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Biomedical subjects

W A Tacker

Publications and source records attributed to W A Tacker.

At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

The impedance of electrodes used for ventricular defibrillation.

This study has shown that the apparent impedance of both electrode-electrolyte interfaces is small at the current levels used for transchest ventricular defibrillation, making it clear that the appearent impedance appearing between the electrode terminals is largely that of the subject. In addition, it has been shown that for measurement of the impedance of the subject, with low-intensity sinusoidal current, the electrode-electrolyte impedance becomes negligible above 10 kHz and is only slightly affected by the magnitude of the current used to make the measurement.

Electric Countershock↗
PubMedDate not supplied

The prediction of the impedance of the thorax to defibrillating current.

In this paper a technique for predicting thoracic impedance to defibrillator pulses is described. The impedance to low-current (1.0 mA) high-frequency (10-500kHz) sinusoidal current is used as an indicator of the impedance of the thorax to high-current, damped sinusoidal waveform pulses. Results from 71 dogs to which defibrillator shocks of 4 to 220 A peak current were applied show that thoracic impedance can be predicted by this method. This information indicates that it is possible to design a defibrillator that can automatically measure chest impedance prior to a defibrillation shock and deliver a predetermined peak current to the subject.

Animals↗
PubMedDate not supplied

Pumping capabilities of the latissimus dorsi and rectus abdominis muscles wrapped around a valved pouch in a mock circulatory system.

The pumping capabilities of nine unconditioned canine rectus abdominus muscles (93-163 gm) and six latissimus dorsi muscles (99-146 gm) were measured. The muscles were wrapped around a 100 ml ellipsoidal pouch in a mock circulatory system in which the afterload was 100 mmHg. Pouch diastolic pressure was kept low by an electrically controlled inlet valve to maximize muscle capillary blood flow. Immediately before tetanic contraction of the pouch-encircling muscle, the inlet valve opened for 450 msec to increase pouch pressure to 100 mmHg, thereby providing a high preload and ensuring a forceful muscle contraction. The motor nerves to the muscles were stimulated with 450 msec trains of 0.1 msec stimuli, using a frequency of 40/sec. The train rates (muscle contractions/min) were 10-50/min. In this circulatory model it was found that the maximum output for both muscle types occurred between 20 and 40 contractions/min. It was also found that for both muscle types, the maximum output (L/min) was dependent upon muscle weight. The data revealed that an output of 4 ml/min was obtained per gram of muscle. The power (mW/gm) developed was related to the output (L) in L/min. For the rectus muscle W = 0.47L, and for the latissimus muscle W = 0.41L mW/gm. Pumping periods lasted approximately 4 hours, with no evidence of fatigue. When viewed as a potential cardiac assist device, the muscles were able to provide a flow equivalent to approximately 25% of the cardiac output. However, it is important to note that the pumping capability is directly related to muscle weight, indicating that a higher output can be achieved with a larger muscle.

Abdominal Muscles↗
PubMedDate not supplied

Sequential pulse defibrillation for implantable defibrillators.

A technique is described that reduces defibrillation threshold for automatic implantable defibrillators, permits either reducing the size of the pulse generator or increasing the effectiveness of the pulse generator, and provides an increased safety factor. Defibrillation threshold was compared in 12 anesthetized dogs with mean (+/- SD) body weight of 21.6 +/- 3.4 kg for two defibrillating modalities: 1) single pulse technique with current flowing from electrodes in the right ventricle to electrodes either in the superior vena cava or on the left ventricular epicardium, and 2) sequential pulse technique. The sequential pulse technique tested uses two pulses and three or four electrodes. Current of the first 5-ms pulse flows from the superior vena caval electrode to an electrode in the right ventricle, and after a 1-ms interval, current of the second pulse flows from electrodes on the left ventricular epicardium to the right ventricular electrode. Ventricular defibrillation threshold was reduced by 56% to 6.3 +/- 1.03 joules (mean +/- SEM) (P less than 0.01). Because defibrillation threshold is less for sequential pulse defibrillation than for conventional techniques, sequential pulse defibrillators can be smaller and more effective than previously available devices.

Animals↗
PubMedDate not supplied

Optimization of epicardial electrode size and implant site for reduced sequential pulse defibrillation thresholds.

The influence of epicardial electrode surface area and implant site on sequential pulse defibrillation threshold was investigated in four isolated heart preparations. Electrodes with surface areas of 2.5, 5.0, and 10.0 cm2 were each sutured, in random order, to the epicardial surface of the isolated heart at each of four sites: mid-ventral left ventricle (LV); mid-dorsal LV; lateral-apical LV; and lateral-basal LV. The epicardial electrode is one of the electrodes in a three-electrode, two-current pathway, sequential pulse system. The first two electrodes, which are catheter-mounted, are located in the right ventricular apex (RVA) and superior vena cava (SVC). In sequential pulse defibrillation, one shock is delivered from the SVC to the RVA, followed 1 msec later by a second shock delivered from the third electrode to the RVA. Sequential pulse defibrillation threshold was obtained with each epicardial electrode used at each site. A single-pulse (SVC to RVA) catheter threshold was also obtained in each heart. The overall mean sequential pulse threshold was 47 per cent less than the mean single-pulse threshold (P less than 0.001). Increasing patch size reduced sequential pulse threshold (P less than 0.03), but no significant effect of patch location could be demonstrated. It is concluded that sequential pulse defibrillation is superior to single-pulse catheter defibrillation and that increasing epicardial patch size is advantageous, although patch location does not influence thresholds in the isolated heart.

Animals↗
PubMedDate not supplied

Improvement of defibrillators for EMS use: a problem in engineering and medicine.

Recent improvement in defibrillators has been limited mostly to decreased size and weight of portable units. An overview of the scientific literature indicates that the main limitation to further improvement in defibrillators is the lack of medical and physiologic information. Technology probably exists to change defibrillators if the manufacturers know what changes would be desirable. Clinical studies are needed for determining (a) more accurate quantitation of electrical dose for human use, (b) the relative effectiveness of different waveforms, (c) the toxicity and damage of electrical shocks to the heart, (d) the effects of drugs upon defibrillation threshold, (e) improvement of defibrillation techniques, (f) optimal placement and size of electrodes, and (g) the effects of cardiac disease on defibrillation threshold. Most of the needed studies are not technically difficult to carry out but they will be moderately expensive. In some cases special equipment may be needed or special techniques may have to be developed. The experimental animal studies appropriate as background for these clinical studies have been completed. With limited resources available, it is important to ask the most important questions first in order to develop improved defibrillation techniques and defibrillators.

Animals↗
PubMedDate not supplied

Some research needs in defibrillation and CPR.

The Fourth Purdue Conference on Cardiac Defibrillation and Cardiopulmonary Resuscitation identified needed defibrillation research, including an appropriate animal model, threshold validity, effects of polarity, and an easy-to-operate defibrillator. CPR research needs include better protocols, hemodynamics and survival studies, the role of pulmonary edema, re-examination of sudden death, and transchest pacing.

Animals↗
PubMedDate not supplied

Cardiac damage produced by transchest damped sine wave shocks.

High-energy transchest damped wave sine defibrillation shocks have been shown to produce cardiac damage when applied in rapid sequence. However, there are no reports as to whether single, threshold-intensity shocks produce damage. In this study, nonfibrillating dogs were subjected either to a single, threshold-intensity (1 A/kg) shock, or to a series of 6 shocks with high intensity (3 to 4.8 A/kg). Electrodes of 8 cm diameter were used to apply the shock through the chest wall. Dogs receiving shocks of adequate (but not excessive) strength to defibrillate showed no cardiac damage, although they exhibited transient ventricular arrhythmias after the shock was applied. All dogs receiving the higher intensity, multiple shocks showed gross and microscopic evidence of cardiac damage. Ventricular lesions were observed in both right and left ventricular free walls and were sometimes transmural in extent. ECG analysis of the records from the dogs receiving multiple, high-intensity shocks showed second and third degree A-V block, ventricular ectopic beats, ventricular tachycardia, S-T segment changes, and T-wave inversion. Although multiple, high-energy, high-current defibrillation shocks produce permanent cardiac damage in dogs, threshold shocks do not produce morphologic changes.

Animals↗