Sensorgesteuerte Herzschrittmacher-Systeme

Werner, J.; Hexamer, Martin; Hoeland, K.; Meine, Mathias

doi:10.1524/auto.1998.46.11.516

Cited by 6 publications

(5 citation statements)

References 5 publications

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“…In den letzten Jahren wurden verschiedene physiologische Parameter, die mit der körperlichen Beanspruchung korrelieren, für die sensorgesteuerte Herzfrequenzanpassung vorgeschlagen. Dazu zählen die maximale rechtsventrikuläre Druckanstiegsgeschwindigkeit, die gemischtvenöse Sauerstoffsättigung und das Atemminutenvolumen [17]. In Bild 10 sind die simulierten Stimulationsfrequenzen über dem Sauerstoffverbrauch, der direkt proportional zum kör-perlichen Belastungsgrad ist [15] Die maximale rechtsventrikuläre Druckanstiegsgeschwindigkeit wird während der isovolumentrischen Anspannungsphase erreicht und ist nach Lowell [14] im Bereich von 80 bis 120 [1/min] positiv mit der Herzfrequenz korreliert.…”

Section: Anwendungenunclassified

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Ein pulsatiles Herz/Kreislauf-Modell für die Herzschrittmachertechnik (A Pulsatile Circulatory Model for the Pacemaker Technology)

Welp¹,

Werner²,

Böhringer³

et al. 2002

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Das unter Matlab/Simulink entwickelte Computermodell des Herz/Kreislaufsystems legt den Schwerpunkt auf eine exakte mathematische Beschreibung der Herzkinematik, um pulsatile Effekte und damit die Blutkreislaufdynamik zu reproduzieren. Dadurch und weiterhin durch die Kopplung des pulsatilen Modells mit dem validierten Modell der Kreislaufregulation von Guyton können kardiologische und kardiotherapeutische Phänomene untersucht werden. Die Simulationsergebnisse wurden mit publizierten Referenzwerten verglichen und Übereinstim-mungen sowohl im Wertebereich als auch in der Dynamik der Druck-, Fluss-, und Volumenkennlinien nachgewiesen. Darüber hinaus wurden das Systemverhalten bei Schrittmacherstimulation, die Auswirkungen von Relaxationsstörungen des Herzmuskels, sowie verschiedene physiologische Steuergrößen für frequenzadaptive Herzschrittmachersysteme evaluiert.The developed computer model of the human circulation system focuses on the detailed description of the heart kinematics to reproduce the pulsatile effects and therewith the circular blood flow dynamics. By this and furthermore by coupling the pulsatile model with the validated Guyton model, it is possible to investigate cardiac and cardio-therapeutical phenomena. The results of the simulation were compared to published references, and analogy concerning the range and dynamics of the characteristics of pressure, flow and volume were verified. Moreover, the system properties at cardiac pacing, the effect of cardiac relaxation disorders and specified physiological variables for control of rate adaptive pacemaker systems were evaluated.

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Section: Anwendungenunclassified

“…Dazu zählt vor allem die Frage nach der Effektivität der unterschiedlichen Schrittmachersysteme (atriale/ventrikuläre Stimulation, frequenzadaptive Stimulation etc.) und deren Verbesserung im Hinblick auf eine sicherere Stimulationssteuerung, die möglichst den ursprüng-lichen physiologischen Regelkreis wiederherstellt [17]. …”

Section: Introductionunclassified

Ein pulsatiles Herz/Kreislauf-Modell für die Herzschrittmachertechnik (A Pulsatile Circulatory Model for the Pacemaker Technology)

Welp¹,

Werner²,

Böhringer³

et al. 2002

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“…This produces a signal that should correlate with the movements of the heart (HOELAND et al, 1999). The information thus gained can be incorporated in various cardio-technical instruments, in cardiac pacemakers, information about the state of the heart and the control of the autonomic nervous system is required to generate an adequate pacing rate (WERNER et al, 1998;. in implantable cardioverter/defibrillators (ICD), additional information would be advantageous to provide a more reliable criterion for shock application, in this case in particular, such information should be derived from a mechanical signal independent of the electrical signals of the heart, as unequivocal analysis in the case of ventricular fibrillation is difficult.…”

Section: Introductionmentioning

confidence: 99%

New sensor based on fibre optics for measurement of heart movement

Hoeland

Kloppe

Hexamer

et al. 2002

Med. Biol. Eng. Comput.

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Innovative fibre-optic sensor technology for measuring the movement of the myocardial walls, and from this the heart chamber volumes, was developed. An optical fibre, with a mirror at its end, is inserted into a catheter located in the heart. An opto-electrical control unit positioned outside the heart contains both the light source and the signal receiver. It generates and couples the light into the fibre and transforms and analyses the reflected signal. With such a system, the movement of the cardiac wall can be continuously measured during each cycle, because the fibre moves synchronously with the heart, and this movement bends the fibre, changing the optical attenuation. Experiments where the fibres were wound around metal cylinders of different diameters revealed a maximum sensitivity of 4% mm(-1), diameter. The noise signal corresponded to about 1% of the diameter. First tests in a working pig heart showed a high correspondence of the fibre signal with cardiac parameters. Although these tests are promising, further long-term, extensive experiments in preclinical test devices, and later in clinical tests, must be carried out before the new sensor is used in clinical practice. The fibre-optic technique could be used in monitoring devices, assist devices, pacemaker systems or cardioverter defibrillators.

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“…Thereby the effectiveness of dif-ferent pacemaker techniques, such as the atrial/ventricular stimulation or the rate adaptive stimulation could be evaluated regarding their ability to restore the physiological closed loop control of heart beat [21]. Therefore a novel circulatory model has to combine the advantages of both approaches, the description of the heart kinematics as well as the respiratory/metabolic effects.…”

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confidence: 99%

Investigation of cardiac and cardio-therapeutical phenomena using a pulsatile circulatory model / Untersuchung kardiologischer und kardiotherapeutischer Phänomene anhand eines pulsatilen Herz/Kreislauf-Modells

Welp

Werner²,

Böhringer³

et al. 2004

Biomedizinische Technik/Biomedical Engineering

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For many years computer models of the cardiovascular system have existed with which the complex physiological interrelations of regulation processes may be studied. However, one major disadvantage of these models is the simplified modeling of the heart kinematics whereby the short term regulation effects of the heart itself on varying physical strains may only be simulated rudimentarily. The developed pulsatile model emphasizes the detailed description of the systolic wall tension progression subject to the Hill/Frank-Starling mechanisms and the simulation of the cardiac valves. Moreover, to be able to describe long term effects the pulsatile model was coupled to the established cardio vascular model of Guyton. Using the coupled system the influences of impaired valve function and ventricular relaxation disorders on the cardiac output as well as the need for an implementation of a physical strain dependent av-delay in existing pacemaker types were investigated. Both the dynamics and the steady-state values of a subset of variables (pressure, volume, flow) were successfully validated by comparing them to published experimental and clinical recordings.

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Sensorgesteuerte Herzschrittmacher-Systeme

Cited by 6 publications

References 5 publications

Ein pulsatiles Herz/Kreislauf-Modell für die Herzschrittmachertechnik (A Pulsatile Circulatory Model for the Pacemaker Technology)

Ein pulsatiles Herz/Kreislauf-Modell für die Herzschrittmachertechnik (A Pulsatile Circulatory Model for the Pacemaker Technology)

New sensor based on fibre optics for measurement of heart movement

Investigation of cardiac and cardio-therapeutical phenomena using a pulsatile circulatory model / Untersuchung kardiologischer und kardiotherapeutischer Phänomene anhand eines pulsatilen Herz/Kreislauf-Modells

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