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  • 1
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We investigated in sheep, non-thoracotomy extraction of leads which had been chronically implanted in the right atrium (RA), coronary sinus/great cardiac vein (CS / GCV) and right ventricle (RV) for atrial implantable defibrillation. Clinical success of extraction as well as gross and histologic findings in the heart are reported. Six of nine sheep had successful extractions. The major complication was laceration of the wall of the great coronary vein with hemorrhage into the pericardial space and cardiac tamponade. Tissue damage included several reversible changes: intra-tissue hemorrhage, thrombosis in the veins, and some necrosis of fat, vascular wall and myocardium. Myocyte necrosis was estimated as 0.03 to 0.3 grams of tissue. Osseous and cartilaginous metaplasia was more common around the RA lead than the CS/GCV lead. In cases where the lead must be removed, removal from the venous insertion site using lead extraction equipment should only be attempted with surgical back-up for emergency thora-cotomy to control hemorrhage in the event of vessel laceration. Safer explantation of these leads from the vein entry site will require the development of new extraction procedures.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1573-9686
    Keywords: Skeletal muscle ventricle ; Electrical stimulation ; Cardiac assistance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Technology
    Notes: Abstract The optimal means of electrically stimulating a skeletal muscle to contract around a fluid-filled pouch (i.e., a skeletal muscle ventricle [SMV]) has not been determined. A SMV was made from the latissimus dorsi muscle in five dogs and the rectus abdominis muscle in five dogs, and each SMV was electrically stimulated via the motor nerve(s) to contract around a fluid-filled pouch, which was connected to a mock circulatory system. The pulse train duration (PTD) was varied from 100 ms to 800 ms in 100 ms increments to determine the effect of this variable upon SMV output. The pulse width of the electrical stimulus was kept constant at 100 μs and the pulse frequency was maintained at 50s−1. For SMV contraction rates of 20, 30, and 40 min−1, the optimal PTD was 400 ms for both muscles. The peak output was 710 ml min−1 for the rectus SMV and 556 ml min−1 for the latissimus SMV. For an SMV contraction rate of 10min−1, the optimal PTD was 800 ms for the rectus SMV and 600 ms for the latissimus SMV. Use of less than an optimal PTD caused reductions in SMV output of 25–50%. Although SMVs made from rectus abdominis and latissimus dorsi had similar values for the optimal PTD, the maximum SMV output was usually greater with the rectus abdominis in this acute study with untrained muscles. We conclude that PTD is an important variable to control, which can markedly affect results when studying the potential use of skeletal muscle power for cardiac assistance.
    Type of Medium: Electronic Resource
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