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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 -
European Journal of Medical Research Mar 2022To provide an economical and practical defibrillator for first aid teaching and training, to reduce the cost of teaching and training, increase teaching and training...
BACKGROUND
To provide an economical and practical defibrillator for first aid teaching and training, to reduce the cost of teaching and training, increase teaching and training equipment, provide trainees with more hands-on training sessions, and improve first aid capabilities.
METHODS
Developing a special teaching defibrillator with the same structure and operation configuration as the clinical medical emergency defibrillator. The appearance, structure and operating accessories of the two defibrillators are the same. The difference between the defibrillator and the clinical medical emergency defibrillator are as follows: the clinical medical emergency defibrillator can be energized, and there are expensive electronic accessories and defibrillation accessories for charging and discharging in the machine. When discharging, the electrode plate has current discharged into the human body; the power plug of the "special defibrillator for teaching and training" is a fake plug. When the power is plugged in, no current enters the body and the machine. There are no expensive electronic accessories and defibrillation accessories for charging and discharging, and no current is discharged during discharge. Then compare the teaching effect of the special defibrillator for teaching and training and the clinical medical emergency defibrillator (including operation score and attitude after training).
RESULTS
The scores of defibrillator operation in the experimental group of junior college students (87.77 ± 4.11 vs. 83.30 ± 4.56, P < 0.001) and the experimental group of undergraduate students (90.40 ± 3.67 vs. 89.12 ± 3.68, P = 0.011) were higher than those in the corresponding control group; The attitude of junior college students in the experimental group and undergraduate students in the experimental group after training was more positive than that of the corresponding control group (P < 0.05).
CONCLUSIONS
The special defibrillator for teaching and training can save the purchase cost of teaching equipment, increase teaching and training resources, and improve the trainee's defibrillation ability, defibrillation confidence and defibrillation security.
Topics: Adolescent; Adult; Cardiology; Defibrillators; Education, Medical; Electric Countershock; Female; Humans; Male; Students, Medical; Teaching; Young Adult
PubMed: 35236410
DOI: 10.1186/s40001-022-00657-4 -
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 -
Annals of Saudi Medicine 2009External electrical cardioversion was first performed in the 1950s. Urgent or elective cardioversions have specific advantages, such as termination of atrial and... (Review)
Review
External electrical cardioversion was first performed in the 1950s. Urgent or elective cardioversions have specific advantages, such as termination of atrial and ventricular tachycardia and recovery of sinus rhythm. Electrical cardioversion is life-saving when applied in urgent circumstances. The succcess rate is increased by accurate tachycardia diagnosis, careful patient selection, adequate electrode (paddles) application, determination of the optimal energy and anesthesia levels, prevention of embolic events and arrythmia recurrence and airway conservation while minimizing possible complications. Potential complications include ventricular fibrillation due to general anesthesia or lack of synchronization between the direct current (DC) shock and the QRS complex, thromboembolus due to insufficient anticoagulant therapy, non-sustained VT, atrial arrhythmia, heart block, bradycardia, transient left bundle branch block, myocardial necrosis, myocardial dysfunction, transient hypotension, pulmonary edema and skin burn. Electrical cardioversion performed in patients with a pacemaker or an incompatible cardioverter defibrillator may lead to dysfunction, namely acute or chronic changes in the pacing or sensitivity threshold. Although this procedure appears fairly simple, serious consequences might occur if inappropriately perfformed.
Topics: Arrhythmias, Cardiac; Defibrillators; Electric Countershock; Emergencies; Equipment Design; Humans
PubMed: 19448376
DOI: 10.4103/0256-4947.51775 -
Sensors (Basel, Switzerland) Dec 2021A wearable cardioverter-defibrillator (WCD) is a temporary treatment option for patients at high risk for sudden cardiac death (SCD) and for patients who are temporarily... (Review)
Review
A wearable cardioverter-defibrillator (WCD) is a temporary treatment option for patients at high risk for sudden cardiac death (SCD) and for patients who are temporarily not candidates for an implantable cardioverter defibrillator (ICD). In addition, the need for telemedical concepts in the detection and treatment of heart failure (HF) and its arrhythmias is growing. The WCD has evolved from a shock device detecting malignant ventricular arrhythmias (VA) and treating them with shocks to a heart-failure-monitoring device that captures physical activity and cardioacoustic biomarkers as surrogate parameters for HF to help the treating physician surveil and guide the HF therapy of each individual patient. In addition to its important role in preventing SCD, the WCD could become an important tool in heart failure treatment by helping prevent HF events by detecting imminent decompensation via remote monitoring and monitoring therapy success.
Topics: Arrhythmias, Cardiac; Death, Sudden, Cardiac; Defibrillators, Implantable; Electric Countershock; Humans; Wearable Electronic Devices
PubMed: 35009564
DOI: 10.3390/s22010022 -
Hellenic Journal of Cardiology : HJC =... 2020
Topics: Death, Sudden, Cardiac; Defibrillators, Implantable; Electric Countershock; Humans
PubMed: 33321183
DOI: 10.1016/j.hjc.2020.12.005 -
Journal of the American College of... Jun 2015
Topics: Cardiac Resynchronization Therapy; Cardiovascular Diseases; Defibrillators, Implantable; Electric Countershock; Female; Humans; Male; Pacemaker, Artificial; Patient Compliance; Remote Sensing Technology
PubMed: 25983010
DOI: 10.1016/j.jacc.2015.04.031 -
Journal of the American Heart... Jun 2021Background COVID-19 was temporally associated with an increase in out-of-hospital cardiac arrests, but the underlying mechanisms are unclear. We sought to determine if...
Background COVID-19 was temporally associated with an increase in out-of-hospital cardiac arrests, but the underlying mechanisms are unclear. We sought to determine if patients with implantable defibrillators residing in areas with high COVID-19 activity experienced an increase in defibrillator shocks during the COVID-19 outbreak. Methods and Results Using the Medtronic (Mounds View, MN) Carelink database from 2019 and 2020, we retrospectively determined the incidence of implantable defibrillator shock episodes among patients residing in New York City, New Orleans, LA, and Boston, MA. A total of 14 665 patients with a Medtronic implantable defibrillator (age, 66±13 years; and 72% men) were included in the analysis. Comparing analysis time periods coinciding with the COVID-19 outbreak in 2020 with the same periods in 2019, we observed a larger mean rate of defibrillator shock episodes per 1000 patients in New York City (17.8 versus 11.7, respectively), New Orleans (26.4 versus 13.5, respectively), and Boston (30.9 versus 20.6, respectively) during the COVID-19 surge. Age- and sex-adjusted hurdle model showed that the Poisson distribution rate of defibrillator shocks for patients with ≥1 shock was 3.11 times larger (95% CI, 1.08-8.99; =0.036) in New York City, 3.74 times larger (95% CI, 0.88-15.89; =0.074) in New Orleans, and 1.97 times larger (95% CI, 0.69-5.61; =0.202) in Boston in 2020 versus 2019. However, the binomial odds of any given patient having a shock episode was not different in 2020 versus 2019. Conclusions Defibrillator shock episodes increased during the higher COVID-19 activity in New York City, New Orleans, and Boston. These observations may provide insights into COVID-19-related increase in cardiac arrests.
Topics: Aged; Boston; COVID-19; Death, Sudden, Cardiac; Defibrillators, Implantable; Electric Countershock; Female; Humans; Incidence; Male; New Orleans; New York City; Out-of-Hospital Cardiac Arrest; Poisson Distribution; SARS-CoV-2
PubMed: 34044586
DOI: 10.1161/JAHA.120.019708 -
Trends in Cardiovascular Medicine Aug 2020The completely subcutaneous implantable cardioverter defibrillator (S-ICD) is rapidly evolving to become a complete alternative for the transvenous ICD (TV-ICD) leaving... (Review)
Review
The completely subcutaneous implantable cardioverter defibrillator (S-ICD) is rapidly evolving to become a complete alternative for the transvenous ICD (TV-ICD) leaving the heart and vasculature untouched. Newer trials and registries in cohorts that are similar to real-world ICD patient populations confirm the initial data on safety and efficacy. Technical improvements have resulted in reduced inappropriate shock rates, although more data are warranted, and new developments such as substernal lead positioning, communication between the S-ICD and a leadless cardiac pacemaker and remote monitoring options have evolved to overcome the shortcomings of S-ICD therapy. With these continuing developments, it is expected that within the next years the S-ICD will continue to evolve to a treatment option for ventricular arrhythmia as effective as the TV-ICD overcoming the shortcomings of transvenous leads as well as the drawbacks of the initial system, providing effective shock therapy, pacing capabilities, low complication and inappropriate therapy rates, and automated remote monitoring.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Defibrillators, Implantable; Diffusion of Innovation; Electric Countershock; Female; Forecasting; Heart Failure; Heart Rate; Humans; Male; Middle Aged; Prosthesis Design; Prosthesis Failure; Remote Sensing Technology; Stroke Volume; Tachycardia, Ventricular; Time Factors; Treatment Outcome; Ventricular Fibrillation; Ventricular Function, Left; Young Adult
PubMed: 31610949
DOI: 10.1016/j.tcm.2019.09.006 -
Global Heart 2022Implantation of implantable cardioverter-defibrillators (ICD) has increased significantly over the past decade. However, limited data exist regarding practices and... (Review)
Review
BACKGROUND AND OBJECTIVES
Implantation of implantable cardioverter-defibrillators (ICD) has increased significantly over the past decade. However, limited data exist regarding practices and policies of ICD implantations in Kazakhstan. We aimed to provide an overview of the current use of ICD in Kazakhstan.
METHODS
Using the Unified Healthcare Information System database of the entire Kazakh adult population, statistical and cost data of ICD implantations in 2017-2019 were evaluated. Cardiologists and electrophysiologists working in cardio surgery centers and departments were asked to go through an online survey focused on subcutaneous-ICD (S-ICD) experience.
RESULTS
Implantation of traditional transvenous cardioverter-defibrillators for residents of Kazakhstan is fully reimbursed. A total of 2,263 ICD interventions (2,252 new implantations and 11 reimplantations) were performed across the country during the study period. According to the tariffs approved by the Ministry of Health, the reimbursement cost for one ICD case is about 14,061.80 US dollars. The survey showed that only two hospitals have implanted S-ICDs. Among the main reasons why S-ICD is not widely used in the country the following were named: lack of trained staff (61.1% of respondents); the cost of device and lack of reimbursement (38.7%); and lack of pacing function (27.8%).
CONCLUSION
The number of ICD implantation in Kazakhstan is steadily continuing to grow, although, compared to developed countries, the implantation rate especially for S-ICD remains low. There is a need in deliberate strategies to remove policy barriers for implementation the most innovative cardiac implantable electronic devices implantations such as S-ICD in the country.
Topics: Adult; Death, Sudden, Cardiac; Defibrillators, Implantable; Electric Countershock; Electrocardiography; Humans; Kazakhstan; Surveys and Questionnaires; Treatment Outcome
PubMed: 35586742
DOI: 10.5334/gh.1119