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Biomedical subjects

M M Mower

Publications and source records attributed to M M Mower.

At least 91 records · Page 5Linked to original sources

The automatic implantable defibrillator.

The automatic implantable defibrillator is an electronic device programmed to monitor the cardiac rhythm continuously, to recognize ventricular fibrillation and ventricular tachyarrhythmias characterized by sinusoidal waveform, and to deliver corrective difibrillatory discharges when indicated. Three patients suffering from recurrent malignant ventricular arrhythmias refractory to medical therapy underwent permanent implantation of this device. Seven episodes of ventricular tachycardia and flutter-fibrillation were documented during the weeks following the implantations; two were induced at electrophysiologic studies and five occurred spontaneously. All were correctly identified and six were automatically reverted to normal sinus rhythm by the implanted device; one induced episode was cardioverted externally before the unit could recycle. Although many problems remain to be solved and the ultimate value of this therapeutic modality has to be determined, a new approach to prevention of sudden death in patients at high risk of developing lethal ventricular arrhythmias has become available.

Adolescent↗

Acute fluoride poisoning leading to fatal hyperkalemia.

Marked peaking of the T waves later recognized as being due to hyperkalemia was noted in a patient with acute fluoride intoxication before developing refractory ventricular fibrillation. Such T wave changes have not been previously described in fluoride intoxication and should alert one to the presence of hyperkalemia complicating this condition, the presence of which may herald the onset of lethal ventricular arrhythmias.

Acute Disease↗

A chronically implanted system for automatic defibrillation in active conscious dogs. Experimental model for treatment of sudden death from ventricular fibrillation.

Ventricular defibrillation was acheived in active conscious dogs with a chronically implanted automatic system composed of a defibrillator and an alternating current fibrillator. The hermetically sealed defibrillator is encased in titanium, weighs 250 g and has a volume of 145 ml. The sensor continuously monitors ventricular electircal activity and recognizes fibrillation by the absence of isoelectric potential segments. Fibrillation is induced by placing a magnet over the implanted fibrillator. The resulting syncope closely resembles the clinical entity of sudden death, while the defibrillator automatically restores normal rhythm with a truncated exponential pulse of 30 J, 15 seconds after the onset of the arrhythmia. The operational status of the defibrillator can be tested in vitro and noninvasively in vivo with an external analyzer. This experimental model allows for the first time a long-term study of the automatic implantable defibrillator approach to prevent sudden death from ventricular fibrillation under a variety of physiopathologic conditions.

Animals↗

Treatment of myocardial infarction in a community hospital coronary care unit. Experience with 1,246 patients.

The hospital mortality in 1,246 consecutive acute myocardial infarction patients treated in a large community hospital coronary care unit was 14.4%. Of the total, 52.3% showed no evidence of heart failure, 25.8% had mild to moderate failure, 9.9% had pulmonary edema, and 12% developed cardiogenic shock; the mortality in these groups was 2.2%, 7.4%, 8.9%, and 87.2%, respectively. The mortalitiy in the 1,097 patints who did not have cardiogenic shock was 4.5%. Only one patient died as a result of primary ventricular fibrillation (0.08%). The mortality of complete heart block in the absence of cardiogenic shock (8.3%) was not significantly different from that of comparable patients who did not have complete heart block (4.3%). These results are lower than those generally reported.

Acute Disease↗

Terminal ECGs.

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Arrhythmias, Cardiac↗