Defibrillators, Implantable ; Electric Countershock

Atrial Fibrillation ; Electric Countershock ; Humans

The occurrence of atrial fibillation during an electrophysiologic study or catheter ablation in patients with accessory pathways is a common problem and sometimes complicates the localization and ablation procedure of accessory pathways. In patients with sustained atrial fibrillation, it is often time-consuming to terminate atrial fibrillation by drugs or electrical cardioversion. We performed successful radiofrequency catheter ablation in a patient with right-sided accessory pathway during atrial fibrillation requiring repeated electrical cardioversion. The target site was determined by activation mapping and morphology of unipolar electrogram at a site of early ventricular activation.
Atrial Fibrillation* ; Catheter Ablation ; Electric Countershock ; Humans

Defibrillators, Implantable ; Electric Countershock ; Humans ; Ventricular Fibrillation

This paper presents a design of multifunctional portable automated external defibrillator based on STM32F103VC SCM. The defibrillator mainly realizes the defibrillation and ECG analysis function, and according to the clinical actual need, increases information storage and transmission function, query of local records, the function of synchronous LCD display and voice prompt in the defibrillation process. The device uses the defibrillating electrodes to measure body resistance, ECG and so on. We detailedly researched and achieved the discharge module of biphasic defibrillation apparatus based on the damping of two order discharge circuit, and finished the real-time LCD display and voice prompt modules of defibrillation information based on the control of PIC24FJ256DA210 chip.
Automation ; Defibrillators ; Electric Countershock ; Electrodes ; Equipment Design

EMG, This paper introduces a slope variability algorithm which uses the CU Database and the AHA Database. The sensitivity, specificity, positive predictivity and accuracy are calculated and these values are compared with the results from two earlier detection algorithms. The results show this algorithm is more effective and fast than other algorithms.
Algorithms ; Defibrillators ; Electric Countershock ; instrumentation ; Predictive Value of Tests ; Sensitivity and Specificity

A distributed simulation method of electric field based on the atrial defibrillation of the heart modeling and finite element solution is proposed in this study. In order to solve the problem that ordinary clinical trials could not measure the actual distribution of the defibrillation electric field in the heart accurately, this method provides a research tool for electrical defibrillation. A complete atrial anatomical structure in the heart model is used in the research, the finite element method is proceeded to solve; Three parameters: defibrillation threshold voltage, the high field strength rate and the defibrillation threshold energy are set to evaluate the effect of defibrillation. The heart electric field distributions of transvenous atrial defibrillation with different electrode locations or sizes are simulated. The simulation results and the reported results match fairly well, which initially verify the feasibility of this method.
Atrial Fibrillation ; therapy ; Computer Simulation ; Electric Countershock ; instrumentation ; methods ; Electrodes

Defibrillator is an important first aid equipment with people attach importance to life and health in today, people pay more attention to the development of defibrillator. This paper reviews the development history of the defibrillator, gives a brief introduction to the structure and working principle of the defibrillator, and then analyzes the key technology of defibrillator, compares the mainstream products on the market and prospects the development trend of defibrillator.
Defibrillators ; Electric Countershock ; First Aid ; Humans ; Technology ; Ventricular Fibrillation ; therapy

OBJECTIVE: To explore the difference in ultrasonic monitoring in carotid blood flow, resuscitation effects and prognosis between interposed abdominal pulling-pressing cardiopulmonary resuscitation (IAPP-CPR) and standard cardiopulmonary resuscitation (STD-CPR). METHODS: Seventy-five cardiac arrest (CA) patients admitted to emergency department of Shijingshan Teaching Hospital of Capital Medical University from June 2015 to December 2017 were enrolled. The patients were divided into STD-CPR group and IAPP-CPR group according to the treatment orders of them and the desire of relatives. All patients were given persistent external compression, airway open, tube intubation, and mechanical ventilation, vasoactive drugs application, defibrillation if required. STD-CPR group was operated according to the 2015 American Heart Association (AHA) CPR guidelines. On the basis of the standard CPR, IAPP-CPR group was recovered using abdominal lifting and compressing CPR instrument to press down to lift the upper abdomen continuously, when the chest compressing relaxed (frequency 100 times/min, down and lift time ratio 1:1, compressing strength 50 kg, lifting strength 30 kg). The patients' gender, age and CA etiology were recorded in the two groups. The vital signs and blood flow of carotid artery were monitored with ultrasonic Doppler during the CPR. The return of spontaneous circulation (ROSC) rate and 48-hour survival rate were observed in patients. The influence factors of ROSC were screened by Logistic regression analysis. RESULTS: The data of 75 patients with CA were enrolled finally, with STD-CPR group of 38 patients and IAPP-CPR group of 37 patients. There were no significant differences in patients' gender, age or CA etiology between the two groups. Comparing with STD-CPR group, the peak blood flow velocity of carotid artery in IAPP-CPR group was speeded up significantly (cm/s: 107.16±13.75 vs. 78.99±14.77, P < 0.01), the overall blood flow volume of carotid artery was increased significantly (mL/min: 989.06±115.88 vs. 751.62±118.92, P < 0.01), but there was no significant difference in inner diameter of carotid artery between the two groups (mm: 4.55±0.25 vs. 4.61±0.21, P > 0.05). During the CPR, the mean arterial pressure (MAP) and the transcutaneous oxygen saturation (SpO₂) in IAPP-CPR group were significantly higher than those of STD-CPR group, but no significant difference was found in heart rate between the two groups. Four patients in STD-CPR group got ROSC, and 3 survived over 48 hours (1 myocardial infarction patient died of ventricular fibrillation) while 6 patients in IAPP-CPR group got ROSC and survived over 48 hours. There was no significant difference in ROSC rate or 48-hour survival rate between the two groups, but data of IAPP-CPR group was slightly higher than that of STD-CPR group [ROSC rate: 16.22% (6/37) vs. 10.53% (4/38), 48-hour survival rate: 16.22% (6/37) vs. 7.89% (3/38), both P > 0.05]. Multivariate Logistic regression analysis showed that the higher the MAP during CPR, the greater the possibility of ROSC was [odds ratio (OR) = 1.361, 95% confidence interval (95%CI) = 1.182-1.669, P = 0.030]. CONCLUSIONS IAPP-CPR was superior to traditional STD-CPR in improving arterial blood flow and resuscitation effect, but no superiority was found in ROSC rate and survival rate, which may be relate to the small number of patients that included in this study. More clinic trials are needed.
Cardiopulmonary Resuscitation ; Electric Countershock ; Heart Arrest ; Humans ; Ultrasonics ; Ventricular Fibrillation

OBJECTIVE: To analyze the effect of interposed abdominal pulling-pressing cardiopulmonary resuscitation (IAPP-CPR) and standard cardiopulmonary resuscitation (S-CPR) on hemodynamics and oxygen metabolism in patients with cardiac arrest, and to evaluate the treatment effect of IAPP-CPR. METHODS: The patients with cardiac arrest, cardiac arrest time less than 30 minutes, and with S-CPR indications admitted to intensive care unit (ICU) of the First People's Hospital of Lianyungang from January 2017 to January 2019 were enrolled. The patients were divided into IAPP-CPR group and S-CPR group according to whether the patients had IAPP-CPR indication or not. The patients in the S-CPR group were operated according to the 2015 American Heart Association (AHA) CPR guidelines; and the patients in the IAPP-CPR group received the IAPP-CPR on the basis of the S-CRP. During the relaxation period, the patients were subjected to abdominal lifting and compressing with amplitude of 4-5 cm, frequency of 100-120 times/min, and the time ratio of lifting to compressing was 1:1. Hemodynamic changes during resuscitation were recorded in the two groups. Hemodynamics, oxygen metabolism, arterial blood gas analysis and prognostic indicators were recorded at 30 minutes after successful resuscitation. RESULTS: During the study period, 77 patients were selected, 24 patients were excluded from giving up treatment and quitting, 53 patients were enrolled in the analysis finally, with 28 patients in the S-CPR group and 25 in the IAPP-CPR group. (1) The heart rate (HR), mean arterial pressure (MAP) and coronary perfusion pressure (CPP) showed an upward trend during resuscitation, and a more significant increase was shown in the IAPP-CPR group. (2) Hemodynamics after successful resuscitation: there were 16 patients with successful resuscitation in the IAPP-CPR group and 13 in the S-CPR group. The MAP, CPP, global ejection fraction (GEF) and stroke volume (SV) of patients with successful resuscitation at 30 minutes after resuscitation in the IAPP-CPR group were significantly higher than those in the S-CPR group [MAP mmHg (1 mmHg = 0.133 kPa): 52.88±3.11 vs. 39.39±4.62, CPP (mmHg): 36.56±6.89 vs. 29.61±6.92, GEF: 0.217±0.036 vs. 0.178±0.027, SV (mL): 38.43±5.25 vs. 32.92±8.28, all P < 0.05], but there was no significant difference in central venous pressure (CVP) or HR between the two groups. (3) Oxygen metabolism after successful resuscitation: the cardiac output (CO), arterial oxygen content (CaO₂), oxygen transport (DO₂) and oxygen consumption (VO₂) of patients with successful resuscitation at 30 minutes after resuscitation in the IAPP-CPR group were significantly higher than those in the S-CPR group [CO (L/min): 2.23±0.38 vs. 1.99±0.29, CaO₂ (mL/L): 158.0±11.8 vs. 141.4±8.2, DO₂ (mL/L): 245.8±29.9 vs. 209.1±28.0, VO₂ (mL/L): 138.2±24.9 vs. 112.8±18.1, all P < 0.05]. (4) Arterial blood gas after successful resuscitation: the values of the pH, arterial oxygen partial pressure (PaO₂), arterial partial pressure of carbon dioxide (PaCO₂), oxygenation index (PaO₂/FiO₂) and central venous oxygen saturation (ScvO₂) of patients with successful resuscitation at 30 minutes after resuscitation in the IAPP-CPR were significantly higher than those in the S-CPR group [pH value: 7.13±0.22 vs. 7.00±0.23, PaO₂ (mmHg): 73.68±13.80 vs. 65.32±15.32, PaCO₂ (mmHg): 36.24±11.77 vs. 29.12±7.82, PaO₂/FiO₂ (mmHg): 73.68±13.80 vs. 65.32±15.32, ScvO₂: 0.628±0.074 vs. 0.589±0.066, all P < 0.05], and the blood lactic acid (Lac) level was significantly lower than that in the S-CPR group (mmoL/L: 9.80±4.28 vs. 12.18±3.63, P < 0.05). (5) The patients in the IAPP-CPR group had a shorter time for cardiac arrest to restoration of spontaneous circulation (ROSC) than that in the S-CPR group (minutes: 10.63±2.94 vs. 14.54±3.84, P < 0.01), and the rate of ROSC, CPR successful rate and 28-day survival rate were significantly higher than those in the S-CPR group [64.0% (16/25) vs. 46.4% (13/28), 60.0% (15/25) vs. 28.6% (8/28), 52.0% (13/25) vs. 21.4% (6/28), all P < 0.05]. There was no significant difference in incidence of rib fracture between the IAPP-CPR and S-CPR groups [92.0% (23/25) vs. 89.3% (25/28), P > 0.05], and no abdominal bleeding was found in both group. CONCLUSIONS IAPP-CPR can produce better hemodynamic effect during and after resuscitation than S-CPR, and oxygen metabolism and arterial blood gas analysis parameters at 30 minutes after resuscitation were better than S-CPR, with higher ROSC rate, CPR successful rate and 28-day survival rate, and no significant difference in complications between the two resuscitation methods.
Cardiopulmonary Resuscitation ; Electric Countershock ; Heart Arrest ; Hemodynamics ; Humans ; Oxygen