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A hemodynamic model for the predicti...

Jones, Bruce Roy.

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A hemodynamic model for the prediction of a maximum pacing rate.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	A hemodynamic model for the prediction of a maximum pacing rate./
作者:	Jones, Bruce Roy.
面頁冊數:	87 p.
附註:	Source: Dissertation Abstracts International, Volume: 58-07, Section: B, page: 3769.
Contained By:	Dissertation Abstracts International58-07B.
標題:	Engineering, Biomedical. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=9738444
ISBN:	0591487101

A hemodynamic model for the prediction of a maximum pacing rate.
Jones, Bruce Roy.

A hemodynamic model for the prediction of a maximum pacing rate. - 87 p.

Source: Dissertation Abstracts International, Volume: 58-07, Section: B, page: 3769.

Thesis (Ph.D.)--University of Minnesota, 1997.

Introduction: During exercise, the clinical benefit of adaptive-rate over fixed-rate ventricular pacing has been well documented. However, no clear evidence exists on how to determine the optimal heart rate, above which, no further increase in clinical benefit occurs. This work investigates the clinical efficacy of a hemodynamic model which calculates an upper rate limit from the heart's filling time.

ISBN: 0591487101Subjects--Topical Terms:

1017684
Engineering, Biomedical.

A hemodynamic model for the prediction of a maximum pacing rate.
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245 1 2 $a A hemodynamic model for the prediction of a maximum pacing rate.
300 $a 87 p.
500 $a Source: Dissertation Abstracts International, Volume: 58-07, Section: B, page: 3769.
500 $a Adviser: James E. Holte.
502 $a Thesis (Ph.D.)--University of Minnesota, 1997.
520 $a Introduction: During exercise, the clinical benefit of adaptive-rate over fixed-rate ventricular pacing has been well documented. However, no clear evidence exists on how to determine the optimal heart rate, above which, no further increase in clinical benefit occurs. This work investigates the clinical efficacy of a hemodynamic model which calculates an upper rate limit from the heart's filling time.
520 $a Methods: Left ventricular volume was determined by echo using the Acoustic $\ rm Quantification\sp{TM} $ technology of Hewlett Packard. From the volume waveform, the shortest possible time for the ventricle to contract and refill to its previous end-diastolic volume was calculated. This interval includes: the electromechanical delay, the isovolumetric contraction and relaxation times, the ejection time, and the shortest possible filling time. To initiate a contraction before the completion of this interval is believed to limit stroke volume and decrease cardiac output. To test the appropriateness of this "optimum" rate, nine pacemaker patients with complete heart block repeated four maximal exercise protocols. Patients were paced at the calculated rate ("HURL" response), 25 or 30 bpm below this rate ("Hypo" response), 25 or 30 bpm above this rate ("Hyper" response), and at a constant 60 bpm ("60" response). Peak oxygen uptake $\ rm (VO\sb{2peak}), $ exercise time, time to anaerobic threshold (AT), and $\ rm VO\sb2 $ at AT were measured to determine the clinical utility of each rate.
520 $a Results: At maximal exercise, a significant difference was found for each rate-responsive mode versus the no rate-response mode for all of the functional parameters. No statistical difference between any of the rate-responsive modes was found, but the average value for each of the parameters was greatest for the hemodynamically optimum response. In addition, 3 patients complained of adverse effects with the "Hyper" response.
520 $a Conclusion: Patient complaints at the higher rate response profile in addition to the reduction of cardiac efficiency at high rates, with no associated increase in exercise performance, indicate the importance of proper rate limitation. Initiation of rate response to at least the "Hypo" level--and rate limitation--the maximum sensor rate set to the "HURL"-level--may be all that is required for adaptive-rate ventricular pacing.
590 $a School code: 0130.
650 4 $a Engineering, Biomedical. $3 1017684
650 4 $a Engineering, Electronics and Electrical. $3 626636
650 4 $a Biology, Animal Physiology. $3 1017835
650 4 $a Health Sciences, Recreation. $3 1018003
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710 2 0 $a University of Minnesota. $3 676231
773 0 $t Dissertation Abstracts International $g 58-07B.
790 1 0 $a Holte, James E., $e advisor
790 $a 0130
791 $a Ph.D.
792 $a 1997
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