Abstract:
:Clinically available automatic implantable defibrillators use a monophasic truncated exponential waveform shock; after delivery the charge remaining on the device's capacitors is "dumped" internally and wasted. The efficacy of a monophasic and biphasic truncated exponential defibrillation waveform produced by a single capacitor discharge was compared in seven closed-chest, pentobarbital-anesthetized dogs. Defibrillation leads consisted of a new deployable intrapericardial electrode system. The monophasic waveform was positive and 6 msec in duration. The biphasic waveform had a positive phase identical to that of the monophasic waveform and a negative phase of equal duration with its initial voltage equal to 50% of the final voltage of the positive phase. Defibrillation shocks of varying initial voltage were delivered to construct curves of the percentage of successful defibrillation versus initial voltage and delivered energy, and the voltage and energy required for 50% (V50 and E50, respectively) and 80% (V80 and E80, respectively) success were compared. The biphasic waveform had significantly lower initial voltage (V50: 194 +/- 48 volts vs 227 +/- 48 volts, p less than 0.001; V80: 217 +/- 55 volts vs 256 +/- 66 volts, p less than 0.02) and energy (E50: 2.7 +/- 1.3 joules vs 3.4 +/- 1.5 joules, p less than 0.01; E80: 3.4 +/- 1.6 joules vs 4.3 +/- 2.2 joules, p less than 0.05) requirements than the monophasic waveform. It is concluded that a biphasic waveform produced by a single discharge that uses the "free" energy remaining on the capacitors significantly reduces the initial voltage and energy requirements for successful defibrillation and may improve the efficacy of future automatic implantable defibrillators.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Fain ES,Sweeney MB,Franz MRdoi
10.1016/0002-8703(89)90779-5subject
Has Abstractpub_date
1989-02-01 00:00:00pages
358-64issue
2eissn
0002-8703issn
1097-6744pii
0002-8703(89)90779-5journal_volume
117pub_type
杂志文章abstract::In this overview we studied evidence for the occurrence of silent myocardial ischemia, its pathophysiologic mechanisms, and the circadian distribution of ischemic episodes. The correlation between many hemodynamic parameters and their potential as drug targets was assessed. ECG evidence of myocardial ischemia (ST segm...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(89)90830-2
更新日期:1989-11-01 00:00:00
abstract:BACKGROUND:Coronary artery disease (CAD) and, increasingly, diabetes are recognized as having an inflammatory basis. Membrane toll-like receptors (TLRs) activate signaling pathways that up-regulate inflammation. We evaluated whether the Asp299Gly polymorphism in the TLR4 gene, which impairs inflammatory responses, is a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.05.049
更新日期:2004-12-01 00:00:00
abstract::A new shape-memory coil for transcatheter closure of the PDA was developed and evaluated in a dog PDA model. The coil is sensitive to temperature (composed of thermal shape-memory nickel-titanium). The coil was delivered to and implanted in the PDA model with a 5F catheter through the femoral artery. The PDA model was...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90189-1
更新日期:1996-05-01 00:00:00
abstract:BACKGROUND:Because coronary artery disease (CAD) is a prevalent comorbidity in patients with low ejection function (EF), a number of patients with heart failure undergo diagnostic cardiac catheterization. The objective of this study was to develop a model to assist clinicians in determining the likelihood of CAD before...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.12.001
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Postinterventional cognitive dysfunction (PICD) is a known complication of coronary artery bypass grafting (CABG). However, it is largely unknown whether PICD occurs after coronary catheterization. METHODS:Neuropsychologic data were obtained from 37 patients who received coronary catheterization and 47 pati...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.07.021
更新日期:2011-10-01 00:00:00
abstract::Mitral valve prolapse (MVP) is a common cardiac valve abnormality that affects women more frequently than men. We have previously shown that mild dehydration induces echocardiographic signs of MVP in approximately 50% of healthy asthenic women with previously normal cardiac findings. The present study was designed to ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90047-0
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Randomized trials have indicated that primary coronary angioplasty performed in patients admitted directly to highly-experienced angioplasty centers offers certain advantages over intravenous fibrinolytic therapy. However, the large majority of patients with acute myocardial infarction are submitted to hospi...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/S0002-8703(03)00316-8
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:In the era of coronary stenting with high-pressure expansion, stent thrombosis remains a major life-threatening risk. Because of its superior imaging mode, intracoronary ultrasound could provide insight into potential risk factors for stent thrombosis. PATIENTS AND METHODS:In 215 patients with stent implant...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70097-3
更新日期:1998-02-01 00:00:00
abstract::We altered the mechanical activity of the atrial myocardium in open-chest dogs and measured changes in coronary blood flow distribution, using the radioactive microsphere technique. When left and right atrial pressures were decreased to 2 mm Hg by hypovolemia, atrial coronary blood flow fell to values nearly 50% below...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90701-9
更新日期:1983-09-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) in the setting of heart failure (HF) is linked to embolic stroke and exacerbation of HF. The rate of new-onset AF in patients with left ventricular dysfunction and mild to moderate HF enrolled in the SoLVD trials was significantly lower with enalapril than with placebo (5.4% vs 24% o...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.07.027
更新日期:2005-11-01 00:00:00
abstract::Detection of mild hypertension by a small number of casual blood pressures may be inaccurate for the determination of average blood pressure. Nonetheless, casual pressures remain the basis for the diagnosis and treatment of hypertensive patients. We compared casual and noninvasive ambulatory blood pressure monitoring ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90180-9
更新日期:1988-10-01 00:00:00
abstract::We evaluated electrocardiographically the acute effect of captopril in the initial treatment of malignant or severe hypertension and the findings were compared with the data obtained with diazoxide. The captopril group included seven patients treated with captopril or with a combination of diuretics. The diazoxide gro...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90702-0
更新日期:1983-09-01 00:00:00
abstract:BACKGROUND:Anemia in heart failure is both common and associated with worse symptoms and increased mortality. Several small randomized controlled trials (RCTs) have assessed erythropoiesis-stimulating agents (ESAs), but definitive evaluation and clinical guidance are required. We sought to systematically review the eff...
journal_title:American heart journal
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ahj.2011.02.013
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Cardiac pacing can be challenging after a Fontan operation, and limited data exist regarding pacing in adult Fontan patients. The objectives of our study were to determine risk factors for pacing and occurrence of device-related complications (DRCs) and pacemaker reinterventions. METHODS:We performed a retr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2017.08.019
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) continues to be one of the most common cardiac problems, placing an expanding burden on the public health system. In several circumstances, AF can increase the risk of stroke and heart failure. Current pharmacologic treatment options are associated with the potential for significant ...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2009.05.024
更新日期:2009-08-01 00:00:00
abstract::The prognostic significance of functional status has not been previously studied in the setting of acute myocardial infarction. We assessed the Karnofsky Performance Status (KPS) score, a simple functional status scale that is commonly used to categorize physical ability, in 849 patients with acute myocardial infarcti...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/0002-8703(91)90141-4
更新日期:1991-05-01 00:00:00
abstract::To study the left ventricular (LV) diastolic function in uncomplicated insulin-dependent diabetic patients without hypertension (n = 25) and comparable controls (n = 15), the effect of acute administration of nitroglycerin and nifedipine on cavity dimensions and transmitral flow pattern was investigated by Doppler ech...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90542-h
更新日期:1993-12-01 00:00:00
abstract:BACKGROUND:Complications of vascular access are one of the most common adverse events after coronary angiography and percutaneous coronary intervention (PCI) and are reported to occur in 1% to 9% of cases. There are conflicting reports of the association of vascular complications with the use of vascular closure device...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2006.12.014
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:In the United States as well as globally, Asians are a growing proportion of patients presenting with non-ST-segment elevation myocardial infarction (NSTEMI), yet little is known about their longitudinal outcomes. METHODS:We linked Centers for Medicare & Medicaid claims data to detailed clinical data for 37...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.10.001
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Accurate, reproducible, noninvasive determination of left ventricular (LV) volumes and ejection fraction (EF) is important for clinical assessment, risk stratification, selection of therapy, and serial monitoring of patients with cardiovascular disease. Three-dimensional echocardiography (3DE) approaches hav...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1067/mhj.2000.108513
更新日期:2000-09-01 00:00:00
abstract::Sixty-five patients with dilated cardiomyopathy were studied by means of 24-hour ECG monitoring. Ventricular arrhythmias were present in 62 (95.4%), of whom 52 (80%) showed a complex form (multiform ventricular extrasystoles, pairs, and ventricular tachycardia). Forty-one patients, presenting with complex ventricular ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90711-3
更新日期:1987-03-01 00:00:00
abstract::This study uses echocardiography to characterize the pattern of left ventricular hypertrophy in a new hypertensive heart failure-prone rat strain designated SHHF/Mcc-cp (SHHF). M-mode echocardiograms of the left ventricle in nine 10- to 12-month old SHHF rats and nine age-matched spontaneously hypertensive rats (SHR) ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90081-0
更新日期:1995-10-01 00:00:00
abstract:BACKGROUND:The oxygen uptake efficiency slope (OUES) is a new submaximal parameter which objectively predicts the maximal exercise capacity in children and healthy subjects. However, the usefulness of OUES in adult patients with and without advanced heart failure remains undetermined. The present study investigates the...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.07.004
更新日期:2005-01-01 00:00:00
abstract::This study examined the value of resting thallium-201 imaging in differentiating patients with primary cardiomyopathy from those with ischemic cardiomyopathy. There were 15 patients with primary cardiomyopathy (group I); 20 with chronic CAD (group II); and 25 with acute Q wave myocardial infarction (group III). All pa...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90113-4
更新日期:1986-04-01 00:00:00
abstract::To investigate the sequence of changes in regional myocardial perfusion which precedes stress-induced angina, we measured great cardiac vein flow (GCVF), draining the anterior left ventricle, during incremental atrial pacing in 10 patients with normal anterior perfusion (group I) and in 11 patients with greater than o...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90374-0
更新日期:1984-02-01 00:00:00
abstract::The extent and time course of recovery of left ventricular function were investigated in 29 patients with no previous symptoms who had acute nonischemic congestive cardiomyopathy and left ventricular ejection fraction of 0.22 +/- 0.07. Improvement in left ventricular ejection fraction by at least 0.05 was observed in ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90038-1
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:We compared efficacy and safety of short- (3 or 6 months) versus long-term (≥12 months) dual antiplatelet therapy (DAPT) after drug-eluting stent (DES) implantation, according to the presence of chronic kidney disease (CKD). METHODS:Patient-level pooled analysis was performed with 7242 patients (87.2% with ...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2017.11.013
更新日期:2018-03-01 00:00:00
abstract::Percutaneous transluminal coronary recanalization, a new therapeutic procedure used in acute myocardial infarction, offers significant reduction in mortality, as well as more effective limitation of the zone of infarction than has been possible with other pharmacologic treatment employed in the past. The risk of coron...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90649-9
更新日期:1981-12-01 00:00:00
abstract::Oxygen has long been assumed beneficial for all ill and injured patients. However, hyperoxia may be harmful and aggravate myocardial injury such as that caused by myocardial infarction. We aimed to investigate if hyperoxia increases myocardial injury following direct current cardioversion compared with room air. METH...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2017.10.006
更新日期:2018-02-01 00:00:00
abstract::To determine how early myocardial infarction can be detected, serial creatine kinase MB concentrations were sampled in 313 patients during triage of acute (less than 12 hours) chest pain. Serum was sampled on hospital arrival (baseline) and hourly for 3 hours (total of four samples). Creatine kinase MB concentrations ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90646-d
更新日期:1992-02-01 00:00:00