Biomedical subjects
S Furman
Publications and source records attributed to S Furman.
A revised code for pacemaker identification.
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External defibrillation and implanted cardiac pacemakers.
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Performance of cardiac pacemaker pulse generators.
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Performance of cardiac pacemaker pulse generators.
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Asystolic episodes during pacemaker implantation.
During normal rate programming of a pulse generator from slower to more rapid rates, intervals of output impulse suppression lasting 2 seconds plus the newly programmed interval to a maximum of 3.935 seconds are possible, and are a result of the pulse interval control system. These occur if programming falls within the susceptible window (the period between the existing interval and the new one) but will not take place if the programming command is given immediately after an output pulse. Four incidents with resulting ventricular asystole of up to 2.8 seconds are documented and explained. No significant clinical complications were observed.
Comparison for active and passive leads for endocardial pacing--II.
Four commercially available transvenous pacing leads were evaluated in a series of 240 implants on a rotational order basis. Total (intra- and post-operative) failure rates for this series were: Cordis 1 mm, 1/60 (1.7%); Biotronik IE-65-I, 5/60 (8.3%); Medtronic 6961, 4/60 (6.7%); and CPI 4116, 6/60 (10.0%). Post-operative failure rates were: 1 mm, 1/60 (1.7%); IE-65-I, 4/59 (6.8%); 6961, 0/56 (0.0%), and 4116, 3/57 (5.3%). In a previous study conducted at this center with identical protocol, total failure rates were: Medtronic 6907, 7/76 (9.2%); Cordis CL, 7/76 (9.2%); Biotronik IE-65-I, 2/76 (2.6%); and the Vitatron MIP-2000, 9/45 (20.0%). Post-operative failure rates were: 6907, 4/73 (5.5%); CL, 6/75 (8.0%); IE-65-I, 2/76 (2.6%); and MIP-2000, 5/41 (12.2%). If the two IE-65-I series are combined, the total failure rate is 7/136 (5.1%), and the post-operative failure rate is 6/135 (4.4%). Significant differences exist between the highest and lowest failure rates in total and post-operative cases for each series. The final decision concerning use of a particular lead must, of course, be based on clinical criteria.
Furman attempts to excise growing antagonism between State Board and Dental Association.
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Output programmability and reduction of secondary intervention after pacemaker implantation.
Six hundred one new or initial pacemaker implants between Jan. 1, 1972, and Dec. 31, 1979, consisted of 289 output-programmable pulse generators and 312 fixed-output generators. Standard leads were used in all instances. Of the 289 output-programmable pulse generators, 4.5% (13) required revision for failure to capture the heart in the postimplant period; of the 312 fixed-output units. 9.6% (30) required revision (p = 0.015). In 41 patients the early threshold was above standard output (5 V. 10 mamp, 0.5 msec), and in six of them approximately 6 months were required to return to stable threshold levels below standard output. In the remainder, threshold rose above standard output and was managed by increased output of the output-programmable pulse generators, either briefly or permanently. We conclude that output programmability allows reduction in secondary intervention after implantation and that threshold evolution may occupy a period as long as 6 months.
A revised code for pacemaker identification. Pacemaker Study Group.
The three-position ICHD code designating pacemaker function has been widely adopted. A revision, expanding the code from three to five positions, incorporates the first three positions as in the earlier version, but includes position IV, programmable functions, and position V, tachyarrhythmia functions. The code indicates how the pacemaker is employed, not necessarily the purpose for which it was designed. For example, a single-chamber inhibited pulse generator with multiprogrammable capabilities which interrupts a tachycardia by a burst of rapid pacing is designated as VVI,MB if placed in the ventricle, and AAI,MB if in the atrium.
Unwanted pregnancy--the role of the general practitioner.
Usually a planned pregnancy is a wanted pregnancy, but not all unplanned pregnancies are unwanted. The general practitioner has an important role to play in counselling patients who request termination of a pregnancy, and must recognize the need to understand the emotional content of the request by a woman to terminate an 'unwanted pregnancy'.
Pacemaker implantation through the internal jugular vein.
During a twelve-year experience with 1,808 patients 90 underwent permanent transvenous implantation through the ligated internal jugular vein. Ninety-two implants were performed. In 2 of the patients both internal jugular veins were used without complication. Out of the ninety-two implants there were three complications; one permanent recurrent laryngeal nerve injury and two episodes of severe thrombophlebitis, which receded with nonoperative therapy. The internal jugular vein is a useful and safe route for permanent pacemaker implant.
In the People's Republic of China.
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Pacemaker and patient response to the "point of sale" terminal as an actual and simulated electromagnetic interference source.
In response to two instances of pacemaker patient complaints of symptomatic episodes in the presence of a "point-of-sale" terminal, comprehensive tests were performed for possible electromagnetic interference effects. Power line frequency and radar transmitter tests in the laboratory indicated that no significant problems exist for recently manufactured pacemakers in the everyday environment. Laboratory and clinical tests with 271 patients and 54 pacer models demonstrated no hazard from "point-of-sale" terminals. Patients showed a generally benign attitude toward potential interference and very low occurrence of random intermittent pacer malfunction or effects from myopotentials.
Spurious pacemaker programming.
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Time dependence of unipolar cathodal and anodal strength-interval curves.
Following pacemaker electrode attachment, greater ventricular vulnerability to arrhythmias exists in an acutely ischemic ventricle with a unipolar anodal than cathodal stimulus falling on the T wave, due to the shorter refractory period exhibited by an anodal stimulus. In order to determine the relationship between anodal and cathodal refractory period at various times following endocardial electrode insertion, ventricular strength-interval curves were determined in nine dogs. With stable electrode position, serial measurements were made for a mean duration of 44 days. It was observed that during the first five days, the anodal refractory period was significantly shorter than cathodal, but within 15-20 days this relationship was reversed in all dogs. The longer anodal refractory period was observed up to the end of each study. These results suggest that due to shorter anodal refractory period, greater vulnerability to arrhythmias may occur with an anodal than cathodal stimulus in the initial 15-20 days following electrode insertion.
Physiologic pacing.
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Significance of isolated H-V interval prolongation in symptomatic patients without documented heart block.
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