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Related Experiment Videos

[The implantable automatic cardioverter-defibrillator].

H Klein1, J Tröster, H J Trappe

  • 1Department Innere Medizin und Dermatologie, Medizinische Hochschule Hannover.

Herz
|April 1, 1990
PubMed
Summary
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The automatic implantable cardioverter/defibrillator (AICD) continuously monitors heart activity, delivering shocks to treat ventricular tachyarrhythmias when medical treatments are insufficient. This life-saving device offers an alternative for patients with life-threatening heart rhythms.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Devices

Background:

  • Ventricular tachyarrhythmias often require advanced treatment beyond medication.
  • Surgical and catheter ablation methods are limited to a select patient group.
  • The automatic implantable cardioverter/defibrillator (AICD) emerged as a significant non-medical treatment option.

Purpose of the Study:

  • To describe the characteristics and implantation procedures of the AICD.
  • To explain the AICD's mechanism for detecting and treating ventricular tachyarrhythmias.
  • To review advancements in AICD technology, including programmable features and biphasic impulses.

Main Methods:

  • Continuous monitoring of cardiac electrical activity.
  • Detection of ventricular tachycardias using electrical signal criteria (e.g., probability density function).

Related Experiment Videos

  • Termination of arrhythmias via direct current shocks or antitachycardia stimulation.
  • Surgical implantation techniques including median sternotomy, subxyphoid approach, and lateral thoracotomy.
  • Intraoperative and postoperative determination of defibrillation thresholds.

    • Main Results:

    • The AICD continuously monitors heart rhythm and delivers programmed electrical therapy (shocks or stimuli) to terminate ventricular tachyarrhythmias.
    • Electrode systems (plate and spiral electrodes) are used for both tachycardia detection and therapy delivery.
    • Programmable defibrillators introduced in 1988 enhanced treatment capabilities, including antitachycardia stimulation.
    • Biphasic defibrillation impulses improve termination reliability and energy efficiency compared to monophasic impulses.
    • Implantation procedures vary based on patient history and surgical approach.

    Conclusions:

    • The AICD is a crucial device for managing life-threatening ventricular tachyarrhythmias when other treatments are inadequate.
    • Technological advancements have improved the AICD's efficacy and safety.
    • Proper implantation and defibrillation threshold determination are essential for optimal AICD performance.