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[Initial clinical experiences with mechanical heart stimulation].

H Bloching1, K Seitz, O Wess

  • 1Kreiskrankenhaus Böblingen, Medizinische Klinik.

Zeitschrift Fur Kardiologie
|July 1, 1989
PubMed
Summary

Rhythmical extrathoracic mechanical stimulation can induce cardiac systoles, offering a temporary solution for patients with asystole or symptomatic bradycardia. This method shows promise in bridging critical time gaps before cardiac pacing or spontaneous heart rate restoration.

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Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Emergency Medicine

Background:

  • Cardiac arrest, including asystole and symptomatic bradycardia, presents a critical challenge in emergency medicine.
  • Prompt restoration of circulation is vital to prevent irreversible organ damage and improve patient outcomes.
  • Existing interventions like cardiac pacing may have a time lag before initiation or effectiveness.

Purpose of the Study:

  • To evaluate the efficacy of rhythmical extrathoracic mechanical stimulation as a temporizing measure.
  • To assess its ability to bridge the interval until definitive cardiac pacing or spontaneous rhythm restoration.
  • To compare its utility against established electrical stimulation methods.

Main Methods:

  • A mechanical stimulator was applied to 31 patients experiencing cardiac arrest.

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  • Circulatory status, including femoral artery pulse, was monitored.
  • Outcomes were compared between patients who responded to mechanical stimulation and those who did not.

    • Main Results:

    • Ten patients achieved sufficient circulation with a palpable pulse.
    • Five patients required subsequent temporary electrical pacing.
    • Five patients successfully treated mechanically died within 24 hours; five were discharged, one needing permanent pacing.
    • Twenty of 21 patients not mechanically stimulated died, often from electromechanical dissociation or circulatory collapse.

    Conclusions:

    • Extrathoracic mechanical stimulation can restore circulation in select patients with cardiac arrest.
    • It serves as a potentially life-saving bridge therapy in emergencies.
    • Further research is warranted to optimize its application and compare it with electrical stimulation techniques.