Electric Nerve Blocks
Mark V. Boswell, B. Eliot Cole in Weiner's Pain Management, 2005
Many have been clinically treated with electricity. Defibrillation, used in emergency situations to reestablish cardiac activity when fibrillation occurs, involves the passage of an electrical current through the chest. Lower back pain often responds to transcutaneous electrical nerve stimulation (TENS) therapy and other electrotherapeutic techniques as part of overall treatment program. Electroconvulsive therapy (ECT) for depression, spinal cord stimulators (SCS)/dorsal column stimulators (DCS) for chronic pain control, bone growth stimulators after orthopedic surgery, neuromuscular stimulation for disuse atrophy, and a number of other electrotherapies are a few examples of the currently used electrical techniques in modern medicine. TENS devices, as designated by the FDA, also include high-voltage galvanic stimulators (HVGS), neuromuscular electrical stimulators (NMES), interference stimulators, and various transcranial stimulators (e.g., the Alpha-Stim® devices and the Liss Transcranial/Body Stimulator®). Most of these electrical devices have been approved by the FDA as safe and efficacious and are allowed for use. Other electromedical treatments include: Thalamic stimulationElectroacupunctureAuricular acupuncture
Frequency-selective heart defibrillation model
Waldemar Wójcik, Sergii Pavlov, Maksat Kalimoldayev in Information Technology in Medical Diagnostics II, 2019
Defibrillation is the cessation of fibrillatory contractions of the heart ventricles or atria. The onset of ventricular fibrillation leads to increased hypoxia and a drop in the tone of the heart, which causes cardiac arrest. The probability of patients survival with ventricular fibrillation decreases by 7–10% every minute (Valenzuela et al. 1997, Haskel 1978, Hossack & Hartwig 1982, Krawczyk et al. 2003). The method of defibrillation is to act on the heart with a strong electric discharge, which removes the ventricular fibrillation and leads to the restoration of normal heart function (Smerdova 2014). The main goal of defibrillation is to successfully interrupt ventricular fibrillation with the smallest discharge to avoid damage to the myocardium, which is often observed when high energy is used (Dahl et al. 1988) (Kerber et al. 1988).
Recognition and management of cardiopulmonary arrest
Peate Ian, Dutton Helen in Acute Nursing Care, 2020
There are different types of defibrillator available in clinical practice: Manual defibrillators: these require a high level of rhythm recognition skills on the part of the operator but have the advantage, when used in expert hands, of reducing the delay in compressions to less than five seconds.Automated external defibrillators (AEDs): these are sophisticated computerised devices that can reliably analyse the heart rhythm and, through voice and visual prompts, guide you through safe defibrillation. In areas where staff may not have skills in rhythm recognition and/or do not use defibrillators regularly, training in the use of AEDs is achieved much more easily and quickly than in the use of manual defibrillators, and offers a way of achieving the goal of delivering the first shock within three minutes of collapse.
Vericiguat for the treatment of heart failure: mechanism of action and pharmacological properties compared with other emerging therapeutic options
Published in Expert Opinion on Pharmacotherapy, 2021
Jean-Sébastien Hulot, Jean-Noël Trochu, Erwan Donal, Michel Galinier, Damien Logeart, Pascal De Groote, Yves Juillière
Available pharmacological therapies in HFrEF consist of renin-angiotensin-aldosterone system (RAS) blockers (either angiotensin-converting-enzyme inhibitor [ACEI] or angiotensin receptor blockers [ARB]) or angiotensin receptor-neprilysin inhibitors (ARNIs, such as sacubitril/valsartan) and mineralocorticoid receptor antagonists (MRAs), that are combined to beta-blockers and diuretics including loop diuretics [7]. When required, a cardiac resynchronization therapy ± implantable cardioverter defibrillator are used. While these therapies address the main pathophysiological mechanisms activated in HF, the WCHF population remains at risk of high event rates despite their effectiveness. Consequently, there is a clinical unmet need to provide more therapeutic options investigating new pathways for patients with WCHF.
Coronary vasospasm as an etiology of recurrent ventricular fibrillation in the absence of coronary artery disease: a case report
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Binita Bhandari, Tejaswi Kanderi, Keerthi Yarlagadda, Mehreen Qureshi, Saketram Komanduri
Management of VF is time-sensitive as it can cause sudden cardiac death if not immediately reverted and also involves diagnostic testing to delineate the cause of VF if possible. Defibrillation remains the mainstay of treatment to prevent significant mortality during acute episodes as well as to prevent further VF episodes. The literature on VF caused by coronary vasospasm is evolving, and a range of presentations from mild chest discomfort to myocardial infarction and life-threatening arrhythmias and sudden cardiac death have been reported [13]. Our patient had recurrent hospital admissions (Figure 5) with chest pain and ST elevations noted on ECG leading to a coronary catheterization. Once ACS was ruled out, VFib was attributed to coronary vasospasm, which was further supported by recurrent episodes with potential anginal attacks but a decrease in the frequency of ICD shocks with the management of coronary vasospasm by calcium channel blockers and nitrates.
Cost-effectiveness analysis of implantable cardiac devices in patients with systolic heart failure: a US perspective using real world data
Published in Journal of Medical Economics, 2020
Dhvani Shah, Xiaoxiao Lu, Victoria F. Paly, Stelios I. Tsintzos, Damian M. May
Cardiac resynchronization therapy (CRT) devices are a specific type of cardiac pacemaker used to re-establish electrical and mechanical coordination of the left and right ventricles. These devices are known as CRT-pacemakers (CRT-P). Implantable cardioverter defibrillators (ICDs) are used to provide therapies, such as defibrillation or anti-tachycardia pacing, to treat life-threatening arrhythmias associated with sudden cardiac death. The American College of Cardiology Foundation (ACCF)/AHA Guidelines for the management of HF make recommendations for the use of ICDs and CRT for patients with HFrEF conditional on specific clinical characteristics and manifestations such as ischemic/non-ischemic heart disease, left ventricular ejection fraction (LVEF), New York Heart Association (NYHA) class, QRS duration and presence of left bundle-branch block (LBBB)8. Modern types of CRT devices combine both the functionality of a CRT-P and that of an ICD and these are referred to as CRT-defibrillators (CRT-D). The relative benefit of these devices has been well established, but is understood to vary based on multiple patient characteristics9,10.
Related Knowledge Centers
- Arrhythmia
- Asystole
- Cardiac Pacemaker
- Depolarization
- Sinus Rhythm
- Ventricular Fibrillation
- Heart
- Cardiac Muscle
- Ventricular Tachycardia
- Sinoatrial Node