Conditions for the indirect transesophageal atrial stimulation (TAS), useful for cardiac diagnosis and treatment, are optimized both by way of clinical experiment and a computer modelling. The paper demonstrates the results of comparison of electric current density, obtained on the surface of the left atrium during computer modelling, with the results of our own experiments. An evaluation was made with the use of spiral CT scanning of the distance between the esophagus and the posterior wall of the left atrium. The average distance in the tested group of 27 subjects was 4.7 ±σ = 1.1 mm. During transesophageal stimulation, we have determined the average excitation threshold of the left atrium, obtaining the value 5.5 ±σ = 1.8 mA in the examined group of 27 patients. The calculated average current density on the surface of left atrium for the selective electrode with point poles used in the experiment amounted to 39.6 μA/mm2. Electric current densities obtained by other researchers by means of computer modelling for omnidirectional and selective ring electrodes turned out to be much lower after adjustment to similar conditions, which was the result of electrically active larger sizes surfaces of the poles of electrodes used in the modelling.
W pracy przedstawiono możliwości diagnostyki i terapii kardiologicznej wykorzystujące techniki nieinwazyjnej elektrostymulacji serca, prowadzonej z użyciem wielofunkcyjnego urządzenia DiagnoStim MDD-501. Na przykładach pacjentów, u których urządzenie spełniło jednocześnie funkcję diagnostyczną i terapeutyczną oraz pacjentów, u których diagnostyczne możliwości urządzenia zadecydowały o wdrożeniu lub zaniechaniu dalszego postępowania inwazyjnego, przedstawiono przegląd technik dostępnych z zastosowaniem MDD-501, wskazując na jego niezwykłą przydatność w sprawnym rozwiązywaniu problemów kardiologicznych.
W pracy opisano przebieg realizacji oraz uzyskane do chwili obecnej wyniki projektu EUREKA! „CARDISCREEN”, podjętego w celu opracowania, standaryzacji i weryfikacji nowej metody diagnostycznej bazującej na kardiostymulacji nieinwazyjnej i elektrokardiografii. Metoda ta umożliwi wykrycie potencjalnego ryzyka wystąpienia choroby wieńcowej w badaniach przesiewowych osób z populacji zagrożonej.
EN
The paper describes the work done and the most recent results of EUREKA! project “CARDISCREEN” aimed at development, standardization and verification of a new diagnostic method based on non-invasive cardiac stimulation and electrocardiography. The method allows detection of potential risk related to occurrence of coronary heart disease using screening tests of people from endangered population.
The Centre of Excellence STIMCARD operating within the Institute of Medical Equipment and Technology ITAM develops Polish technologies of transesophageal, transcutaneous and transvenous cardiac stimulation as well as technologies supporting the supervision of patients undergoing electrocardiotherapy, such as in the case of an implanted pacemaker or cardioverter defibrillator. The paper reviews non-invasive electro stimulation techniques, as well as the diagnosis and therapy of the coronary artery disease (CAD) and arrhythmias. As far as CAD is concerned, the paper presents solutions applied in the construction of electrodes and pacemakers intended for both transesophageal and transcutaneous cardiac stimulation tests. The clinical value of the developed cardiac stimulation test has been assessed for the diagnosis of stable cardiac symptoms and management of patients with unstable cardiac disease, as well as for the identification of subjects in danger of sudden cardiac death. The system of stimulated ischemic preconditioning has also been discussed. Also, the paper demonstrates dedicated solutions used in ECG recording channels in the area of diagnosis and treatment of arrhythmias. The solutions make it possible to obtain stable and interpretable recordings during stimulation, both on the surface of the body and in the esophagus. Finally, the paper analyses solutions introduced in pacemakers which make it possible to induce (for diagnostic purposes) and stabilize quick paroxysmal heart arrhythmias, as well as the idea of supported hemodynamics, particularly useful during surgery.
The paper presents the results of study on optimizing of ECG-signal filtration in case of ECG recordings during noninvasive transesophageal and transcutaneous diagnostic and therapeutic heart stimulation. The study comprised an effectiveness of hardware-software noninvasive stimulator artifact elimination system applied in electrocardiograph DEK-631 (ITAM – Zabrze) as well as the effectiveness of analogous circuit of spike artefacts elimination applied in recording channel of diagnostic cardiostimulator SP-5plus (ITAM). The influence of filtration on a quality of ECG signal recorded and a possibility of drawing the objective diagnostic conclusions have been assessed. Analogous artifact elimination system (AES) contained in SP-5plus ensured obtaining of good quality of ECG recording during noninvasive stimulation of atria and ventricles in all diagnostic and therapeutic applications.
The work has been aimed at evaluation of ECG records quality during transcutaneous heart stimulation performed in the three-electrode layout by means of a new analog Artefact-Elimination System (AES) external to the recoder. The transcutaneous ventricular stimulation was performed with the use of noninvasive cardiostimulator NAP-601 (ITAM Zabrze) coupled with transesophageal cardiostimulator SP-5 plus eqipped additionally with the analog AES in ECG recording channel. Efficacy of the system has been evaluated in 15 patients at a duration of artefact elimination equal to 60 and 120 ms. Threshold of ventricular excitation was 47 mA and was located within a range 33 to 80 mA.
JavaScript jest wyłączony w Twojej przeglądarce internetowej. Włącz go, a następnie odśwież stronę, aby móc w pełni z niej korzystać.