardiac devices have steadily increased. The leads implanted for the functioning of these devices, however, have a limited duration in time and more and more their extraction will be a frequent issue in clinical practice, in order to treat short- and long-term complications, such as infections and failures. Aim of this book is to provide readers with a state-of-the-art on lead extraction techniques. The chapters deal with leads characteristics, indications to lead removal, patient preparation, tools and techniques for extraction, and prevention and management of complications. In addition, a series of tips and tricks on how to treat some particular conditions (tight cost-clavicular space, fractured leads, ICD leads, dangered leads...etc.), are given. A new extracting technique, according to which the extraction is performed through the internal jugular vein is described; several examples are included and many figures provide a thorough depiction of this innovative procedure. The volume will be an excellent resource for all those involved in the management of cardiac patients: cardiologists, arrhythmologists, cardiac surgeons, GPs, pediatricians, and post-graduate students in these disciplines.
Consisting of 13 chapters, this book is uniformly written to provide sensible, matter-of-fact methods for understanding and caring for patients with permanent pacemakers, ICDs and CRT systems. Now improved and updated, including a new chapter on programming and optimization of CRT devices, this second edition presents a large amount of information in an easily digestible form. Cardiac Pacing and Defibrillation offers sensible, matter-of-fact methods for understanding and caring for patients, making everyday clinical encounters easier and more productive. Readers will appreciate the knowledge and experience shared by the authors of this book.
Power reduction is a central priority in battery-powered medical implantable devices, particularly pacemakers, to either increase battery lifetime or decrease size using a smaller battery. Low Power Analog CMOS for Cardiac Pacemakers proposes new techniques for the reduction of power consumption in analog integrated circuits. Our main example is the pacemaker sense channel, which is representative of a broader class of biomedical circuits aimed at qualitatively detecting biological signals. The first and second chapters are a tutorial presentation on implantable medical devices and pacemakers from the circuit designer point of view. This is illustrated by the requirements and solutions applied in our implementation of an industrial IC for pacemakers. There from, the book discusses the means for reduction of power consumption at three levels: base technology, power-oriented analytical synthesis procedures and circuit architecture. At the technology level, we analyze the impact that the application of the fully depleted silicon-on-insulator (FD SOI) technology has on this kind of analog circuits. The basic building block levels as well as the system level (pacemaker sense channel) are considered. Concerning the design technique, we apply a methodology, based on the transconductance to current ratio that exploits all regions of inversion of the MOS transistor. Various performance aspects of analog building blocks are modeled and a power optimization synthesis of OTAs for a given total settling time (including the slewing and linear regions) is proposed. At the circuit level, we present a new design approach of a class AB output stage suitable for micropower application. In our design approach, the usual advantages of the application of a class AB output stage are enhanced by the application of a transconductance multiplication effect. These techniques are tested in experimental prototypes of amplifiers and complete pacemaker sense channel implementations in SOI and standard bulk CMOS technologies. An ultra low consumption of 110 nA (0.3μ W) is achieved in a FD SOI sense channel implementation. Though primarily addressed to the pacemaker system, the techniques proposed are shown to have application in other contexts where power reduction is a main concern.
With a focus on the growing field of cardiology remote monitoring, this state-of-the-art reference provides must-know clinical and technical information as well as recent advances in application, engineering, and clinical impact from the current literature. Authoritative coverage of implantable devices and ambulatory ECG brings you up to speed on recent practice changes in remote monitoring that have alleviated the volume of in-office patient follow-ups, allowed for physicians to monitor more patients, enabled better patient compliance, and most importantly, provided earlier warning signs of cardiac problems.
From basic clinical facts to new advanced guidelines, Practical Cardiology, by Drs. Majid Maleki, Azin Alizadehasl, and Majid Haghjoo, is your new go-to resource for new developments in cardiology knowledge, imaging modalities, management techniques, and more. This step-by-step, practical reference is packed with tips and guidance ideal for residents, fellows, and clinicians in cardiology, as well as internal medicine, cardiac surgery, interventional cardiology, and pediatric cardiology. Features a wealth of information, including practical points from recently published guidelines, ECGs, hemodynamic traces of advanced imaging modalities in real patients, and much more. Offers a comprehensive review of cardiovascular medicine, from basic to advanced.