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Automatic defibrillation in man. The initial surgical experience

L Watkins, M Mirowski, M M Mower

    The Journal of Thoracic and Cardiovascular Surgery
    |October 1, 1981
    PubMed
    Summary
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    The automatic implantable defibrillator safely treats life-threatening ventricular arrhythmias in high-risk patients. This device effectively detects and corrects malignant arrhythmias, improving patient outcomes.

    Area of Science:

    • Cardiology
    • Biomedical Engineering

    Background:

    • Malignant ventricular arrhythmias pose a significant risk of sudden cardiac arrest.
    • Patients with recurrent arrhythmias unresponsive to conventional therapy require advanced treatment options.

    Purpose of the Study:

    • To evaluate the safety and efficacy of the automatic implantable defibrillator (AID) in patients with life-threatening ventricular arrhythmias.
    • To assess the device's ability to detect and terminate malignant ventricular arrhythmias.

    Main Methods:

    • Implantation of the automatic implantable defibrillator in 19 high-risk patients.
    • Surgical approaches included left lateral thoracotomy and median sternotomy, with some patients undergoing concomitant cardiac procedures.
    • Follow-up averaged 6 months, with a maximum of 14 months.

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    Main Results:

    • No operative deaths were recorded.
    • The device successfully terminated 47 documented episodes of malignant ventricular arrhythmias, including spontaneous and induced events.
    • Twenty-six spontaneous arrhythmias, 17 outside the hospital, were corrected with a single 25-joule pulse.

    Conclusions:

    • The automatic implantable defibrillator demonstrates capability in diagnosing and terminating potentially lethal ventricular arrhythmias.
    • Implantation is safely achievable in a high-risk patient population.
    • Further validation of the automatic implantable defibrillator is warranted.