One Monitored Case of Sudden Death

Gould, Lawrence; Gopalaswamy, C.; Chandy, F.; Abdou, O.

doi:10.1111/j.1540-8159.1983.tb04351.x

Cited by 4 publications

(1 citation statement)

References 9 publications

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“…In addition, a review of the literature is given in order to summarize the electrocardiographic findings observed in patients with sudden cardiac death during ambulatory electrocardiogram monitoring. A total of 57 patients was collected (Bissett et al, 1980; Bleifer ef af., 1974; Denes et af., 1981;Gould et al, 1983;Gradman et al, 1977;Hinkle et al, 1977;Lahiri et al, 1979;Nicolic et al, 1982;Olsson and Rhenqvist, 1982;Panidis and Morganroth, 1983;Pool et af., 1978;Pratt et af., 1983;Salerno et al, 1981;Savage et al, 1983;Tye et al, 1980). Special reference is given to so called "warning arrhythmias" as well as terminal rhythm disturbances.…”

Section: Introductionmentioning

confidence: 99%

Sudden cardiac death recorded during ambulatory electrocardiographic monitoring

Hohnloser

Weiß

Zeiher

et al. 1984

Clinical Cardiology

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Section: Introductionmentioning

confidence: 99%

Sudden cardiac death recorded during ambulatory electrocardiographic monitoring

Hohnloser

Weiß

Zeiher

et al. 1984

Clinical Cardiology

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Analysis of ambulatory electrocardiograms in 14 patients who experienced sudden cardiac death during monitoring

Savage

Kissane

Becher

et al. 1987

Clinical Cardiology

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Summary: The Holter monitors of 14 patients (out of58, 000 Holter recordings performed between 1978 and 1984) who experienced cardiac arrest and expired during the recording period were analyzed. Tachyarrhythmic arrest patients frequently had coronary heart disease, congestive heart failure, and prolonged QTc intervals. The highest incidence of intermediately frequent premature ventricular complexes (PVCs) occurred between 15 and 6 hours prior to death. The frequency of ventricular couplets increased toward the time of arrest. The hours with greatest frequency of ventricular tachycardia (VT) were found to be the last 5 hours of life. An increasing incidence of ST-segment changes greater than 2 mm was noted throughout all of the risk periods until the third hour prior to arrest when the incidence diminished. Conversely, the incidence of lower amplitude ST-segment changes (usually elevation) increased over the final 6 hours. The mean time of death was 0228 hours f 5:20. In conclusion, we observed two patterns of Holter-monitored changes which usually occurred prior to death and may represent predictors of sudden death: (1) an increasing incidence of intermediately fresuent isolated PVCs followed by increased ventricular couplets and runs of VT; (2) return of high amplitude ST-segment changes toward baseline. To our knowledge, the temporal relationship of the degree of ST-segment deviation to sudden death and the time of sudden death have not been reported in large studies of Holter-monitored sudden death patients.

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Panel I: Present State of Industrial Development of Devices

Jenkins

Arzbaecher

Martin

et al. 1984

Pacing Clinical Electrophis

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Four representatives of the pacemaker industry served as panel members for a presentation and open discussion of the present state of industrial development of devices. Each panel member made a brief presentation describing his or her own company's approach to antitachycardia pacing. The panelists had been encouraged to provide as much detail about novel features as proprietary considerations would allow, as well as device limitatioris and major problems. Summaries of the initial presentations appear below, followed by the discussions which ensued.Dr. Martin: Traditionally, tachycardias have been classified into two basic categories: those resulting from abnormal automaticity, and tbose produced by a rapidly circulating impulse in an anatomically or functionally determined reentrant pathway. Reentrant tachycardias are readily initiated and terminated by pacing. Termination depends upon the delivery, of a pacing pulse of sufficient prematurity to "coUide" with the tachycardia wavefront, thereby interrupting the circus pathway. Success in termination depends on several factors, including the type and nature of the tachycardia, the proximity of the pacing electrode to the tachycardia circuit, the reliable detection of the tachycardia, and the delivery of impulses at the proper time.Accepted forms of pacing for tachycardias include overdrive pacing, underdrive pacing, single or double extrastimuli, train pacing, and simultaneous pacing at two (or more] sites.The mechanism involved in tachycardia overdrive pacing (often referred to as burst pacing) requires pacing at a rate in excess of the tachycardia with 1:1 capture for a few impulses, followed by abrupt cessation of pacing.A specific example of an automatic burst pacemaker is the CyberTach* 60. This pacemaker was developed approximately 5i years ago and has been in clinical use for the last 4 years. Prior to the time of its introduction, some success had been achieved with patient-activated devices.The CyberTach 60 circumvents the problems associated with patient-activated systems. The device, after automatically detecting the tachycardia, delivers a rapid burst of pulses at a programmable rate and duration. Tachycardia detection is based upon the presence of 7 consecutive intrinsic intervals with a cycle length shorter than the programmable tachycardia criterion.In addition to its burst capabilities, the device also operates as a conventional demand pacemaker.To date, there have been 172 clinical implantations of the CyberTach 60; 114 atrial applications and 58 ventricular applications. Clinical evaluation of this system has been limited to a relatively small number of institutions which have the capability of performing the thorough electrophysiologic examination required prior to implantation. Through the use of intracardiac recording and programmed electrical stimulation, the mechanism of an arrhythmia is identified and localized. The tachycardia is then initiated and terminated with programmed stimulation. These initial studies are of paramount importance in ...

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One Monitored Case of Sudden Death

Cited by 4 publications

References 9 publications

Sudden cardiac death recorded during ambulatory electrocardiographic monitoring

Sudden cardiac death recorded during ambulatory electrocardiographic monitoring

Analysis of ambulatory electrocardiograms in 14 patients who experienced sudden cardiac death during monitoring

Panel I: Present State of Industrial Development of Devices

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