ABSTRACT
An internal cardioverter defibrillator (ICD) is normally extensively tested during implantation. The necessity of retesting prior to discharge of the patient is a matter of debate. In our material of 30 patients undergoing first-time implantation of a transvenous internal defibrillator system, we retrospectively compare the predischarge defibrillation test with the peroperative test. A successful peroperative defibrillation test with no failed shocks at 10 J below maximal energy level was followed by a successful predischarge test with the same safety margin in 18/19 patients, while one patient required a maximal energy ICD shock for conversion at the predischarge test. We conclude that the predischarge defibrillation test can be omitted if the peroperative test was successful, with no failed shocks at 10 J below maximal energy level and if the shock therapy is set to maximal energy level.
Subject(s)
Defibrillators, Implantable , Heart Function Tests , Female , Humans , Male , Middle Aged , Patient DischargeABSTRACT
Transesophageal atrial pacing and recording performed in 128 patients for palpitations or tachycardia was retrospectively evaluated and compared to the same procedure in 77 routinely evaluated patients after a catheter ablation procedure. The sensitivity and specificity of the described protocol was 74 and 90% respectively. The procedure was well tolerated and a majority of patients could be completely evaluated according to the protocol. The outcome of the first time investigation influenced the subsequent choice of therapy in the studied population. The results suggest that transesophageal pacing is a valuable tool for evaluation of atrial tachycardias with specificity, sensitivity and tolerability comparable to other noninvasive methods used in cardiology.
Subject(s)
Cardiac Pacing, Artificial , Tachycardia/diagnosis , Adult , Case-Control Studies , Catheter Ablation , Female , Humans , Male , Retrospective Studies , Sensitivity and Specificity , Tachycardia/epidemiology , Tachycardia, Supraventricular/diagnosis , Tachycardia, Supraventricular/surgerySubject(s)
Health Care Rationing , Health Policy , Physician's Role , Health Priorities , Humans , SwedenABSTRACT
A system has been developed for off-line analysis of discharge characteristics of continuously firing nerve cells. The programs, which are mainly written in FORTRAN IV, determine mean firing rates, variability and other parameters of the impulse activity, and construct interspike interval histograms. They are run under time-sharing on a small laboratory computer. To disclose possible non-stationarities in the data all interspike interval samples are analysed with the non-parametric Kolmogorov-Smirnov test. This test is very powerful in detecting any differences between two samples and is still very easy to implement in programming. Raw data and computed statistics are stored in random access data files.
