Electrotherapy of the Heart de Max Schaldach

Electrotherapy of the Heart: Technical Aspects in Cardiac Pacing

Max Schaldach

Since 1958, when the first cardiac pacing system wasimplanted, the exemplary collaboration between medicine andengineering has developed into an extremely successfultherapy.The book highlights many of the recent and most importanttechnological advances and shows the multidisciplinarynature of the technical task of pacemaker development whichis based on the diverse components of physiology,electronics, physics, electrochemistry and the materialsciences.

Citește tot Restrânge

Cuprins

Basic Anatomy and Physiology of the Heart.- Position and Structure of the Heart.- Generation and Tine Course of Excitation.- Excitation-Contraction Coupling and the Contraction Process.- Physiology of the Heartbeat.- The Pacemaker Potential and the Spread of Excitation.- Cardiac Mechanics.- Adjustments of the Heartbeat.- Neural-Humoral Control of Circulation.- Role of the Autonomic Nervous System in Cardiovascular Regulation.- Circulatory Regulation in Patients with Disorders of the Heart’s Pacemaking or Conducting System.- Monitoring the Electrical Activity of the Heart.- Pathophysiology.- Disorders of the Pacemaking Function.- Disturbances of Conduction.- Therapy for Cardiac Rhythm Disturbances.- Electrotherapy in the Treatment of Cardiac Rhythm Disturbances.- Pacemaker Technology.- Implantable Pacemakers: History, Current Status and Trends.- Multiprogrammable Single-Chamber Pacemakers.- Technical Solution for the Multiprogrammable Single-Chamber Pacemaker.- Multiprogrammable Dual-Chamber Pacemaker.- Technical Solution for the Dual-Chamber Pacemaker.- Controlled and Regulated Pacemakers.- Control Aspects of Cardiac Output Adjustment.- Different Strategies of Rate Adaptation.- Forward Consideration of Disturbance Variables.- Open-Loop Control Using Corporeal, Non-Cardiac State Variables.- Rate Adaptation Using Cardiac Parameters.- Status of the Application of Corporeal Control Parameters.- Motion Energy as a Control Parameter.- Central Venous Temperature as a Corporeal Control Parameter.- Cardiac Control Parameters.- Principles of Intracardiac Conductance Measurement.- Basic Aspects of Conductance.- Anisotropic Impedance.- Employment of PEP for Rate Adaptation.- Improving the PEP Control: Concept of VIP.- Unipolar Right Ventricular Conductance Measurement.- ClinicalResults.- Employment of Volume Information for Rate Adaptation.- Conclusions.- The Stimulating Electrode.- Electrode/Myocardium Interface.- Helmholtz Doublelayer.- Electrical Characteristics.- Electrode Materials.- Porous Electrode.- TiN as an Electrode Material.- Comparative Studies.- Materials in Pacemaker Technology.- Definition of a Biomaterial.- Summary of Biomaterials in Common Use.- General Characteristics of Biomaterials.- Biomaterials in Soft-Tissue Implants.- Resistance to Corrosion.- Biocompatibility.- Quality Testing and Reliability.- Physiological Characteristics of the Blood.- Interactions Between Blood and Artificial Surfaces.- Determination of Blood Compatibility.- Pacemaker Power Sources.- Battery Development.- State of the Art in Pacemaker Power Sources.- The Elements of a Primary Battery.- Battery Performance.- Chemistry of the Lithium/Iodine-Polyvinylpyridine (Li/I2-PVP) System.- Design of Lithium/Iodine-PVP Cells.- Discharge Characteristics of the Li/I2-PVP Battery.- Cell Design and Qualification.- Reestablishment of Physiological Regulation—A Challenge to Technology.- New Concepts in Electrotherapy of the Heart.- Conclusions.