Abstract:
:Automatic external defibrillators (AEDs) represent an important technologic innovation in the management of out-of-hospital cardiac arrest. We propose the following concept: AEDs are machines with the limited task of ventricular fibrillation (VF) identification, countershock delivery, and defibrillation. They cannot be expected to produce "saves" independently. This study tested this concept by using the same AED in two different emergency medical systems: outcomes dependent upon the device should be the same in both groups, whereas outcomes dependent upon patient and system factors should be different. Paramedics, with the AED as their initial monitor/defibrillator, treated 16 cardiac arrest patients in VF; EMTs (emergency medical technicians), with the same AED, treated 17 patients in VF. There were no significant differences in the outcomes proposed to be machine-dependent: sensitivity, defined as the percentage of VF rhythm segments shocked; specificity, defined as the percentage of non-VF rhythms not shocked; and defibrillation of segments of VF to non-VF rhythms. There were, however, differences in the outcomes dependent on patient and system factors (paramedic group presented first): percent converted to a perfusing rhythm (23% vs 69%; p less than 0.05); percent admitted to the hospital (19% vs 65%; p less than 0.025); and percent discharged from the hospital (6% vs 29%; p = N.S.). We conclude that AEDs should be compared and evaluated on device-dependent outcomes and not on the basis of producing "saves".
journal_name
Am Heart Jjournal_title
American heart journalauthors
Cummins RO,Eisenberg MS,Hallstrom AP,Hearne TR,Graves JR,Litwin PEdoi
10.1016/0002-8703(85)90002-xsubject
Has Abstractpub_date
1985-12-01 00:00:00pages
1133-8issue
6eissn
0002-8703issn
1097-6744pii
0002-8703(85)90002-Xjournal_volume
110pub_type
杂志文章abstract::We evaluated the use of simple balloon overinflation to induce neointimal hyperplasia in a porcine model of coronary artery restenosis. By using standard percutaneous transluminal coronary angioplasty techniques, left anterior descending (LAD) and/or left circumflex (LCX) coronary arteries of either juvenile feeder pi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90505-3
更新日期:1994-01-01 00:00:00
abstract::The primary objective of this study was to apply a sophisticated coagulation monitoring system including estimation of the concentration of prothrombin fragment 1 + 2 (PTF 1 + 2) and the activity of prothrombin (coagulation factor II or FII) to cases of stent implantation and to compare the results with those of stand...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(95)90433-6
更新日期:1995-08-01 00:00:00
abstract::In 10 treated and 2 control dogs, the short-term effects of intravenous propafenone (2 mg/kg/10 minutes, followed by 1 mg/min [n = 2] or 25 micrograms/kg/min [n = 8]) on the internal ventricular defibrillation energy requirements (DER) were investigated. Multiple stored energy levels were randomly tested and the perce...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90577-5
更新日期:1991-11-01 00:00:00
abstract::We assessed the relationship between echocardiographic and hemodynamic parameters in 28 patients with documented acute myocardial infarction (AMI), who underwent M-mode echocardiography and Swan-Ganz catheterization during the same hospitalization. Patients with valvular heart disease were excluded from the study. On ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90542-8
更新日期:1984-07-01 00:00:00
abstract:BACKGROUND:Coronary artery disease (CAD) is the most common cause of left ventricular systolic dysfunction (LVSD). Patients with ischemia as the cause of LVSD may warrant revascularization. Angiography is the most accurate method of CAD diagnosis but is invasive, expensive, and associated with some risk. Noninvasive im...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/j.ahj.2010.03.026
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Sexuality is an important factor influencing quality of life that may be altered for patients with coronary disease. Little is known about the extent to which patients want their cardiologists to counsel them about sexuality. PURPOSE:Our study evaluated the extent to which patients with known coronary disea...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.124053
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:Strenuous exercise can be a major trigger for coronary thrombosis and it enhances platelet aggregation. METHODS:We evaluated the effect of antiplatelet therapy on shear stress-induced platelet aggregation (SIPA), in addition to agonist-induced aggregation, before and immediately after ergometer exercise in ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mhj.2001.116485
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:Drug-eluting stents have been shown to reduce restenosis in many types of lesions. The purpose of this article is to assess the efficacy of sirolimus- and paclitaxel-eluting stents in patients with bifurcation lesions. METHODS:Between June 2003 and October 2004, 205 patients were enrolled in a prospective r...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2006.10.017
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:The incidence of end-stage renal disease (ESRD) has been consistently shown to be higher among blacks and Hispanics compared to whites with unmeasured risk factors and access to care as suggested explanations. In a high-risk cohort with frequent protocol-directed follow-up, we evaluated the influence of race...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2015.05.008
更新日期:2015-08-01 00:00:00
abstract::In order to properly advise cardiac patients in the regulation of their sexual activity, more basic physiologic information is needed concerning the cardiovascular effects of sexual intercourse. This study examined the effects of the male's position during sexual intercourse on heart rate and blood pressure responses....
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(76)80106-8
更新日期:1976-09-01 00:00:00
abstract:BACKGROUND:Pregnancy is increasingly common in women with congenital heart disease (CHD), but little is known about long-term cardiovascular outcome after pregnancy in these patients. We studied the incidence of cardiovascular events 1-year postpartum and compared cardiac function prepregnancy and 1-year postpartum in ...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2014.11.010
更新日期:2015-02-01 00:00:00
abstract::The purpose of this study was to assess the recovery of the left ventricular pressure (PLV), and the incidence and type of arrhythmias after effective low-dose defibrillation (Imax = 18-70 A) in healthy hearts and in hearts with acute myocardial infarction (AMI) in the intact dog. In fifteen dogs 84 episodes of fibril...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90195-3
更新日期:1983-08-01 00:00:00
abstract::A total of 127 patients with chronic heart failure referred to our exercise laboratory were studied retrospectively to identify parameters predictive of prognosis. Patients were followed for a mean of 14.6 months. The group as a whole had severe ventricular dysfunction with a median ejection fraction of 17% and a medi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90656-g
更新日期:1992-02-01 00:00:00
abstract::To assess the effects of chronic left ventricular (LV) dysfunction on intravascular pulmonary blood volume (PBV) and extravascular lung water (EVLW) lung fluid volumes, 56 dogs were evaluated by means of double-indicator dilution techniques. PBV and EVLW were measured in seven control dogs, in eight dogs 4 hours after...
journal_title:American heart journal
pub_type: 杂志文章,收录出版
doi:10.1016/0002-8703(84)90421-6
更新日期:1984-09-01 00:00:00
abstract:BACKGROUND:Lipid lowering through statin therapy significantly reduces the risk of cardiovascular events. The ENHANCE study is an international 2-year, randomized, double-blind, controlled trial designed to test the hypothesis that treatment of hypercholesterolemia by use of 2 complementary agents, ezetimibe (a specifi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.06.024
更新日期:2005-02-01 00:00:00
abstract::Acute myocardial infarction, particularly of the inferior wall, is frequently associated with bradycardia and hypotension. This study reports the occurrence of transient bradycardia hypotension (TBH) (Bezold-Jarisch reflex) following thrombolytic therapy with intravenous streptokinase. Of the 52 patients, 42 had succe...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90508-9
更新日期:1986-09-01 00:00:00
abstract::Patients experiencing out-of-hospital cardiac arrest (OHCA) without ST-segment elevation are a heterogenic group with a variety of underlying causes. Up to one-third of patients display a significant coronary lesion compatible with myocardial infarction as OHCA trigger. There are no randomized data on patient selectio...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2018.12.005
更新日期:2019-03-01 00:00:00
abstract::Plasma catecholamine levels were determined in 26 cases of uncomplicated myocardial infarction within 24 hours of onset of acute chest pain. Blood samples were collected at time of entry and at 4-hour intervals during the 48 hours following admission. Average values of plasma catecholamines within 1 hour of onset of p...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(79)90278-3
更新日期:1979-11-01 00:00:00
abstract::We studied the diagnostic value of exercise electrocardiographic (ECG) testing in 191 patients who were completely asymptomatic 6 months after a successful percutaneous transluminal coronary angioplasty procedure. With > 70%- and > 50%-diameter stenosis at follow-up as restenosis criteria, the sensitivities of exercis...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(95)90267-8
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND:Familial hypertrophic cardiomyopathy (HCM) is a clinically and genetically heterogeneous disease of the sarcomere. Molecular genetic studies have shown that familial HCM involves mutations in 8 different genes that encode proteins of the myofibrillar apparatus. METHODS:We thoroughly searched these genes to ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.112487
更新日期:2001-02-01 00:00:00
abstract::Plasma concentrations of immunoreactive alpha-human atrial natriuretic polypeptide (i alpha-hANP) and cyclic guanosine monophosphate (cGMP) were measured in 70 patients with heart disease. Plasma concentrations of i alpha-hANP were directly related to the severity of heart disease (F = 29.61, p less than 0.001). Plasm...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90663-6
更新日期:1987-06-01 00:00:00
abstract::We discuss the anatomy, physiology, and pathophysiology of epicardial adipose tissue and its relationship to coronary atherosclerosis. Epicardial fat stores triglyceride to supply free fatty acids for myocardial energy production and produces adipokines. It shares a common embryological origin with mesenteric and omen...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2007.03.019
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:l-arginine is a commonly consumed dietary conditional essential amino acid found in food items and supplements, which is closely related to asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA). l-arginine is thought to increase nitric oxide and be cardioprotective, whereas ADMA and SDMA m...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.07.021
更新日期:2016-12-01 00:00:00
abstract::Adenosine thallium stress testing has a demonstrated utility in the detection of coronary artery disease. The optimal dose for diagnostic efficacy with minimal side effects has not been critically evaluated. A randomized 3- and 6-minute infusion of adenosine (140 micrograms/kg/min) was performed in 11 subjects. Subjec...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-8703(07)80015-9
更新日期:1993-07-01 00:00:00
abstract::Angina pectoris before and after MI was evaluated in a sample of 729 men and women from a general population in whom MI developed during a 36-year period of follow-up. Relations of AP to subsequent CHD events and mortality after initial MI were analyzed by proportional hazards regression models and were adjusted for c...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90406-8
更新日期:1996-07-01 00:00:00
abstract::The medical records of 254 patients with atrial fibrillation were reviewed to determine the incidence of embolic events in relation to type of cardiovascular disease, duration of atrial fibrillation, and use of anticoagulants. During a total follow-up of 833 patient-years in atrial fibrillation, there were 32 instance...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90318-2
更新日期:1986-11-01 00:00:00
abstract:BACKGROUND:Epidemiologic studies suggest that inhibition of renin-angiotensin system with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may prevent development of atrial fibrillation (AF). OBJECTIVE:The objective of the study was to assess if there is significant indication for using angio...
journal_title:American heart journal
pub_type: 杂志文章,meta分析
doi:10.1016/j.ahj.2006.01.007
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Infants born to cocaine-using mothers have a 3- to 8-fold increase in sudden infant death syndrome. Its underlying cause, in part, may be attributed to abnormal autonomic function. We proposed to study heart rate variability, reflecting autonomic control of the heart, in cocaine-exposed infants. METHODS:Fro...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.118112
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:In the United States, there continues to be debate about whether certain types of hospitals deliver improved patient outcomes. We sought to assess the association between hospital organizational characteristics and in-hospital outcomes for percutaneous coronary intervention (PCI). METHODS:Retrospective anal...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2011.10.010
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Although inflammation is a core element of atherogenesis and plasma levels of fibrinogen (FGB), homocysteine, and intercellular adhesion molecule-1 (ICAM-1) differ by race/ethnicity, little is known about the role of genetic polymorphisms in the FGB, methylenetetrahydrofolate reductase (MTHFR), and ICAM-1 ge...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.12.012
更新日期:2009-04-01 00:00:00