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  • 1
    ISSN: 1573-8256
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Technology
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Medical & biological engineering & computing 31 (1993), S. S108 
    ISSN: 1741-0444
    Keywords: Autonomous nervous system ; Cardiac pacing ; Exercise protocol ; Impedance method ; Multicentre study ; Myocardial contractile performance ; Rate adaptation ; Sympathetic activity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Chemistry and Pharmacology , Medicine
    Notes: Abstract Modern pacemaker technology makes the adaptation of pacing rate to haemodynamic requirements possible. The most ambitious approach aims at restoration of the physiological closed-loop system by utilising the information that is supplied by the autonomic nervous system (ANS) and extracted from myocardial contractile performance. Measurement is accomplished by the impedance method, with the stimulation electrode as measuring electrode. The ventricular inotropic parameter (VIP) has been identified as an ANS-dependent parameter. A special detection algorithm RQ (regional effective slope quantity) with high ANS sensitivity has been developed. Rate adaptation has been achieved by using an individually adjustable inotropic index (II). The concept has been evaluated in a multicentre study employing a standardised exercise protocol. The results in patients with AV block demonstrate the excellent agreement between the spontaneous sinus rhythm and the ANS-controlled stimulation rate during different forms of exercise. Measurement of mean arterial blood pressure (MABP) supports the physiological approach to adapting the pacing rate to different kinds of haemodynamic challenge.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Medical & biological engineering & computing 31 (1993), S. S123 
    ISSN: 1741-0444
    Keywords: Amorphous silicon carbide ; Clotting proteins ; Haemocompatibility ; Hybrid design ; Fibrinogen ; PECVD
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Chemistry and Pharmacology , Medicine
    Notes: Abstract State of the art in biomaterial research and implant design is a compromise between functionality and biocompatibility. Consequently, results often have disadvantages with respect to both aspects. With regard to biocompatibility, the activation of the clotting system by alloplastic materials is of great significance, because it necessitates anticoagulant therapy. Further improvements in implant technology require an understanding of the interactions between blood and implants. Therefore a microscopic model of thrombogenesis at alloplastic surfaces is briefly presented, relating thrombogenicity of a material to the electronic structure of its surface. The electronic requirements for high haemocompatibility, which result from this model (especially a low band-gap density of states and a high surface conductivity) are fulfilled by an amorphous alloy of silicon and carbon (a-SiC:H). The advantage of amorphous materials is that they do not obey stoichiometric rules. Thus they allow a continuous adjustment of the electronic parameters without fundamental changes in their mechanical and chemical properties. The theoretical results were checked in vitro by total internal reflection intrinsic fluorescence (TIRIF) spectroscopy as well as thrombelastography experiments (TEG). In comparison with conventional materials such as titanium or LTI carbon, the TEG-clotting time of a-SiC:H-coatings was prolonged by in excess of 200 per cent. As a consequence, a-SiC:H is well suited as a haemocompatible coating material for hybrid structuring of cardiovascular implants.
    Type of Medium: Electronic Resource
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