We Have Come a Long Way with Device Therapy: Historical Perspectives on Antiarrhythmic Electrotherapy

Abstract

Historical Perspectives on Antiarrhythmic Electrotherapy. The history of device therapies is long and fascinating. In the beginning, there is not simply the anatomy and physiology of the heart, but also analysis of the pulse, which indicates the activity of the heart. The analysis of the (peripheral) pulse as a mechanical expression of heart activity goes back several millennia. In China, in 280 BC, Wang Shu He wrote 10 books about the pulse. The Greeks called the pulse “sphygmos”; thus, sphygmology deals with a theory of this natural occurrence. In Roman times, Galen interpreted the various types of pulse according to the widespread presumption of the time that each organ in every disease has its own form of pulse. The growing clinical importance of electrical cardiac stimulation was recognized and renewed as Zoll in 1952 described a successful resuscitation in cardiac standstill by external stimulation. Meanwhile, millions of patients with cardiac arrhythmias worldwide have been treated with pacemakers in the last 40 years. The concept of a fully automatic implantable cardioverter defibrillator system for recognition and treatment of ventricular tachyarrhythmias was first suggested in 1970. The first implantation of the device in a human being was performed in February 1980. Further developments involved atrial and atrioventricular defibrillators, radiofrequency ablation, laser therapy, and advanced antiarrhythmic surgery. Since 1990, there has been a growing interest in using cardiac pacing as additional treatment in severe cardiac failure. Recent reports have suggested that intervention with left ventricular or biventricular pacing may be helpful for a subgroup of patients with congestive heart failure. Despite encouraging (preliminary) acute and short‐term results, pacing strategies for heart failure still are limited and currently regarded as investigational. Advances in the field of therapeutic application of pharmacologic and electrical tools as well as alternative methods will continue as rapidly as before and provide us further significant aid in taking care of patients.

Clinical and Economic Impact of Remote Monitoring on the Follow-Up of Patients with Implantable Electronic Cardiovascular Devices: An Observational Study

“…2 IECDs include pacemakers, ICDs, and CRT devices as well as implantable loop recorders and hemodynamic monitors. 7,8 ICDs are devices designed to deliver high-energy shocks after detecting a potentially malignant ventricular arrhythmia.…”

“…These devices have the ability of restoring the normal ventricular activation sequence and/or detect and treat malignant tachyarrhythmias using electric therapy. 2 In the last few years the development of the technology used in these devices along with emergence of new techniques and technologies has drastically increased the density of analysis and interpretation algorithms and therefore the complexity and duration of routine follow-up. Additionally, the development of the technology used in the batteries allowed an extension in the life of generators, thus increasing the mean number of follow-up years.…”

Zásady pro implantace kardiostimulátorů, implantabilních kardioverterů-defibrilátorů a systémů pro srdeční resynchronizační léčbu 2009

“…V průběhu tohoto období byla její účinnost ve smyslu ovlivnění kvality života, morbidity a mortality potvrzena objektivně, a to jak na základě klinické praxe, tak i na základě řady randomizovaných studií. (4)(5)(6)(7)(8) Během poslední dekády se stala TKS v podobě SRL uznávanou léčebnou metodou pro pacienty s pokročilým srdečním selháním refrakterním na optimalizovanou medikamentózní léčbu a s poruchou nitrokomorového vedení vzruchu.…”

Relationship between temperature change and the requirement for a permanent pacemaker implantation in bradyarrhythmias

“…They not only reduce morbidity and mortality but also improve quality of life for many patients (Lamas et al 1998;Luderitz 2002;Newman et al 2003;Skagen and Fischer 1976;Trohman et al 2004). Symptomatic bradyarrhythmias caused by advanced sinus node dysfunction (SND) or atrioventricular block (AVB) are classified as class I or IIa indications for a PPM implantation according to the current consensus guidelines (Carlson et al 2006).…”