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Chapter 16 Electrophysiology
Published in B H Brown, R H Smallwood, D C Barber, P V Lawford, D R Hose, Medical Physics and Biomedical Engineering, 2017
Cardiology deals with all aspects of cardiac function. The heart is a single muscle which produces an electrical signal when the muscle depolarizes. The measurement of this electrical signal (the electrocardiograph) is one of the oldest medical techniques. The ECG/EKG was first recorded by Einthoven in the Netherlands and Waller in England in 1895.
The CardioMEMS Heart Failure System for chronic heart failure – a European perspective
Published in Expert Review of Medical Devices, 2023
Sumant P. Radhoe, Pascal R.D. Clephas, Hamraz Mokri, Jasper J. Brugts
Results from the Dutch randomized MONITOR HF trial are expected soon. This trial will provide the much-needed evidence that is generalizable to other parts of Europe as well [24]. The MONITOR HF trial is relevant as its design and the Dutch healthcare structure with dedicated HF outpatient clinics and nurses are representative for a large part of Europe [24]. HF care in the Netherlands has been shown to be of high quality, also in comparison to the U.S [45,54]. Importantly, this trial may provide novel insights into CardioMEMS PA pressure guided management against a background of contemporary HF therapy, including ARNi and SGLT2-inhibitors. Results from the planned cost-effectiveness analyses will be elucidating from an economical point of view [24]. The MONITOR HF trial will be important for the level of recommendation in the European Society of Cardiology Guidelines for Heart Failure [10].
Outcomes after mechanical versus manual chest compressions in eCPR patients
Published in Expert Review of Medical Devices, 2021
Christopher Gaisendrees, Stephen Gerfer, Borko Ivanov, Anton Sabashnikov, Julia Merkle, Maximilian Luehr, Georg Schlachtenberger, Sebastian G Walter, Kaveh Eghbalzadeh, Elmar Kuhn, Ilija Djordjevic, Thorsten Wahlers
Our institutional eCPR protocol has been described in detail previously [10–13]. In brief, the interdisciplinary eCPR team comprises members of Cardiothoracic Surgery and Cardiology departments, respectively. In situations of ongoing CPR, physicians and surgeons are equally involved in the management and further treatment: eCPR is initiated when interdisciplinary consensus is achieved. The V-A ECMO (Maquet, Rastatt, Germany) implantations required for eCPR are performed either in the catheterization laboratory, the intensive care unit (ICU) or the emergency room. Following a standardized general clinical examination with additional echocardiography, the left or right groin is sterilized and prepared for ECMO implantation. To assess the initial parameters of oxygenation and metabolism, at least one blood gas analysis is performed prior to cannulation. The decision to cannulate is based on participating physicians’ judgment and with regard to the following criteria:
Optimizer Smart System for the treatment of chronic heart failure: Overview of its safety and efficacy
Published in Expert Review of Medical Devices, 2021
Habib Hymie Chera, Mohammed Al-Sadawi, Nickolaos Michelakis, Michael Spinelli
Early versions of the system have had CE Mark approval in the European Union since 2002. The current version, Optimizer Smart has had the EU CE Mark since 2016. The system is referenced in the European Society of Cardiology clinical guidelines for heart failure. It is recommended by European Society of Cardiology (ESC) for patients with HFrEF with QRS duration <120 ms [42]. In 21 March 2019, United States Food and Drug Administration (FDA) approved using Optimizer Smart system in patients with HFrEF with EF between 25% to 45%, in normal sinus rhythm and normal or mildly increased QRS duration and symptomatic in spite of optimal medical treatment. The FDA also recently issued a conditional approval for patients with Optimizer CCM to undergo magnetic resonance imaging (MRI). The China Food and Drug Administration (CFDA) approved Optimizer smart system for treatment of chronic heart failure on December 2017. Moreover, Ministry of Public Health in Russia approved the system for clinical application in HFrEF. The system has also been used in Hong Kong, Saudi Arabia, United Arab Emirates, Brazil, and Poland.