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1
Myers, Gina. "The impact of participation in a support group on perception of social support and level of anxiety in patients with an implantable cardioverter defibrillator". Diss., Online access via UMI:, 2005. http://wwwlib.umi.com/dissertations/fullcit/3165054.
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2
Reid, Suzanne Shirley. "Friend or intruder? : Living with an implantable defibrillator : patients' and partners' experiences /". Electronic version, 2001. http://adt.lib.uts.edu.au/public/adt-NTSM20041104.172632/index.html.
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3
Sadarmin, Praveen P. "Cardiologists' knowledge, attitudes and application of risk towards implantable cardioverter defibrillators". Thesis, University of Leicester, 2016. http://hdl.handle.net/2381/37600.
Testo completoAbstract (sommario):
Patients with impaired left ventricular systolic function have an increased risk of sudden cardiac death. The implantable cardioverter defibrillator (ICD) is an effective therapy to treat life-threatening arrhythmias and randomized controlled trials have demonstrated statistically significant reductions in all-cause mortality in select patient groups. Despite this wealth of published data, the uptake of ICDs in high risk population remains low and the exact reasons not known. My study focuses on the evidence for ICD therapy from the landmark RCTs that have influenced the current guidelines. Most trials have only published relative risk reduction or hazard ratios. The first part of this thesis analyzes data to reveal absolute risk reduction, the number needed to treat and the findings standardized for length of follow-up. There is considerable variation in the magnitude of benefit between different heart failure aetiologies and other patient characteristics highlighting the difficulty in generalising the results. UK cardiologists’ knowledge of guidelines, estimates of 3-year mortality, management decisions, factors that influence decisions, influence of age, device cost, and overall attitudes to ICDs as a form of therapy was assessed with a questionnaire. There was lack of awareness of UK ICD guidelines amongst non-implanting cardiologists and even when guidelines were known they were often not applied, particularly in primary prevention setting. Most cardiologists are not aware of the magnitude of benefit an ICD offers and overestimate the effect in secondary prevention. In addition, there is also bias against elderly patients. The final part of my thesis focuses on exploring barriers to primary prevention ICD uptake. The aim was to see what action was taken when all the data required for making a referral or assessment was available. Our study suggests more than half of potentially eligible patients do not receive ICD therapy. A low referral rate, lack of screening programmes and age bias seem to be the stumbling blocks for primary prevention ICD in the UK.
4
Hopgood, Daniel A. L. "Quality of Life in Adolescents and Young Adults with Implantable Cardioverter-Defibrillators". University of Cincinnati / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ucin150479872457424.
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5
Crawford, Rebecca Susan. "Health Beliefs Related to Physical Activity in Patients with Implantable Cardioverter Defibrillators". Diss., The University of Arizona, 2013. http://hdl.handle.net/10150/311469.
Testo completoAbstract (sommario):
Low levels of physical activity (PA) are a significant predictor of early death among recipients of implantable cardioverter defibrillators (ICDs). Regular, moderate PA is associated with improved quality of life (QOL), reduced arrhythmia burden, and improved health outcomes in ICD recipients yet many do not engage in PA and the reasons for lack of engagement are unclear. The purpose of this descriptive, cross-sectional study was to examine health beliefs related to PA and QOL in adults living with ICDs. The Health Belief Model provided the theoretical framework for this study. A convenience sample of 107 adult, ICD recipients (26 females and 81 males) were recruited from five cardiology clinic settings within the same private practice. Seventy-seven percent completed the study tasks (N=81). Subjects completed a Demographic Data Questionnaire, Self-Efficacy Expectations after ICD Scale, Exercise Self-Efficacy Scale, Health Belief Questionnaire, Incidental and Planned Exercise Questionnaire and Quality of Life Medical Outcomes Survey-SF36®. Clinical data was collected from the medical record. Mean age of the subjects was 70.23 yrs. ± 11.76 yrs. The majority were male (71.6 percent) and 77.8 percent were White, non-Hispanic. Most were insured by Medicare (79 percent), were retired (50 percent) and reported incomes less than 20,000 dollars/year (39 percent). Over 98 percent were diagnosed with heart failure and almost 40 percent reported their physical activity had decreased since having an ICD implanted. There were no differences in health beliefs and QOL scores between subjects who had an ICD as a primary or secondary prevention of sudden cardiac death. Predictors of PA participation in this population were Self-Efficacy for Exercise (SEE) beliefs, Self-Efficacy ICD (SEICD) beliefs, age and NYHA Class. Almost 33 percent of variance in PA participation can be explained by SEE (b = 2.407, β = .390, t = 3.911, p<.01); SEICD (b =2.304, β = .215, t = 2.149, p<.05); age (b = -.394, β = -.234, t =-2.277, p<.05); and NYHA Class (b = -6.373, β =-.198, t = -1.998, p =<.05). Findings indicate the strength of self-confidence in influencing healthy behavior. Findings support the need for more research in identifying barriers and predictors of PA participation in adult, ICD recipients.
6
Humphreys, Nina Kumari. "Living with an ICD : developing a brief psychological intervention for patients living with an implantable cardioverter defibrillator". Thesis, Swansea University, 2014. https://cronfa.swan.ac.uk/Record/cronfa43026.
Testo completoAbstract (sommario):
The implantable cardioverter defibrillator (ICD) is a small medical device, implanted underneath the collarbone with wires leading from it to the heart. The device detects and terminates ventricular arrhythmias by delivering an electric shock, that otherwise would most likely lead to sudden cardiac arrest and sudden cardiac death. The ICD is perceived as the 'gold standard' treatment therapy for patients at risk of sudden cardiac death resulting from fast electrical rhythms (Bleasdale, Ruskin, O'Callaghan, 2005). However, ICD recipients have reported high levels of psychological distress such as anxiety and depression and a reduced quality of life (e.g. clinical review by Sears, Matchett & Conti, 2009). This thesis describes the development of a brief psychological intervention for patients living with an ICD based on the Medical Research Council's (2008) guidelines. The first stage in the development of the intervention was a qualitative study. Thirtysix ICD participants (ICD patients and partner) were recruited in south Wales. Semistructured interviews were conducted with each participant separately. Thirteen of the patients had not experienced an ICD shock. Transcripts were analysed by thematic analysis (Braun and Clarke, 2006) using a cognitive-emotional-coping framework. General findings revealed patients did not know how to regain normality after their ICD and highlighted common worries were identified. Accordingly, the intervention aimed to be a structured guide underpinned by cognitive behavioural theory. It aimed to address common worries and bridge the gap between hospital discharge and patient's 6-week follow up appointment. The intervention was tested using a pilot randomised control trial. Ninety-nine participants were randomised to an intervention or control group. Differences between groups at baseline were adjusted by analysis of covariance (ANCOVA) to control for differences at 3- and 6-months. Results revealed the intervention group reported improved levels of depression, increased levels of mild exercise and increased patient acceptance to the ICD compared to the control group at 6-months. The simplicity and cost-effectiveness of this intervention suggests that not only is it theory and evidenced based, but should be sustainable long term. The next stage would be to carry out a fully powered randomised control trial.
7
Velavan, Periaswamy. "Risk stratification in patients with heart failure and in patients with implantable cardioverter-defibrillators". Thesis, University of Hull, 2011. http://hydra.hull.ac.uk/resources/hull:5294.
Testo completoAbstract (sommario):
Heart failure is a very common medical condition with significant mortality and morbidity. Patients hospitalised with heart failure are at high risk of death in the short term and patients with chronic heart failure in the community are also at a high risk of death in the medium to long term. It is difficult to accurately identify those at a higher risk of death as current methods of risk stratification lack both sensitivity and specificity. The available treatments for prevention of sudden death in patients with heart failure such as Implantable Cardioverter Defibrillators (ICD) are expensive and do not abolish the risk of sudden death completely. Hence it is necessary to improve risk stratification methods in patients with heart failure and identify factors predicting mortality in those patients with ICD protection. This thesis first describes a series of studies examining the clinical factors that predict increased risk of short-term mortality in patients with a recent hospitalisation for heart failure. These include examination of patient demographics, clinical history and examination, blood tests, electro-cardiographic and echo-cardiographic variables and medication. Based on these variables, I have formulated a simple scoring system to predict short term mortality in hospitalised patients with heart failure. This score was validated in a prospective study of contemporary heart failure population with a recent hospital admission. The relationship of cholesterol and risk of death in heart failure was examined in detail. Then, the utility of Holter monitoring and signal averaged electro cardiograms (SAECG) for risk stratification were examined based on the prognostic value of abnormalities found by these tests in patients with chronic heart failure. Finally patients with heart failure deemed at high risk of sudden death and had ICDs implanted were studied and factors predicting shocks and mortality were identified. Two separate studies were done, first in population who had ICDs mainly for secondary prevention and the second in patient population who had ICDs exclusively for primary prevention. From these studies, I have identified those clinical characteristics that are associated with high risk of death in patients with acute and chronic heart failure and those associated with death in patients with heart failure after ICD implantation.
8
Wilson, David G. "Subcutaneous and transvenous implantable cardioverter defibrillators : developing an individualised approach to assessment and treatment". Thesis, University of Southampton, 2017. https://eprints.soton.ac.uk/415534/.
Testo completoAbstract (sommario):
In recent years the subcutaneous implantable cardioverter-defibrillator (S-ICD) has emerged as a novel technology which offers an alternative choice to the traditional transvenous implantable cardioverter-defibrillator (TV-ICD) in treatment and prevention of sudden cardiac death. Early experience with the S-ICD however has highlighted that its capacity to accurately sense the cardiac signal can be challenged, in particular with regard to the risk of varying amplitude of signals and risk of T wave oversensing. S-ICD sensing is therefore an important weakness of this technology which this thesis addresses. Initially only a relatively small group of patients were thought to be suitable for S-ICD, in particular patients with difficult venous anatomy or young patients. Therefore I explored how the important ECG parameters in S-ICD sensing, the R wave, the T wave and the R:T ratio, vary when measured from a right compared to a left parasternal lead position in a population of patients with complex congenital heart disease and normal controls. I go on to explore how the R wave, T wave and R:T ratio in the same patient population vary with posture and discuss how this relates to potentially clinically important in relation to S-ICD sensing. As the sensed S-ICD signal resembles the signal measured with a standard 12 lead ECG, I go on to evaluate what are the ECG predictors of T-wave oversensing are. Lastly, I explore how application of mathematical vector transformation techniques can help reconstruct an 8 lead ECG from 2 S-ICD vectors, and from then create a 12-lead ECG, and I discuss how this technique may potentially help solve some sensing problems related to the S-ICD. Within this thesis, I demonstrate that much could be done at an individual level (optimise lead position, identify patients at risk of T wave oversensing and using vector transformation to reduce the likelihood of inappropriate therapy) in order to maximise the potential benefit (and reduce the unwanted consequences) of S-ICDs. This thesis has advanced the understanding of how to improve therapy to treat SCD by reducing the unwanted events of S-ICD therapy by developing a concept of a tailored assessment of patient’s suitability for ICD therapy.
9
Byrd, Israel A. "Interactions between trains of premature stimuli and anatomically anchored reentrant wavefronts implications for antitachycardia pacing /". Birmingham, Ala. : University of Alabama at Birmingham, 2006. http://www.mhsl.uab.edu/dt/2006p/byrd.pdf.
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10
Jama, Zimasa Vuyo. "Performance of re-used pacemakers and implantable cardioverter defibrillators compared with new devices at Groote Schuur Hospital, Cape Town, South Africa". Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/20958.
Testo completoAbstract (sommario):
Objectives: Little is known about the performance of re - used pacemakers and implantable cardioverter defibrillators (ICDs) in Africa. We sought to compare the risk of infection and the rate of malfunction of re - used pacemakers and ICDs with new devices at Groote Schuur Hospital in Cape Town, South Africa. Methods: This was a retrospective case comparison study of performance of re - used pacemakers and ICDs in comparison with new devices at Groote Schuur hospital over a 10 year period. The outcomes were incidence of device infection, device malfunction, early battery depletion, and device removal due to infection, malfunction, or early battery depletion. Results: Data for 126 devices implanted in 126 patients between 2003 and 2013 were analysed, of which 102 (81%) were pacemakers (51 re - used and 51 new) and 24 (19%) were ICDs (12 re - used and 12 new). There was no device infection, malfunction, early battery depletion or device removal in either the re - used or new pacemaker groups ov er the median follow up of 15.1 months (interquartile range (IQR), 1.3 - 36.24 months) for re - used pacemakers and 55.8 months (IQR, 20.3 - 77.8 months) for new pacemakers. In the ICD group, no device infection occurred over a median follow up of 35.9 months (I QR, 17.0 - 70.9 months) for re - used ICDs and 45.7 months (IQR, 37.6 - 53.7 months) for new ICDs. One device delivered inappropriate shocks which resolved without intervention and no harm to the patient, this re - used ICD subsequently needed generator replacement 14 months later. In both, the pacemaker and ICD groups, there were no procedure non related infections documented for the respective follow up periods. Conclusion: No significant differences were found in performance between re - used and new pacemakers and ICDs with respect to infection rates, device malfunction, and battery life and device removal for complications. Pacemaker and ICD reusee is feasible and safe and is a viable option for patients with bradyarrhythmias and tachyarrthythmias.
11
Hill, Loreena Michelle. "Management of implantable cardioverter defibrillators in advanced heart failure : an exploratory study of heart failure patients', carers' and healthcare professionals' perspectives". Thesis, Ulster University, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.695317.
Testo completoAbstract (sommario):
Background: The ICD is cornerstone in the treatment of life-threatening arrhythmias, although there is growing concern that dying patients are receiving multiple futile shocks. Expert guideline recommendations regarding ICD deactivation are not implemented in practise and ICD deactivation is rarely discussed. This limits patients' and carers' knowledge and choice at end-of-life. Aim: To explore perspectives of patients, carers and professionals regarding ICD deactivation and to examine the impact these have on clinical judgements about end-of-life management. Methods: Sequential exploratory mixed methods design incorporating two phases. • Phase One: Data from a systematic review of literature, case studies and retrospective case note review were synthesised and used to generate nine independent variables. • Phase Two: Variables were randomly manipulated and embedded within vignettes of a factorial survey disseminated to UK and Irish professionals. Results: Phase One data confirmed pre-implantation information on ICD's functionality and possible deactivation was inadequate. Patients' and professionals' held a positive perception of the ICD and were reluctant to discuss deactivation until death was imminent. Most patients wanted involvement in critical discussions, although agreed the decision concerning deactivation should be made by their cardiologist, without burdening family. Carers' were kept uninformed unless the patient became cognitively impaired. Phase Two: 534 vignettes were completed by 89 professionals (22 Cardiologists, 57 Nurses, 10 Clinical Physiologists). Nurses were more likely to favour a pre-implantation discussion than cardiologists, although all groups agreed the subject of deactivation should be broached when death was imminent. Clinical indicators of heart failure severity (NYHA IV) and diagnosis of bowel cancer increased the likelihood of this discussion. All groups felt deactivation was warranted when the patient experienced multiple shocks, however data from Phase One found no evidence of this occurring. Professionals in post for at least six years were most confident in clinical decision-making. Conclusions: These data highlight missed opportunities to involve patients in shared decision-making, with the majority of professionals reluctant to discuss deactivation. Lack of pre-implantation information compromised patients' knowledge and restricted informed decision-making to last days of life. Professionals' relied on their intuitive judgement rather than evidence-based guidance. Data extends the factorial survey methodology and provides direction to improve end-of-life care for patients with an ICD.
12
Casselden, Louisa. "An exploration of body image and self-esteem in adolescents with implantable cardioverter defibrillators (ICDs) : a qualitative study and clinical research portfolio". Thesis, University of Glasgow, 2015. http://theses.gla.ac.uk/6700/.
Testo completoAbstract (sommario):
Introduction. Adolescents with Implantable Cardioverter Defibrillators (ICDs) have to negotiate the tasks of growing up while coping with their ICD device. Current research on the psychosocial effect of ICDs in this population is limited. Issues of body image may be particularly salient for adolescents with visible health conditions, as they experience typical physical and emotional development in addition to the burden of their health condition. This study aims to explore the effect of having an ICD device on adolescent’s body image and self-esteem, and other challenges they encounter. Method. This study utilised a qualitative research design comprised of in-depth individual interviews lasting between thirty minutes to one hour. Participants were recruited from the Royal Hospital for Sick Children, Glasgow. The data were analysed using Interpretative Phenomenological Analysis (IPA). Results. The sample comprised four males aged between 12-17 years old. Six superordinate themes emerged from the analysis of the transcripts: Physical effect, Emotional impact, Sense of self, Coping Strategies, Development over time and Evaluation of ICD. Conclusions. The findings suggested that ICDs influenced participant’s sense of self, and for some had a negative effect on body image. Although some negative consequences of having an ICD were identified, participants showed a determination to overcome challenges and a positive progression in adjustment over time.
13
Kundu, Suman. "Prognostic markers of ventricular arrhythmia : is further refinement of risk stratification possible? : a prospective study of patients with implantable cardioverter defibrillators and left ventricular systolic dysfunction". Thesis, University of Leicester, 2012. http://hdl.handle.net/2381/28108.
Testo completoAbstract (sommario):
The management and prevention of Sudden Cardiac Death remains a great challenge in modern Cardiology. Implantable Cardioverter Defibrillators (ICDs) have been shown to reduce mortality. Despite decades of research, the mechanisms are not fully understood and ICD treatment is crude, palliative and expensive. Nonetheless, outcome studies have helped to inform national and international guidance in the implantation of these devices. Patient selection is crucial to ensure correct patients are identified and appropriately treated. More refined and stringent risk stratification is needed to identify patients at high risk. This thesis examines non-invasive, readily measureable markers to see whether they can be used to assess the risk of ventricular arrhythmia in patients with cardiomyopathy who have indications for ICD implantation. Baseline data in the form of 12 lead electrocardiograms, echocardiography, 24 hour Holter monitoring and venous blood were obtained to analyse QT dispersion, Heart Rate Variability (HRV), QT Variability Index (QTVI), ECG restitution measures and NTproBNP levels in these patients. Patients were followed up for a two year period through the ICD clinic and appropriate therapy was recorded as a surrogate marker for ventricular arrhythmia. Patients with and without appropriate therapy were then compared to look for significant differences in the examined markers. The percentage of beats with a QT/TQ ratio>1 was associated with appropriate shocks when compared with no therapy (p=0.04). However, the result was not significant when all appropriate ICD therapy was compared with no therapy (p=0.06). This possibly reflects the period of time the heart spends on the more ‘unstable portion’ of the restitution slope in patients at highest risk. Median BNP was non-significantly higher in patients with arrhythmia compared to those who were shock free. None of the other examined markers were predictive of appropriate therapy. There is thus promise in the use of some non-invasive markers in the refinement of patient selection with LVSD being considered for ICD therapy.
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Canlas, Joel. "Creating software libraries to improve medical device testing of the Pacing System Analyzer (PSA) at St. Jude Medical". DigitalCommons@CalPoly, 2011. https://digitalcommons.calpoly.edu/theses/599.
Testo completoAbstract (sommario):
Software testing, specifically in the medical device field, has become increasingly complex over the last decade. Technological enhancements to simulate clinical scenarios and advancements in communicating to medical devices have created the need for better testing strategies and methodologies. Typical medical device companies have depended on manual testing processes to fulfill Food and Drug Administration (FDA) submission requirements specifically Class III devices which are life supporting, life sustaining devices. At St. Jude Medical, software testing of Class III devices such as implantable cardioverter-defibrillators (ICDs), pacemakers, and pacing analyzers are given top priority to ensure the highest quality in each product. High emphasis is made on improving software testing for ease of use and for catching more software errors in each device. A significant stride in testing has automated the process and has provided software verification teams with the tools they need to successfully test and deliver high quality products. By creating software libraries which interact with communication to the other interfaces needed to test medical devices, test engineers can focus on fully testing device requirements and will not be concerned with how each test will interact with the device or any other testing tools. The main focus will be a specific St. Jude Medical device known as the Pacing System Analyzer (PSA). The PSA device will be used to demonstrate how verification engineers are able to benefit from software libraries and allow the testing process and test development to be fully automated. New technologies and standards will be created to simulate clinical scenarios and to communicate to new devices. The goal is to use software engineering principles to create standard test libraries which sustain these changes while still allowing testers to focus on finding issues for each device.
15
Ischinger, Nina Fleur [Verfasser], Jürgen [Akademischer Betreuer] Beckmann e Karl-Heinz [Akademischer Betreuer] Ladwig. "End-of-Life Management of patients with Implantable Cardioverter Defibrillators (ICD) : A survey-based investigation on problem awareness, attitudes and preferences of ICD carriers / Nina Fleur Ischinger. Gutachter: Karl-Heinz Ladwig ; Jürgen Beckmann. Betreuer: Jürgen Beckmann". München : Universitätsbibliothek der TU München, 2014. http://d-nb.info/1051734967/34.
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16
Marinskis, Germanas. "Tachikardijų elektrofiziologinė diagnostika ir nemedikamentinis gydymas". Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2009. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2009~D_20090408_085250-65904.
Testo completoAbstract (sommario):
Šiame darbe apžvelgiama Vilniaus Universiteto Širdies ligų ir kraujagyslių klinikoje 1991−2008 metais sukaupta patirtis taikant nemedikamentinį gydymą pacientams su supraventrikulinėmis tachikardijomis ir skilveliniais ritmo sutrikimais. Apibendrinome nemedikamentinio gydymo rezultatus 1693 pacientams: 753 pacientams su atrioventrikulinio mazgo paroksizmine tachikardija, 657 pacientams su papildomais laidumo takais, 169 pacientams su skilvelinėmis tachikardijomis. Be to, apibendrinome kardioverterių defibriliatorių implantavimo rezultatus 118 pacientų. Nustatėme, kad atrioventrikulinio mazgo tachikardijos kateterinės abliacijos efektyvumas 99,2%, komplikacijų dažnis 0,53%. Įrodėme, kad saugu atlikti „lėtos“ zonos abliaciją pacientams su ilgu PQ intervalu. Papildomų laidumo takų kateterinė abliacija buvo efektyvi 98,1% atvejų, komplikacijų dažnis 1,7%. Papildomų laidumo takų grupėje sudėtingiausios lokalizacijos yra užpakalinė pertvarinė dalis ir vidurinė pertvarinė dalis (pastaroji – dėl rizikos sukelti III laipsnio AV blokadą). Skilvelinių tachikardijų kateterinės abliacijos rezultatas priklauso nuo etiologijos. „Idiopatinių“ skilvelinių tachikardijų atvejais kateterinės abliacijos efektyvumas viršija 90%. Koronarinės širdies ligos ir kardiomiopatijų atvejais kateterinė abliacija mažiau efektyvi (~60%). Kardioverterių defibriliatorių grupėje iki 11 m. stebint pacientus, defibriliatorius suveikė 68,6% atvejų.This paper reviews the 1991−2008 experience with non-pharmacological treatment of supraventricular and ventricular tachycardias in the Clinic of Heart and vessel diseases of Vilnius University. We summarized the results of managing 1693 patients: 753 patients with atrioventricular nodal tachycardia, 657 patients with accessory pathways, 169 patients with ventricular tachycardias, and 118 patients with implanted cardioverter defibrillators. We have shown that the success rate of catheter ablation for atrioventricular nodal tachycardia is 99.2% with complication rate 0.53%. The safety of ablating the “slow” pathway in patients with prolonged PQ interval has been shown. The success rate of catheter ablation of accessory pathways is 98.1% with 1.7% complication rate. The most complex accessory pathway localization for ablation was posteroseptal area and midseptal area (the latter because of the risk to induce a complete atrioventricular block). The result of catheter ablation for ventricular tachycardia depends on etiology. For “idiopathic” ventricular tachycardias success rate exceeds 90%. In patients with coronary heart disease and cardiomyopathies, catheter ablation is less effective (60%). During the follow-up with duration up to 11 years, 68.6% of patients with implanted cardioverter defibrillators have experienced therapy delivered by the device.
17
Chang, David Wei-Péng. "ST. JUDE MEDICAL: PULMONARY EDEMA MONITORING IN PACEMAKERS AND ICDS". DigitalCommons@CalPoly, 2013. https://digitalcommons.calpoly.edu/theses/1112.
Testo completoAbstract (sommario):
Pulmonary edema occurs when fluid leaks from the pulmonary capillary network into the lung interstitium and alveoli. When the heart is not able to pump blood to the body efficiently, fluid can back up into the veins that take blood through the lungs to the left atrium. This then builds up the pressure in the blood vessels and fluid is pushed into the alveoli in the lungs. The fluid reduces normal oxygen movement through the lungs and can cause impaired gas exchange and respiratory failure. There are many causes of congestive heart failure that may lead to pulmonary edema such as heart attack, any diseases of the heart that weaken or stiffen the heart muscle, a leaking or narrowed heart valve, and sudden, severe high blood pressure.
Pulmonary edema is a strong indicator of congestive heart failure in patients and therefore can be used as a gauge for congestive heart failure. One way to diagnose cardiogenic pulmonary edema constantly is through the continuous monitoring of the transthoracic impedance throughout the day. One method to achieve this constant monitoring is through the use of a cardiac pacemaker or an implantable cardioverter defibrillator (ICD). Many patients who are at risk of heart failure have these medical devices implanted already. In these implantable cardiac devices, the connected cardiac leads can be utilized to continually screen several impedance vectors for decreases in impedance in the thoracic cavity. A pacemaker or ICD that implements Pulmonary Edema Monitoring is designed to continuously monitor these impedance vectors and alert the patient to seek medical attention. This thesis will discuss the implementation of Pulmonary Edema Monitoring via screening of multiple impedance vectors in a pacemaker or implantable cardioverter defibrillator and the effectiveness of this monitoring method. Furthermore, the design, implementation, and testing of this feature will be explored in greater detail.
18
Kwan, Siu-ki, e 關兆奇. "Development of high performance implantable cardioverter defibrillatorbased statistical analysis of electrocardiography". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B38320289.
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Kwan, Siu-ki. "Development of high performance implantable cardioverter defibrillator based statistical analysis of electrocardiography". Click to view the E-thesis via HKUTO, 2007. http://sunzi.lib.hku.hk/hkuto/record/B38320289.
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20
Flemme, Inger. "Living with life-saving technology : Long-term follow up of recipients with implantable cardioverter defibrillator". Doctoral thesis, Högskolan i Halmstad, Centrum för forskning om välfärd, hälsa och idrott (CVHI), 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-2913.
Testo completoAbstract (sommario):
The evidence that treatment of life-threatening arrhythmia (LTA) with an Implantable Cardioverter Defibrillator (ICD) can prolong life is convincing. Living with a lifelong heart disease will gradually influence the everyday life and encompasses some or all aspects of life. In order to influence health outcomes, the impact of the ICD must be considered in a broader context including not only the physical, but also the psychological and social functioning of the individual. The general aim of this thesis was to describe everyday life in recipients living with an ICD in a longterm perspective. The aim in Paper I was to describe changes in the life situation of recipients’ with an ICD over a period of 1 year. The aim in Paper II was to describe quality of life (QOL) and uncertainty in recipients who have an ICD and to predict QOL at long-term follow-up. Fifty-six recipients participated (I) and 35 of these recipients, who had survived at least five years, were further included (II). The Quality of Life Index-Cardiac version (I, II), Mishel Uncertainty in Illness Scale-Community version (I, II), Patient ICD Questionnaire (I) and multiple regression analysis (II) were used. Higher scores indicate higher QOL and uncertainty. The questionnaires were completed before implantation, three and twelve months after implantation (I) and also five years after implantation i.e. long-term follow up (II). At the long-term follow up, the average ICD recipient had lived with an ICD for six years and nine months (6.9 years). The results showed the overall QOL and QOL in the health/functioning domain were unchanged over time. QOL in the socio-economic (p= .002) and psychological/spiritual domains (p= .012) decreased in the first year. From baseline to long-term follow up, the QOL in the family domain (p= .011) and overall uncertainty (p= .002) decreased. Uncertainty related to the information decreased at year 1 in relation to baseline (p= .001). The aim in Paper III was to illuminate the main concern of recipients living with an ICD and how they handle this in their daily life. Sixteen recipients who had lived with an ICD between six to twenty-four months were interviewed. Data was collected and analysed in a simultaneous process according to guidelines for classical grounded theory. In the analysis, a substantive theory was generated explaining the main concern of ICD recipients and how they handle this in their daily life. The core category, labelled “Striving to resume command”, illuminates the main concern of ICD recipients. To manage this main concern, the recipients used the following strategies: Economizing resources, Distracting oneself, Submitting to one’s fate and Re-evaluating life. The aim in Paper IV was to explore relationships between OQL, coping strategies, anxiety, depression and perceived control in recipients living with an ICD and to compare those having received an ICD less or more than one year ago and those with a primary or secondary preventive indication. A cross-sectional, correlational, multicenter design was used, and 147 recipients who had lived with an ICD between six to twenty-four months completed Quality of Life Index-Cardiac version, Jalowiec Coping Scale, Hospital Anxiety and Depression Scale and Control Attitude Scale. The results showed that anxiety, depression and perceived control were predictors of QOL. Anxiety was also a predictor of coping with optimistic coping being the most used coping strategy. There was no relationship between QOL and coping. No differences were found in QOL, coping, anxiety, depression and perceived control between recipients implanted either on a primary or secondary preventive indication or having the device less or more than one year. In this thesis, it was concluded that the ICD recipients strived to resume command over their life (III) and the more control the recipients perceived the more satisfied they were with their QOL (IV) and the more symptoms of anxiety, depression and uncertainty they experienced the less satisfied they were with their QOL (II, IV). Coping strategies were used more frequently by ICD recipient perceiving more anxiety (IV). QOL was fairly good 6,9 years after implantation and ICD recipients felt less uncertain once they had passed the first year of their illness.
21
McDonough, Annette. "The Experiences of Younger Adults (18-40 Years) Living with an Implanted Cardioverter Defibrillator (ICD): A Dissertation". eScholarship@UMMS, 2007. https://escholarship.umassmed.edu/gsn_diss/5.
Testo completoAbstract (sommario):
Sudden cardiac death (SCD) is responsible for 300,000 deaths in the United States each year. Of these 300,000 deaths, 3,000-5,000 are younger adults (18-40 years) (American Heart Association (AHA), 2005; Sudden Arrhythmia Death Syndromes Foundation (SADS), 2005). Implanted cardioverter defibrillators have become the treatment of choice for individuals with life threatening arrhythmias (Cannom Prystowsky, 2004; Glikson & Friedman, 2001; Josephson, Hein, & Wellens, 2004). Although this life sustaining technology has been found to be effective in terminating life threatening arrhythmias, adjustment to an ICD may be difficult for some patients (Ganz, 2004). Few studies have investigated how younger adults manage life with an ICD (Sears, Burns, Handberg, Sotile, & Conti, 2001). It has been reported that older adults view the ICD as an extension of life, whereas, younger ICD recipients associate the ICD with significant life changes, body image concerns, and decreased independence (Arteaga & Windle, 1995).
The purpose of this study was to describe the day-to-day experiences of younger adults (18-40 years old) [N = 20] living with an implanted cardioverter defibrillator. A qualitative descriptive design was used with naturalistic inquiry guiding data collection, management, and analysis. Using open-ended, in-depth interviews, younger adults were asked to describe their life after ICD implantation, physiological or psychosocial issues related to ICD implantation, and strategies used to manage life with an ICD. Data were managed using NVIVO software and analyzed using content analysis. The results revealed an overarching theme, A cautious transition to a new normal, with five subthemes: Initial diagnosis: anxiety and concern; Caution, awareness, and security: daily life with an ICD; Childbearing: passing my disease to my children; Financial concerns; and Strategies for living with an ICD: be positive and live life to the fullest.
This study presented some of the unique developmental and transitional issues that younger adults with ICDs are facing and strategies they used to assist in adaptation to life with an ICD. Their experiences can provide the basis for intervention programs that are developmentally sensitive and age-specific.
22
Santos, Nuno Miguel Alves dos. "Security and Privacy for Implantable Cardioverter Defibrillators". Master's thesis, 2014. http://hdl.handle.net/10400.6/5731.
Testo completoAbstract (sommario):
In a world where the number of people with health issues directly related with the heart is increasing,
the need for this people to implant auxiliary systems for the normal functioning of the
human body’s main organ is exponentially increasing. Amongst the range of devices belonging to
the family of implantable medical devices (IMDs), implantable cardioverter defibrillators (ICDs)
currently are the devices that posses the widest range of therapeutic features for the different existing
cardiac anomalies. However, these systems possess some flaws at the communications security
level, mainly due to the difficulty in balancing privacy and security with safety and utility.
The present dissertation presents a study on security and privacy of communications between
ICDs, their respective programmers and the range of health card entities involved in receiving and
monitoring information from and to these devices. The current standards of hardware, communication,
and security and privacy of these devices are presented and in addition, it is presented
how simple it can be to intercept a radio frequency (RF) signal sent by a key fob, process which
is similar to the communications done between an ICD and its programmer. As well as this study
the principal focus of this thesis is to study and present some alternative proposals for the current
communications architecture of ICD communications with the backoffice, where we include
the implementation of two proof-of-concept android applications, using near field communication
(NFC) and message queuing telemetry transport (MQTT) technologies.Num mundo onde existem cada vez mais pessoas com problemas de saúde diretamente relacionados com o coração, estas possuem muitas vezes a necessidade da implantação de sistemas de auxílio para o normal funcionamento do principal órgão humano, a qual tem vindo a aumentar de forma exponencial. Dentro da gama de dispositivos pertencentes à família de dispositivos médicos implantáveis (IMDs - Implantable Medical Devices), os desfibriladores cardioversores implantáveis - ICDs (Implantable Cardioverter Defibrillators) - são atualmente aqueles que possuem maior gama de auxílio para as diferentes anomalias cardíacas. No entanto, estes sistemas possuem algumas falhas a nível de segurança de comunicações, muito devido à dificuldade em conjugar privacidade e segurança com salvaguarda e usabilidade. A presente dissertação apresenta um estudo sobre a segurança e privacidade das comunicações entre ICDs e os respetivos programadores, onde são apresentados os atuais standards de hardware, comunicação, segurança e privacidade dos mesmos. Analisam-se ainda algumas soluções já existentes que propõem melhorar a segurança e privacidade das comunicações entre ICDs e programadores, apresentando uma análise e crítica. Para além disso, é também apresentado o quão simples é o procedimento para intercetar um sinal de rádiofrequência emitido pela chave de um carro, processo o qual é idêntico ao das comunicações realizadas entre um ICD e o seu programador. Por fim, são apresentadas algumas propostas de novas arquiteturas para as comunicações de um ICD com as diferentes entidades que constituem o backoffice, incluindo ainda a implementação de duas aplicações android que recorrem ao uso das tecnologias near field communication (NFC) e message queuing telemetry transport (MQTT), servindo como provas de conceitos.
23
Gale, TJ. "Modelling the electric field from implantable defibrillators". Thesis, 1995. https://eprints.utas.edu.au/19647/1/whole_GaleTimothyJohn1996_thesis.pdf.
Testo completoAbstract (sommario):
This thesis presents a mathematical model of the electric field from implantable
defibrillators, together with the numerical implementation, validation
and examples of application of the model.
The model was based on Laplace's equation for potential and was implemented
using the boundary element method with constant quadrilateral
elements and realistic torso structures. An efficient out-of-core solver was developed,
allowing any size problem to be solved, subject only to computer
speed and time available. A method was also developed that allowed matrices
calculated in one problem to be used in other, similar problems, often reducing
calculation times by an order of magnitude. Model validation included comparison of myocardial potentials from the
model to those from a finite element model (r.e..2.8%) and from measurements
in a sheep (c.c.=0.464, r.e..23.6%). Validation was also done against
resistance and voltage at defibrillation threshold from 29 patients implanted
with a transvenous system and 8 patients with the transvenous system and an
additional subcutaneous patch. Without the patch, the relative error between
the average of the clinical results and the model result was 9.4% (voltage)
and 0.8% (resistance). The average of the relative errors between each clinical
result and the model result was 23.4% (voltage) and 11.6% (resistance). With
the patch, the equivalent relative errors were 33.9%, 19.4%, 44.0% and 22.5%.
Transvenous, epicardial and subcutaneous electrode configurations were
modelled in a series of investigations. The best transvenous configuration was
with a right ventricular cathode and an anode in the inferior vena cava, where
defibrillation voltage and energy were reduced by 35% and 55%, respectively,
compared to a standard configuration with the anode in the superior vena
cava. Configurations with a right ventricular cathode and large epicardial
patch performed best, though, and reduced voltage and energy by up to 59%
and 79%, respectively. The optimal length of the right /ventricular transvenous
electrode was approximately 60mm. An infarcted heart was also modelled.
For future work, anisotropy may be added to the heart and skeletal muscle
of the model. Anisotropic regions may be represented by many small boundary
element regions or by finite elements. Automated construction of the torso
mesh and an algorithm for automatically optimising electrode position may
be developed. Individual patients may be modelled and predicted values of
defibrillation voltage, energy and resistance compared to values measured at
the time of implantation.
In conclusion, the boundary element model was successful in modelling the
electric field in the torso and in predicting implantable defibrillator performance.
The model has potential to be used in research and development and
in clinical settings.
24
"Friend or intruder? : living with an implantable defibrillator : patients' and partners' experiences". Thesis, University of Technology, Sydney. Faculty of Nursing, Midwifery & Health, 2001. http://hdl.handle.net/10453/20348.
Testo completoAbstract (sommario):
University of Technology, Sydney. Faculty of Nursing, Midwifery and Health.The implantable cardioverter defibrillator (ICD) is a reliable, cost-effective implanted device designed to terminate life-threatening cardiac arrhythmias and prevent sudden death. The recent exponential increase in implantation rates emphasises the need for nurses, doctors and other clinicians to understand the experience of living with an ICD for patients and partners. Current knowledge of patient experiences is mostly derived from overseas studies of specific variables, including physical problems, psychosocial outcomes, ICD shocks and quality of life issues. Studies of partner experiences focus on psychosocial concerns. Using van Manen's (1990) hermeneutic phenomenological approach, this study describes the experience of living with an ICD for seven Australian patients and six partners. Experiential descriptions, obtained in tape-recorded conversational interviews, were subjected to three levels of analysis. The first descriptive analysis summarised individual experiences of living with an ICD. The second, thematic analysis phenomenologically described the collective lived experience of being a patient, and of being a partner. Each description identified a challenging and changing experience through the themes of Being Disrupted and Distressed, Reconstructing Life, Appreciating and Celebrating Life, and Accommodating the ICD. For the patient, various everyday interactions, events and activities meant either being able to trust the ICD as a reassuring protection or experiencing it as an inescapable intrusive object. For the partner, a trusting reliance on the ICD's protective security eased the vulnerability and onerous perceived responsibility for the patient's survival and well-being. Threats to the partner's restored sense of normality, security and hope occurred when the patient wanted the ICD removed or discontinued. The third hermeneutic analysis specifically explored how the ICD, as an implanted biomedical device, was perceived, embodied and comprehended by patients. This analysis disclosed the varied, ambiguous existential meanings derived from and accorded to the ICD's presence, power and potential. The interpretation concluded that the ICD was either embodied as a trusted and reassuring friend, or existentially rejected as an intruder that thwarted meaningful possibilities. Theoretical and practical implications of this understanding of living with an ICD included several recommendations for improving staff education, as well as practical interventions for informing and supporting patients and partners. A proposal for implementing these recommendations concluded with suggestions for future inquiries that would extend understanding of this increasingly common human phenomenon.
25
"Friend or Intruder? Living with an Implantable Defibrillator: Patients' and Partners' Experiences". University of Technology, Sydney. Faculty of Nursing, Midwifery & Health, 2001. http://hdl.handle.net/2100/236.
Testo completoAbstract (sommario):
The implantable cardioverter defibrillator (ICD) is a reliable, cost-effective implanted device designed to terminate life-threatening cardiac arrhythmias and prevent sudden death. The recent exponential increase in implantation rates emphasises the need for nurses, doctors and other clinicians to understand the experience of living with an ICD for patients and partners. Current knowledge of patient experiences is mostly derived from overseas studies of specific variables, including physical problems, psychosocial outcomes, ICD shocks and quality of life issues. Studies of partner experiences focus on psychosocial concerns. Using van Manen's (1990) hermeneutic phenomenological approach, this study describes the experience of living with an ICD for seven Australian patients and six partners. Experiential descriptions, obtained in tape-recorded conversational interviews, were subjected to three levels of analysis. The first descriptive analysis summarised individual experiences of living with an ICD. The second, thematic analysis phenomenologically described the collective lived experience of being a patient, and of being a partner. Each description identified a challenging and changing experience through the themes of Being Disrupted and Distressed, Reconstructing Life, Appreciating and Celebrating Life, and Accommodating the ICD. For the patient, various everyday interactions, events and activities meant either being able to trust the ICD as a reassuring protection or experiencing it as an inescapable intrusive object. For the partner, a trusting reliance on the ICD's protective security eased the vulnerability and onerous perceived responsibility for the patient's survival and well-being. Threats to the partner's restored sense of normality, security and hope occurred when the patient wanted the ICD removed or discontinued. The third hermeneutic analysis specifically explored how the ICD, as an implanted biomedical device, was perceived, embodied and comprehended by patients. This analysis disclosed the varied, ambiguous existential meanings derived from and accorded to the ICD's presence, power and potential. The interpretation concluded that the ICD was either embodied as a trusted and reassuring friend, or existentially rejected as an intruder that thwarted meaningful possibilities. Theoretical and practical implications of this understanding of living with an ICD included several recommendations for improving staff education, as well as practical interventions for informing and supporting patients and partners. A proposal for implementing these recommendations concluded with suggestions for future inquiries that would extend understanding of this increasingly common human phenomenon.
26
Ong, Lephuong. "Predicting psychological outcomes and antiarrhythmic therapies of defibrillator recipients : the role of dispositional vulnerability /". 2008. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:NR51759.
Testo completoAbstract (sommario):
Thesis (Ph.D.)--York University, 2008. Graduate Programme in Psychology.Typescript. Includes bibliographical references (leaves 99-127). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:NR51759
27
Firestone, Jill Stanley. "The effect of a psychological intervention on patients' adjustment to the implantable cardioverter defibrillator (ICD) : a prospective study /". 2008. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:NR39008.
Testo completoAbstract (sommario):
Thesis (Ph.D.)--York University, 2008. Graduate Programme in Psychology.Typescript. Includes bibliographical references (leaves 123-161). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:NR39008
28
Chang, Yu Chuan, e 張玉娟. "Exploration of depression and quality of life in patients after Implantable Cardioverter Defibrillators". Thesis, 2014. http://ndltd.ncl.edu.tw/handle/41797472183170929650.
Testo completoAbstract (sommario):
碩士國立臺北護理健康大學
護理研究所
102
ABSTRACT This study is aimed to investigate depression and quality of life of patient who uses implantable cardioverter-defibrillator (ICD). Mixed method with triangulation design was applied in this study. Quantitative as well as qualitative method were used to collect data and analyze the depression and quality of life for patients 3 months before ICD implantation, 3, 6 and 12 months after implantation.By convenient sampling, SF-36 quality of life scale and BDI-ⅡDepression Scale were utilized for data collection at cardiac clinic or ward in a medical center in northern Taiwan from January to September 2013. Totally 62 patients were recruited. All statistical analyses were performed with the use of SPSS 20.0 to conduct t-test, one way ANOVA, Pearson's correlation, Kruskal-Wallis test and Wilcoxon Rank Sum to check association and difference in each variable, supplemented by qualitative data analysis. The results of the study showed: (1) the highest quality of life score among patients with ICD is "bodily pain, BP" (66.58 ± 25.37, p = 0.041); the lowest is " role limitation due to physical problems,RP“ (33.47 ± 39.19 points, p = 0.041). From time scale, the lowest quality of life score is 3 months after ICD implantation (49.1 ± 16.6); the highest is 12 months after implantation (60.4 ± 18.4). Among basic properties, the patients with work before implantation have a significantly better quality of life. (2) The highest depression score is "loss of interest in sex". From time scale, the highest score is 3 months after ICD implantation (15.2 ± 9.3), which is a mild depression; the lowest is before ICD implantation (9.7 ± 8.6). (3) The depression and quality of life of patients showed a significant negative correlation (r = -0.83, p <0.001), suggesting the higher score of quality of life, the lower depression of patient with ICD. The results of this study can help health professionals to have better understanding of depression and quality of life among patients with ICD and therefore provide more appropriate health care. Health care providers should not only concerned the benefit of ICD that prolongs patients’ life but also pay more attention to life adaptation and psychological adjustment after ICD implantation. Key words: implantable cardioverter-defibrillator (ICD)、quality of life、depression、mix method triangulation
29
"Patient selection for cardiac resynchronization therapy /cby Fung Wing Hong". Thesis, 2007. http://library.cuhk.edu.hk/record=b6074454.
Testo completoAbstract (sommario):
The effect of CRT on incidence of AF development in patients with severe HF was explored by comparing 36 patients with conventional indication for the CRT to 36 HF patients without CRT, matched for age, sex and LV systolic function (Publication 5). After a follow up of 3 years, the annual incidence of AF in the CRT group was 2.8%, which was significantly lower than the control group (10.2%). Moreover, the echocardiographic benefit by CRT was compared between these 36 patients with SR and 15 patients with persistent AF. The results showed that the echocardiographic response was similar between the two groups. These findings suggested that CRT may have the potential to reduce AF burden in patients with severe HF and that patients with persistent AF may also benefit from CRT.The objective of the study (Publication 1) was to assess the feasibility of using non-contact LV mapping to delineate the LV endocardial activation pattern in 7 HF patients in NYHA class III, with low LVEF and wide QRS complex (>120ms). Non-contact mapping was safely performed and there were two endocardial conduction patterns identified, namely homogenous (Type I) and conduction block (Type II). The second part of the study (Publication 2) was to determine the implication of these two distinct activation patterns to echocardiographic and clinical response to CRT. 23 patients in NYHA class III, with LVEF <35% and QRS duration >120ms were recruited in this study. 15 patients had Type II pattern and 8 Type I. The QRS duration between the two types of conduction patterns were comparable. Patients with Type II pattern had a more favourable echocardiographic and clinical response to CRT than those with Type I. It was concluded that, despite the similar QRS duration between the two types of LV endocardial activation patterns, patients with Type II pattern had a more favourable response to CRT.
The significance of baseline renal function in CRT was assessed in 85 consecutive patients with conventional indication for the CRT (Publication 7). There was no significant relationship between baseline renal function and significant LV reverse remodeling after CRT, suggesting baseline renal insufficiency probably would not affect the response to CRT. (Abstract shortened by UMI.)
This study (Publication 3) was to determine the effect of CRT in patients with narrow QRS complex and evidence of mechanical dyssynchrony as determined by TDI. 51 patients in NYHA class III or IV, with LV ejection fraction <35%, and QRS duration <120ms were recruited for the CRT. The effect of the device therapy on LV systolic function in this cohort was compared to 51 patients who fulfilled the current criteria with wide QRS complex. CRT significantly improved the LV systolic function, NYHA class and exercise capacity in those with narrow complex to a similar extent in those with wide complex. With co-existing mechanical dyssynchrony determined by TDI, patients in both narrow and wide QRS complex groups showed more favourable response to CRT than those without significant mechanical dyssynchrony. This confirmed that QRS was a poor marker of mechanical dyssynchrony and the current selection criteria are probably not adequate to include more potential responders to the therapy.
This study (Publication 4) was to determine the role of optimal medical therapy in CRT recipients before implantation. The echocardiographic and clinical effect of CRT in 30 patients without the optimal combination of ACEi or ARB and beta-blockers was compared to 30 patients matched for age, sex, NYHA class and HF etiology. Patients with optimal medical therapy had significantly better echocardiographic and clinical response to CRT. The results confirmed that optimal medical therapy is necessary to achieve maximal response by CRT.
This study (Publication 6) was to determine if patients with moderate LV systolic function and wide QRS complex would benefit from the CRT. Significant improvement in LV systolic function was observed in 15 patients with LVEF between 35 and 45%, NYHA class III and QRS duration >120ms after CRT, suggesting that presence of LV systolic dysfunction and cardiac dyssynchrony may be the major determining factors for favourable CRT response. Therefore, patients with less advanced HF may also benefit from the CRT.
"May 2007."
Adviser: Yu Cheuk Man.
Source: Dissertation Abstracts International, Volume: 69-08, Section: B, page: 4657.
Thesis (M.D.)--Chinese University of Hong Kong, 2007.
Includes bibliographical references (p. 133-151).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
School code: 1307.
30
"Factors influencing health-related quality of life in patients with implantable cardioverter defibrillator". 2013. http://library.cuhk.edu.hk/record=b5884405.
Testo completoAbstract (sommario):
Wong, Mei Fung Florence.Thesis (D.Nurs.)--Chinese University of Hong Kong, 2013.
Includes bibliographical references (leaves 178-208).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstract also in Chinese.
31
Luscombe, Anna Louisa. "Investigating key factors that influence quality of life in implantable cardioverter defibrillator patients in the cardiac clinic at Groote Schuur Hospital". Diss., 2017. http://hdl.handle.net/10500/23261.
Testo completoAbstract (sommario):
Text in EnglishInternational studies have demonstrated that Implantable Cardioverter Defibrillators (ICDs) can have a significant impact on the Quality of Life (QOL) of patients. This is often due to factors that cause considerable psychological distress and has not been investigated in South Africa before. This research study thus investigated factors that influence QOL in patients with ICDs who are followed up in the Cardiac Clinic at Groote Schuur Hospital. The objectives were to describe demographic, clinical, ICD and patient support characteristics; to determine the prevalence of anxiety and depression; to assess QOL and to establish factors that influence depression, anxiety and QOL. The method involved a quantitative approach and a descriptive, cross-sectional and correlational design. All eligible patients with ICDs from the Cardiac Clinic were invited to participate. Participants completed a Demographic and Clinical Questionnaire, the Hospital Anxiety and Depression Scale (HADS) and the SF-36v2 Health Survey. A descriptive analysis of frequencies and summary statistics were done, followed by a regression, comparison and correlational analyses. A total of 70 patients (57 years mean, 65% male) participated in the study. The HADS mean score for anxiety was 6.50, SD 4.52 and for depression 4.96, SD 3.36. The SF-36v2 QOL Physical Component Summary (PCS) mean score was 43.83, SD 9.43 and the Mental Component Summary (MCS) was 47.81, SD 10.71. Factors associated with depression, anxiety and poor QOL included having more than 5 ICD shocks (appropriate or inappropriate). Patients who felt that the ICD influenced their lifestyle positively, was 10.46 times more like to have mental well-being. This study showed that patients with ICDs managed in the state sector, is a vulnerable population. They often live far from hospital, have a high unemployment rate and a poor income. The HADS revealed that 21.4% of the patients had depressive symptoms and 28.6% fulfilled criteria for anxiety. The SF-36v2 revealed that the QOL of patients with ICDs was significantly lower than the norm, with regard to their physical and mental well-being. The study highlights the need for psychological and social support of patients living with ICDs. Keywords: quality of life; implantable cardioverter defibrillator; sudden cardiac death; arrhythmia; anxiety; depression; HADS; SF36v2.
Psychology
M.A. (Psychology)
32
ŠAFAŘÍKOVÁ, Iva. "Kvalita života u pacientů s kardiologickými implantáty sledovaných systémy dálkové monitorace". Master's thesis, 2017. http://www.nusl.cz/ntk/nusl-320689.
Testo completoAbstract (sommario):
Abstract Introduction: The perception of quality of life (QoL) in patients with implantable cardiac devices including implantable cardioverter-defibrillators (ICD), followed by telemonitoring care (Home Monitoring HM), has recently become an extremely hot topic due to constantly increasing number of patients wearing these devices. This increase has resulted in an increased demand for safe, prompt, and more effective out-patient care. Methods: Our research was carried out between December 2016 and March 2017. A cohort of 150 consecutive patients with ICD, followed using the Home Monitoring system (HM+), and 150 consecutive patients with ICD, followed using conventional in-office check-ups (HM-), was retrospectively drawn from the Ceske Budejovice Hospital Patient Information System. A questionnaire, which specifically addressed QoL (EQ5D), level of anxiety and depression (HADS), and a custom questionnaire examining the relationship between patients and the HM system and telecare workflow, was sent out to all patients. Results: For the final statistical analysis, 91 (60.7%) and 104 (69.3%) of the questionnaires were used from the HM+ and HM- groups, respectively. Our results showed that the method of ICD device follow-up did not directly influence QoL. Our statistical comparison of the data did not show any difference between HM+ and HM- patients. A non-significant trend towards better QoL in HM+ compared to HM- patients was noted based on total QoL scores from the EQ5D questionnaire (68.6 ? 19 vs. 64.6 ? 16.5, p = 0.09). Regarding anxiety and depression, statistical testing also failed to find any difference between HM+ and HM- patients. However, more than half of the patients in both groups were in the "normal" population range with respect to anxiety and depression. The most striking difference between HM+ and HM- patients was noted in the preference for the type of follow-up: while 54.9% of HM- patients expressed an interest in remote follow-up and 45.1% said they preferred in-office check-ups, only 6.7% (p < 0.0001) of HM+ patients expressed an interest in switching to in-office check-ups with personal contact instead of remote monitoring. Willingness to partially cover the financial costs of telecare was similar in both groups. HM+ patients were more inclined to use remote ICD monitoring (p = 0.007) and had a more positive attitude toward the telecare approach overall, compared to HM- patients (p = 0.034). Conclusion: The method of device follow-up does not significantly affect QoL in patients with ICD devices, nor does it affect levels of anxiety and depression. Generally, patients with ICDs followed using the HM system were very satisfied with telecare and would prefer not to lose remote ICD monitoring. Although, the willingness to, at least partially, cover the costs of the HM system was limited and comparable to that of patients receiving conventional follow-up.
33
Bickel, Iris. "Spiritual well-being of healthy adults and adults who recently experienced a cardiac arrest or syncope requiring an implantable cardioverter defibrillator report submitted in partial fulfillment ... for the degree of Master of Science, Medical-Surgical Nursing ... /". 1994. http://catalog.hathitrust.org/api/volumes/oclc/68797665.html.
Testo completo