Defibrillation systems therapy

Fig. 18.36 Posteroanterior chest radiograph obtained after the prior device was upgraded to a cardiac resynchronization therapy defibrillator system. During the course of the upgrade, the central venous circulation was perforated, and when dye was injected to determine the position of the sheath, the contrast material was seen in the mediastinum.

Medical Device Batteries describes wearable and implantable medical devices powered by batteries. Devices include those that are used for cardiac rhythm management (pacemakers, defibrillators, and heart failure devices), hearing loss, bone growth and fusirm, drug delivery for therapy or pain relief, nerve stimulation for pain management, urinary incompetence and nervous system disorders, vision, diagnostic measurements and monitoring, and mechanical heart pumps. 

Rao, H.B. and S. Saksena, Implantable defibrillators configured for hybrid therapy of persistent and permanent atrial fibrillation initial clinical experience with a novel lead system. Journal of interventional cardiac electrophysiology, 2005. 13 Suppl 1 p. 79-86. 

Intra-arterial catheters have been used for different objectives, such as the placement of other devices like stents, the delivery of drugs to various targets in the cardiovascular system and the delivery of embolic materials to close arterial-venous fistulas. Drug therapy has also been combined with catheter ablation, pacemakers and cardioverter defibrillators in order to treat arrhythmias. On the other hand, implants for the reconstruction or functional replacement of cardiovascular components have been combined with drugs to prevent thrombosis. Finally, drugs to avoid restenosis have been widely employed in different devices such as drug-eluting stents. 

An implantable cardioverter-defibrillator (ICD) has a programmable pulse generator and lead system that monitors the heart s activity, detects ventricular arrhythmias and other tachyarrhythmias, and responds with appropriate therapies. The range of therapies includes antitachycardia and antibradycardia pacing, cardioversion, and defibrillation. Newer defibrillators can also pace both atrium and ventricle. 

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