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Archives of Cardiovascular Diseases Mar 2019Out-of-hospital sudden cardiac arrest (OHCA) is a major public health issue, with a survival rate at hospital discharge that remains below 10% in most cities, despite... (Review)
Review
Out-of-hospital sudden cardiac arrest (OHCA) is a major public health issue, with a survival rate at hospital discharge that remains below 10% in most cities, despite huge investments in this domain. Early basic life support (BLS) and early defibrillation using automated external defibrillators (AEDs) stand as key elements for improving OHCA survival rate. Nevertheless, the use of AEDs in OHCA remains low, for a variety of reasons, including the number, accessibility and ease of locating AEDs, as well as bystanders' awareness of BLS manœuvres and of the need to use AEDs. Several measures have been proposed to improve the rate of AED use, including optimization of AED deployment strategies as well as the use of drones to bring the AEDs to the OHCA scene and of mobile applications to locate the nearest AED. If they are to be effective, these measures should be combined with large communication campaigns on OHCA, and wide-scale education of the public in BLS and AEDs, to reduce the burden of OHCA.
Topics: Defibrillators; Electric Countershock; Health Knowledge, Attitudes, Practice; Health Promotion; Health Services Accessibility; Humans; Out-of-Hospital Cardiac Arrest; Outcome and Process Assessment, Health Care; Time-to-Treatment; Treatment Outcome
PubMed: 30594573
DOI: 10.1016/j.acvd.2018.11.001 -
Giornale Italiano Di Cardiologia (2006) Nov 2019Overcoming lead-related complications, the subcutaneous implantable cardioverter-defibrillator (S-ICD) represents the greatest advancement in the management of patients... (Review)
Review
Overcoming lead-related complications, the subcutaneous implantable cardioverter-defibrillator (S-ICD) represents the greatest advancement in the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Due to the absence of leads within the body, the S-ICD requires an innovative approach for sensing of subcutaneous signals and defibrillation. The aim of this review is to analyze the current evidence regarding patient selection, technical aspects such as the implant technique, programming and follow-up, as well as complications and troubleshooting of this innovative technology.
Topics: Arrhythmias, Cardiac; Death, Sudden, Cardiac; Defibrillators, Implantable; Electric Countershock; Humans; Patient Selection
PubMed: 31697271
DOI: 10.1714/3254.32225 -
Europace : European Pacing,... Mar 2017The wearable cardioverter-defibrillator has been available for over a decade and now is frequently prescribed for patients deemed at high arrhythmic risk in whom the... (Review)
Review
The wearable cardioverter-defibrillator has been available for over a decade and now is frequently prescribed for patients deemed at high arrhythmic risk in whom the underlying pathology is potentially reversible or who are awaiting an implantable cardioverter-defibrillator. The use of the wearable cardioverter-defibrillator is included in the new 2015 ESC guidelines for the management of ventricular arrhythmias and prevention of sudden cardiac death. The present review provides insight into the current technology and an overview of this approach.
Topics: Arrhythmias, Cardiac; Cost-Benefit Analysis; Death, Sudden, Cardiac; Defibrillators; Diffusion of Innovation; Electric Countershock; Equipment Design; Health Care Costs; Humans; Patient Compliance; Patient Satisfaction; Risk Factors; Treatment Outcome
PubMed: 27702851
DOI: 10.1093/europace/euw180 -
Journal of Cardiovascular... May 2022
Topics: Death, Sudden, Cardiac; Defibrillators; Defibrillators, Implantable; Electric Countershock; Humans; Wearable Electronic Devices
PubMed: 35175650
DOI: 10.1111/jce.15416 -
European Heart Journal Aug 2020
Topics: Defibrillators, Implantable; Electric Countershock; Heart; Humans
PubMed: 32785602
DOI: 10.1093/eurheartj/ehaa609 -
Der Anaesthesist Aug 2019Charging defibrillators prior to analyzing heart rhythms may decrease the no-flow time during rhythm check pauses while resuscitating in cardiac arrest. Although this... (Review)
Review
INTRODUCTION
Charging defibrillators prior to analyzing heart rhythms may decrease the no-flow time during rhythm check pauses while resuscitating in cardiac arrest. Although this anticipatory method is already used in some centers little is known about its safety. This study was carried out to confirm the safety and feasibility of the anticipatory method. It was hypothesized that this anticipatory method results in shorter total no-flow times, while other parameters of defibrillation efficacy including defibrillator safety and minimization of peri-shock pauses are unchanged.
METHODS
This manikin study assigned 243 medical students randomly to study groups, 121 to the anticipatory method and 122 to the recommended European Resuscitation Council (ERC) algorithm. Of these 237 students ultimately underwent training (112 anticipatory method vs. 125 ERC algorithm). Participants were assessed and video recorded during a simulated cardiac arrest scenario which included three different heart rhythms (ventricular fibrillation [VF], pulseless ventricular tachycardia [pVT], asystole) in randomized order. Video and software analyses were performed. Defibrillation safety was assessed using a 17-item checklist defined beforehand.
RESULTS
A total of 203 simulated cardiac arrests (75 anticipatory method and 128 ERC 2010 algorithm) were analyzed. The anticipatory method did not significantly reduce no-flow time (25.8 s, standard deviation, SD 7.4 s vs. 27.4 s SD 8.4 s, p = 0.19); however, peri-shock pauses were significantly longer in the anticipatory group compared to the ERC 2010 group (9.5 s SD 2.8 s vs. 3.3 s SD 1.9 s, p < 0.001). No significant difference concerning defibrillation safety between the groups was observed according to the 17-item checklist (14.6 SD 1.6 vs. 15.0 SD 1.4, p = 0.07).
CONCLUSION
Charging defibrillators before rhythm analysis did not decrease total no-flow time in simulated cardiac arrests but resulted in significantly longer peri-shock pauses exceeding 5 s. No significant differences in defibrillation safety were observed between the groups.
Topics: Adult; Cardiopulmonary Resuscitation; Defibrillators; Electric Countershock; Heart Arrest; Humans
PubMed: 31332449
DOI: 10.1007/s00101-019-0623-x -
Current Opinion in Cardiology Jan 2014To consider the case of need that underpinned the development of the subcutaneous implantable cardioverter-defibrillator (SICD), the preclinical and clinical data... (Review)
Review
PURPOSE OF REVIEW
To consider the case of need that underpinned the development of the subcutaneous implantable cardioverter-defibrillator (SICD), the preclinical and clinical data obtained so far, its current role and likely future.
RECENT FINDINGS
The data from prospective clinical evaluation of the device demonstrated safety and efficacy leading to Food and Drug Administration approval. This superseded earlier reports from Europe that raised some clinical concerns, previously anticipated through the introduction of new technology. Recent estimates indicate maybe 55% of patients in routine clinical practice needing an ICD are potentially suitable for a subcutaneous device.
SUMMARY
The SICD provides a useful alternative for high-energy (ICD) therapy in those deemed at risk and who need defibrillation and in whom there are no indications for cardiac resynchronization, bradycardia support or antitachycardia pacing. There is the possibility of both higher specificity and the avoidance of myo-cellular damage with shock delivery, and if these two aspects play out subcutaneous defibrillation could become an option of choice in many settings.
Topics: Cardiac Resynchronization Therapy; Cardiac Resynchronization Therapy Devices; Death, Sudden, Cardiac; Defibrillators, Implantable; Device Approval; Electric Countershock; Humans; Treatment Outcome; United States; United States Food and Drug Administration
PubMed: 24284982
DOI: 10.1097/HCO.0000000000000031 -
Current Problems in Cardiology Feb 2018Sudden cardiac death is a potentially fatal clinical event demanding use of emergent intervention such as defibrillation. Over the last 1 decade, development of devices... (Review)
Review
Sudden cardiac death is a potentially fatal clinical event demanding use of emergent intervention such as defibrillation. Over the last 1 decade, development of devices such as implantable and wearable cardioverter defibrillators (WCD) has provided new avenues in the management of sudden cardiac death. Several clinical studies have commented on the therapeutic and preventive aspect of WCD, however, literature describing the device functioning and limitations is limited. In this review study, we describe the technical aspects and limitations of WCD with a focus on identifying potential areas of improvement and framework for future research studies.
Topics: Clothing; Death, Sudden, Cardiac; Defibrillators; Diffusion of Innovation; Electric Countershock; Equipment Design; Humans; Risk Factors; Treatment Outcome
PubMed: 29277221
DOI: 10.1016/j.cpcardiol.2017.04.002 -
Heart Rhythm Feb 2022
Topics: Defibrillators, Implantable; Electric Countershock; Risk Factors
PubMed: 34757192
DOI: 10.1016/j.hrthm.2021.10.029 -
Minerva Cardioangiologica Feb 2018The implantable cardioverter defibrillator (ICD) is today an indisputable evidence-based treatment for cardiac sudden death both in primary and secondary prevention.... (Review)
Review
The implantable cardioverter defibrillator (ICD) is today an indisputable evidence-based treatment for cardiac sudden death both in primary and secondary prevention. However many clinical conditions that would represent an indication to ICD implantation, according to guidelines, may be potentially reversible or may be accompanied by temporary contraindications to the implant. Moreover transvenous cardioverter defibrillator implantation still carries a not negligible risk of complications both acutely and at follow-up. The Wearable Cardioverter Defibrillator and the Subcutaneous Defibrillator are two recently developed technologies that can potentially overcome the aforementioned limitations of traditional transvenous ICDs. This review will discuss the main aspects of these 2 technologies, the data coming from clinical experiences and future perspectives.
Topics: Death, Sudden, Cardiac; Defibrillators; Defibrillators, Implantable; Electric Countershock; Humans; Practice Guidelines as Topic; Primary Prevention; Secondary Prevention; Wearable Electronic Devices
PubMed: 28696089
DOI: 10.23736/S0026-4725.17.04468-1