Catálogo de publicaciones - libros

A reliable ICD needs both sensing of the endocardial signal and detection algorithms for arrhythmia diagnosis. Initially, the only target was ventricular fibrillation, but with the possibility of rate detection ventricular tachycardia could be detected as well. This led to the development of tiered-therapy devices with arrhythmia zones. Simple arrhythmia discriminators as stability and sudden onset became available, and proved to be very useful. The place of more complex algorithms is still unclear.

A reliable ICD needs both sensing of the endocardial signal and detection algorithms for arrhythmia diagnosis. Initially, the only target was ventricular fibrillation, but with the possibility of rate detection ventricular tachycardia could be detected as well. This led to the development of tiered-therapy devices with arrhythmia zones. Simple arrhythmia discriminators as stability and sudden onset became available, and proved to be very useful. The place of more complex algorithms is still unclear.

Diagnostic data of a pulse generator and the patient are now available, offering an array of alphanumerical data. When considering an arrhythmia, data can be clarified with numerical information (intervals), displayed in lists or tables. Event counters can provide information on all kind of events or interventions. Tachograms (or interval plots) display intervals versus time. Electrograms can be taken with different techniques from different channels. Physiological data can be obtained using sensors. All this information can be sent to the patient file, and even become available on the Web for the treating physician.

Stored electrograms in ICDs have not only improved patient management, but also increased our understanding of tachyarrhythmias. Stored electrograms are usually analyzed visually by physicians. This analysis can also be performed in a methodological way by using building blocks with physiologic information. Each block contains specific timing- or morphology-based characteristics of arrhythmias. A systematic approach is proposed, which can help physicians and technicians to avoid a biased analysis.

A step-wise logical approach is presented both for devices with and without atrial information. The presented flow charts can help to interpret rhythm strips, but keep their limitations, certainly for single chamber devices.

The line assignment and the component allocation problems are tackled in this chapter. To optimize each of the PCB assembly problems, both mathematical modeling and heuristic methods have been applied. Some observations concerning these problems are made:

The next chapter will develop a prototype of the “Printed Circuit Board Assembly Planning System” (PCBAPS).