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Titolo:
Mechanisms by which AC leakage currents cause complete hemodynamic collapse without inducing fibrillation
Autore:
Malkin, RA; Hoffmeister, BK;
Indirizzi:
Univ Memphis, Joint Program Biomed Engn, Memphis, TN 38152 USA Univ Memphis Memphis TN USA 38152 gram Biomed Engn, Memphis, TN 38152 USA Univ Tennessee, Memphis, TN USA Univ Tennessee Memphis TN USAUniv Tennessee, Memphis, TN USA Rhodes Coll, Memphis, TN 38112 USA Rhodes Coll Memphis TN USA 38112Rhodes Coll, Memphis, TN 38112 USA
Titolo Testata:
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
fascicolo: 10, volume: 12, anno: 2001,
pagine: 1154 - 1161
SICI:
1045-3873(200110)12:10<1154:MBWALC>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
UPPER-LIMIT; STIMULATION; VULNERABILITY;
Keywords:
AC leakage currents; ventricular fibrillation; medical device safety; hemodynamic collapse;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
14
Recensione:
Indirizzi per estratti:
Indirizzo: Malkin, RA Univ Memphis, Joint Program Biomed Engn, ET330-BIOM, Memphis, TN 38152 USA Univ Memphis ET330-BIOM Memphis TN USA 38152 phis, TN 38152 USA
Citazione:
R.A. Malkin e B.K. Hoffmeister, "Mechanisms by which AC leakage currents cause complete hemodynamic collapse without inducing fibrillation", J CARD ELEC, 12(10), 2001, pp. 1154-1161

Abstract

AC-Induced Non-VF Collapse. Introduction: The first study of weak alternating current (AC) stimulation in closed chest humans showed that complete hemodynamic collapse can occur below the threshold for inducing ventricular fibrillation (VF), a heretofore unknown danger to patients. This article, and the accompanying simulation article, explore the mechanisms responsible for the collapse. Methods and Results: A quadripolar pacing catheter was placed in the rightventricle (RV) of six dogs. The tip of the catheter (17 mm(2)) carried 5 seconds of AC stimulation ranging from 10 to 160 Hz and 10 to 1,000 muA. Thelead H body surface ECG, femoral artery pressure, and a bipole from the proximal pair of electrodes on the RV catheter were recorded 2 seconds before, during, and 2 seconds after stimulation. Based on the blood pressure, every episode was categorized as VF, COLLAPSE without VF, extrasystolic without COLLAPSE (EFFECT), or having caused no effect (NSR). The electrical activation interval (interspike interval [ISI]) from the RV bipole was compared with the mechanical activation interval, determined from M-mode ultrasound. COLLAPSE is associated with a short ISI (NSR = 408 +/- 110 msec; EFFECT = 305 +/- 113 msec; COLLAPSE = 179 +/- 25 msec; P < 0.001) with a high degreeof regularity (P < 0.001): coefficient of variation of ISI for COLLAPSE (0.038 +/-0.069) versus VF (0.389 +/-0.222), EFFECT (0.420 +/-0.241), and NSR(0.016 +/-0.048). Electrical activation and mechanical activation rates occurred at integer multiples of the AC stimulation period. Conclusion: COLLAPSE (86 +/- 37 muA; minimum 50 muA in two animals) occursbelow the VF threshold (108 +/- 28 muA) by causing rapid, regular excitation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/03/20 alle ore 18:50:40