By David L. Hayes, Samuel J. Asirvatham, Paul A. Friedman
Along with thirteen chapters, this e-book is uniformly written to supply brilliant, matter-of-fact tools for knowing and taking good care of sufferers with everlasting pacemakers, ICDs and CRT systems.Now enhanced and up to date, together with a brand new bankruptcy on programming and optimization of CRT units, this moment variation provides a large number of info in an simply digestible shape. Cardiac Pacing and Defibrillation deals good, matter-of-fact tools for knowing and taking care of sufferers, making daily medical encounters more uncomplicated and extra productive.Readers will savor the data and event shared by means of the authors of this e-book.
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Additional resources for Cardiac Pacing and Defibrillation: A Clinical Approach
C H AP T E R 1 Clinically Relevant Basics of Pacing and Defibrillation 35 Fig. 38 Defibrillation thresholds with right-sided and left-sided cardioverterdefibrillator implantation of active can and cold can devices. Defibrillation threshold (DFT) is on ordinate, and side of placement and can type are on abscissa. 143 (From Friedman et al. 145 However, abdominal insertion is technically more challenging, requiring two incisions, lead tunneling, abdominal dissection (often necessitating surgical assistance), and general anesthesia.
This iterative decremental process is continued until the first shock fails or until an energy of 5 or 6 J succeeds (at which point the DFT is often defined as ≤ 5 or 6 J). The lowest successful energy is taken as the DFT, and the first shock of the device is chronically programmed to the DFT energy plus 10 J. Often during testing, the second defibrillator shock is programmed to an energy equal to the last successful shock energy plus 10 J, and rescue is performed by the defibrillator (rather than externally).
There are many factors that may result in elevated defibrillation threshold. 101 An important finding in this study was that in patients with high defibrillation thresholds who receive an ICD, arrhythmia death remained a significant long-term risk (42% of the deaths were arrhythmia related). An interesting observation is that there is a circadian variation in the defibrillation threshold. 103 In addition, the first failed shock rate is more often in the morning compared with other times during the day.
Cardiac Pacing and Defibrillation: A Clinical Approach by David L. Hayes, Samuel J. Asirvatham, Paul A. Friedman