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C F Babbs

Publications and source records attributed to C F Babbs.

153 records · Page 9Linked to original sources

Evaluation of the operating internal resistance, inductance, and capacitance of intact damped sine wave defibrillators.

A method is developed for determing actual values of circuit elements in a damped sine wave (Lown waveform) defibrillator solely from measurements of the output, using two or more power resistors and a storage oscilloscope. If a defibrillator containing capacitance C, inductance L, and internal resistance RI, is discharged into increasing 5- to 100-ohm resistive loads R, it is shown for underdamped output waveforms that â = RI/2L + R/2L and ĉ = CRI + CR, where â = pi[t2tan(pit1/t2)], ĉ = 2â/[â2 + (pi/t2)2], t1 = time from onset to peak, and t2 = time from onset to first zero crossing of the output waveform on the oscilloscope trace. Linear plots of â vs R are constructed for seven defibrillators, and values of RI and L computed as intercept/slope and 1/(2 slope) respectively. C is given by the slope of a linear plot of ĉ vs R. Delivered energy is accurately predicted as stored energy X R/(RI + R).

Electric Conductivity↗

Effects of myocardial infarction on catheter defibrillation threshold.

Because the automatic implantable defibrillator may be used in patients having ischemic heart disease, it is important to know whether myocardial ischemia changes the threshold for ventricular defibrillation under experimental conditions simulating automatic internal defibrillation. We determined changes in ventricular defibrillation threshold following coronary occlusion, using an electrode catheter designed for use with an automatic implantable defibrillator. Acute myocardial ischemia was produced without thoracotomy in 10 dogs (experimental group) by embolization with a plastic bead injected via a catheter into the left coronary artery. A control group of 4 dogs had only saline injected into the artery. Defibrillation threshold was measured at 15-min intervals from 1 hour before embolization to 2 hours after embolization. In the control group, voltage, current, energy, and impedance were unchanged after injection of saline into the coronary artery, and india ink perfusion revealed no ischemic areas. In the experimental group postembolization threshold current and energy were significantly higher than preembolization values: 0.47 vs 0.40 A/kg and 1.01 vs 0.80 J/kg, respectively (p less than 0.01). The magnitude of the peak change in threshold current after embolization was positively correlated (r = 0.79) with the size of the ischemic zone, determined by weighing unstained areas after india ink perfusion. Defibrillation threshold for a catheter electrode configuration increases for at least 2 hours following onset of acute myocardial ischemia. This finding must be accounted for in the design and use of an automatic implantable defibrillator.

Animals↗

Biology of local heat therapy for cancer.

Successful cancer therapy must selectively destroy tumor tissue while sparing the host's normal tissues. Local heat treatment can have such a selective effect because abnormalities in tumor blood vessels supply less oxygen to heat-stressed tumor cells and are less efficient in cooling tumor tissue by blood perfusion.

Animals↗

Equipment for local hyperthermia therapy of cancer.

Technology for local heat therapy of cancer is evolving rapidly at a number of technologically diverse and geographically scattered institutions and companies. No single technology is superior to others in all applications, and no single company, laboratory, or research group has all the answers. An ideal system would provide focused heating at depth in a predictable fashion, with little probability of generating undesired hot spots in normal tissues and little interference with monitoring equipment. Existing systems approximate this ideal to different degrees, depending on the anatomy and geometry of the tumor and its surrounding tissues. In the foregoing discussion the important problem of measuring temperatures in tumors and normal tissues has been slighted. At the present time, all thermometry is necessarily invasive, and there are limitations to the number of points at which temperatures can be measured utilizing percutaneously placed catheters as conduits for thermometers. However, further advances in the art, the science, and the technology of local heat therapy are likely to be forthcoming in the next few years from a diverse community of investigators and young companies who are following an interesting variety of approaches. Continued research and development in the spirit of constructive, rather than destructive, competition will certainly advance the field substantially--much to the benefit of patients. At present, however, clinical engineers should realize that hyperthermia therapy for cancer is still experimental. Despite the flurry of commercial activity, considerable caution should be exercised in the purchase and use of hyperthermia equipment.

Equipment and Supplies↗

Physical principles of local heat therapy for cancer.

Local hyperthermia therapy for cancer can produce selective heating of solid tumors on the basis of known physical laws. If energy is deposited in the general region of the tumor, temperature tends to develop in the tumor higher than that in surrounding normal tissues. The goal of therapy is to achieve cytotoxic temperature elevations in the tumor for an adequate period of time, without damaging nearby normal tissues. Several modalities exist for local heat treatment, of which radiofrequency and ultrasound offer the most promise for controlled, localized heating at depth. A paucity of blood flow in the tumor compared to that in adjacent normal tissues can enhance selective tumor heating considerably. The tumor types that have reduced flow in their central regions are especially vulnerable to heat therapy, both because they can be heated more efficiently and because hypoxic and acidotic tumor tissues are more susceptible to damage by heat. This effect is more pronounced in larger tumors, which have smaller surface-to-volume ratios and so lose heat less rapidly by thermal diffusion. Selective heat treatment of larger tumor masses with low blood perfusion, therefore, is physically practical and rational therapy. Vigorous research efforts are now underway at many centers to optimize this approach.

Diathermy↗

An animal model for testing automatic defibrillators.

A promising therapy for ventricular fibrillation--a life-threatening cardiac arrhythmia--is implantation of an automatic defibrillator. A critical component of such a device is the system that detects the presence of ventricular fibrillation. Automatic systems for detecting ventricular fibrillation have been tested with arrhythmias produced by electric shocks in normal canine hearts, but have not been tested with spontaneous arrhythmias in hyperirritable hearts. We have developed an animal model to create arrhythmias without electrical stimulation and have used it to test our automatic defibrillator. This model permits evaluation of both reliability to diagnose VF and reliability to reject other tachyarrhythmias.

Animals↗

Optimal spacing of right ventricular bipolar catheter electrodes for detecting cardiac pumping by an automatic implantable defibrillator.

Our defibrillation-detecting system uses both ECG and right ventricular impedance change (delta Z). We studied the effect of catheter electrode spacing on delta Z in 10 dogs with body weights of 10 to ,5 kg and heart weights of 67 to 220 g. Impedance to 20-kHz 100--muA square waves was measured between two 1-cm-long electrodes mounted on a No. 12F catheter and wedged into the right ventricular apex. Catheters with spacings of 5 to 25 mm between the electrodes were tested during sinus rhyhm and ventricular fibrillation. During sinus rhythm the mean beat-to-beat delta Z was 23 +/- 4 omega using the 5-mm spacing. Wider spacing gave smaller, and hence less desirable, delta Z. Some delta Z signals were recorded during ventricular fibrillation, and 5-mm spacing was more sensitive to these than wider spacing. This resulted in some prolongation of the time between onset of fibrillation and application of the defibrillation shock, but should decrease false positive diagnosis of fibrillation. No clear relationship was observed between delta Z and body weight or heart weight. We conclude that the 5-mm spacing is best for detection of pumping by the catheter-impedance method in hearts of this weight range.

Animals↗