Physiological Changes in Threshold

Sowton, Edgar; Barr, Isaac

doi:10.1111/j.1749-6632.1969.tb34128.x

Cited by 58 publications

(6 citation statements)

References 3 publications

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“…The stimulation parameters for threshold and optimal abduction required some adjustments only for the first two postoperative weeks, in accordance with the well-known pattern for stimulating electrodes [13]. They remained stable for the subsequent follow-up period.…”

Section: Discussionmentioning

confidence: 93%

Pre-clinical evaluation of a minimally invasive laryngeal pacemaker system in mini-pig

Foerster

Arnold

Bischoff

et al. 2015

Eur Arch Otorhinolaryngol

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Microlaryngoscopic enlargement techniques have been the standard treatment for bilateral vocal fold paralysis (BVFP) for decades. Laryngeal pacing is a promising alternative treatment based on the electrostimulation of the posterior cricoarytenoid (PCA) muscle. This paper reports on the results of a pre-clinical study aiming to evaluate this method. Eight Göttingen mini-pigs were implanted with a laryngeal pacemaker (LP) implant prototype and with two LP electrodes, one in each PCA muscle. The 6-week follow-up included endoscopic stimulation controls in general anaesthesia and radiographic controls of electrode integrity and position stability. Stimulation parameters for optimal glottal opening were evaluated via videolaryngoscopy. Histopathology was performed upon conclusion of the study. 7/8 (87.5 %) animals were successfully implanted with the LP implant prototype and two LP electrodes. In general, stimulation was effectively delivered and correlated with the expected PCA muscle activation. 2/14 (14.3 %) electrodes dislocated and 1/14 (7.1 %) electrode tip broke. The LP system used in this experiment to induce vocal fold abduction by means of selective functional electrical stimulation of the PCA showed promising results. It may be a valid alternative to the current golden standard for BVFP treatment. Clinical studies are needed to confirm the medical relevance of the LP.

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Section: Discussionmentioning

confidence: 93%

Pre-clinical evaluation of a minimally invasive laryngeal pacemaker system in mini-pig

Foerster

Arnold

Bischoff

et al. 2015

Eur Arch Otorhinolaryngol

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“…It is well known that stimulation thresholds are dependent on many physiological factors (21,27,30) and therefore they were measured in each patient at the same time of day and under as identical circumstances as possible. When inexplicable threshold rises were encountered, the serum electrolytes were checked, but no abnormal values were disclosed.…”

Section: Discussionmentioning

confidence: 99%

Low Threshold Endocardial Electrodes for Permanent Cardiac Pacing

Wahlberg¹,

Edhag²,

Lagergren³

1977

Journal of Internal Medicine

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Three different electrodes, i.e. conventional large and small surface endocardial electrodes and a new large contact area‐small active surface electrode, have been compared with respect to their stimulation thresholds for cardiac pacing in 94 patients with 96 electrodes. Both capacitor discharge and constant current pulses were used for the measurements. The average 2 msec impulse threshold for the 47 mm2 electrode reached its maximum on the 14th postoperative day and was 3.6±1.4 V and 4.4±1.8 mA. One month after insertion, the threshold was 3.2±1.4 V and 3.9±1.7 mA. Corresponding values after one month for the 6 mm2 electrode were 2.0±1.0 V and 1.7±0.9 mA and for the new electrode 1.7±0.9 V and 1.4±0.8 mA. Thresholds increased by about 20% when the impulse duration was diminished from 2 to 0.5 msec. The new large area‐small active surface electrode offers the advantages of significantly smaller increases in stimulation thresholds during the first month after insertion and good attachment to the endocardium.

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“…Use of newer devices that can measure the capture threshold on a beat-to-beat or periodic basis can reduce the need for these higher outputs, yet provide the safety needed for the patient should the threshold rise. Any severe metabolic or electrolyte derangement can lead to acute threshold changes [177][178][179][180][181][182][183][184][185][186][187][188] (Box 29-10). The threshold may rise steadily over time until noncapture occurs or until the threshold exceeds the pacemaker's maximum output, typically referred to as exit block.…”

Section: Presenting Cardiogram 25 Mm/secmentioning

confidence: 99%

Pacemaker Troubleshooting and Follow-up

Love¹

2011

Clinical Cardiac Pacing, Defibrillation and Resynchronization Therapy

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Physiological Changes in Threshold

Cited by 58 publications

References 3 publications

Pre-clinical evaluation of a minimally invasive laryngeal pacemaker system in mini-pig

Pre-clinical evaluation of a minimally invasive laryngeal pacemaker system in mini-pig

Low Threshold Endocardial Electrodes for Permanent Cardiac Pacing

Pacemaker Troubleshooting and Follow-up

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