In the following blog we will talk about the design and development of a pacemaker and a defibrillator, systems included within a DEA equipment.
They are devices capable of maintaining the heartbeat when the mechanisms that mark the rhythm of the heart fail. Their safety and efficacy in treating the symptoms and risks of slow cardiac rhythms make them an essential therapeutic resource today that saves thousands of lives a year.
The heart constantly and regularly produces electrical impulses that travel through the electrical pathways of the heart. These impulses cause the contraction of the cardiac muscle that pumps the blood through the body. The contractions are perceived as beats and the passage of the blood through the arteries like ' pulse ' in the superficial places where one can palpate.
The electrical system or ' natural pacemaker ' of the heart can be damaged and cause the impulses not to be generated quickly enough or to cause delays or blockages in the conduction system. This type of disease is manifested by fewer normal heartbeats and slow pulses, which is called bradycardia, or even total absence of heartbeats for a generally short time.
These alterations may be permanent or appear occasionally and cause symptoms such as fatigue, dizziness, loss of consciousness, shortness of breath, chest pains, palpitations, numbness and headaches. The treatment of these processes with slow pulse is the implantation of a pacemaker.
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1) GLOSSARY
HEARTBEAT DETECTORS
pacemakers are electrical appliances, such as a mini, that are able to detect their own heartbeats and emit small electric shocks that make the heart beat when their own impulses are missing or too Slow.
A pacemaker consists of a small device called a generator, about four centimeters in diameter and a few millimeters thick, which contains a small electrical circuit and a battery that supplies the energy. One, two or sometimes three very fine cables, called electrodes, are connected to the generator, which are carried to the heart cavities.
The electrodes can ' feel ' or detect the heartbeats and transmit the generator's discharges that stimulate the heart when necessary. To put a pacemaker is necessary a surgical intervention that is usually done with local anesthesia, with the patient awake. The operation lasts one or two hours, but the time is variable in each patient.
There are two types of definitive pacemaker: unicameral and bicameral. 3 depending on the basic pathology, age and characteristics of the person, the implantation of one or the other is chosen. The type of stimulation is also valued, so that they can carry or not a mechanism of adaptation of the heart rate according to the metabolic needs, to stimulate or to detect in the atrium, ventricle or both chambers and can respond to that detection of several Ways.
These pacemakers capture the heart's frequency and only stimulate it when the cardiac frequency drops below that to which the device is adjusted. There are very different types of pacemakers on demand, even programmable, in which the heart rate, intensity and duration of impulse and refractory period can be adjusted
The cardiac resynchronization pacemaker is used to stimulate the two ventricles synchronously in people with heart failure refractory to pharmacological treatment with depressed ventricular function, wide QRS and intra-asynchrony Interventricular. The electrodes are placed in the apex of the right ventricle and in the epicardial vein of the left ventricle through the coronary sinus.
ARRHYTHMIA
Arrhythmia is the loss of the rhythmic sequence of the heart by an alteration of the electrical impulses that determine the heartbeat. When a person is at rest or performing some normal physical activity (such as walking, driving or showering), the heart beats within a range of normality ranging from 60 to 100 beats per minute. If the heartbeat is faster than expected, very slow or irregular, we can say that there is arrhythmic.
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CARDIAC WAVE FORM
The Waves are the different curvatures that the EKG tracing takes upwards or downwards. They are a product of the action potentials that occur during cardiac stimulation and are repeated from one heartbeat to another, except for alterations. The electrocardiographic waves have been called P, Q, R, S, T, U in that order and are linked together by an isoelectric line.
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ALARMS
Alarm one:
The alarm is activated once the defibrillator is unloaded
Alarm two:
The alarm is activated when it detects bradycardia or tachycardia
3) RESULTS
A DEA team was obtained which combines the functions of a pacemaker and a defibrillator. In the case of the defibrillator, the equipment generates a train of pulses with a frequency of 1Hz and a useful cycle suitable for the human heart. While in the case of the defibrillator the equipment generates 3 discharges where the energy of the previous one always increases, when it reaches the limit the equipment stops its operation and declares the patient dead. The equipment responds to any activity of the heart, therefore, if a change in the pathology occurs and the patient returns to his normal state or needs treatment such as for example the pacemaker the equipment is in the capacity to detect it and produce the change. The equipment is designed to respond to pathologies such as bradycardia and tachycardia with pacemakers and fibrillations or stops with the defibrillator.
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4) CONCLUSIONS
1) The design of a pacemaker was carried out as an optimal response system for pathologies that cause changes in the normal rhythm of heart function. 2) The corrector functioning of a defibrillator was determined taking into account the system of 3 discharges and the variations of energy between each of them 3) Through the use of a patient simulator, a DEA equation was developed that responds adequately to each of the two pathologies.
5) REFERENCES
1) Rodríguez, R. O., de Juan Montiel, J., Pascual, T. R., Ruiz, A. B., & de Miguel, E. M. (2000). Guías de práctica clínica de la Sociedad Española de Cardiología en marcapasos. Revista Española de Cardiología, 53(7), 947-966.
2) Grupo de Trabajo de la Sociedad Europea de Cardiología. (2007). Guía de práctica clínica sobre marcapasos y terapia de resincronización cardiaca. Revista Española de Cardiología, 60(12), 1272-e1.
3) Martín, J. L. M., Sánchez, O. E., Torres, E. C., BUSTAMANTE, R. M. S., & Román, M. I. V. (2009). Efectividad de la implementación de la desfibrilación semiautomática en las Unidades de Soporte Vital Básico. Emergencias, 21, 12-16.
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