Improved electrical diagnosis, monitoring, and therapy for congestive heart failure.

摘要

Congestive heart failure (CHF) is a progressive disorder in which damage to the heart causes weakening of the cardiovascular system. It manifests by fluid congestion or inadequate blood flow to tissues. CHF is increasing as a global health problem. Approximately 23 million people worldwide are afflicted with CHF, and 2 million new cases of CHF are diagnosed each year. In contrast to other cardiovascular disorders that have actually declined during the past few decades, the incidence of heart failure is on the rise. As part of an ongoing effort to improve health care for heart failure patients, this thesis explores techniques from the viewpoint of electrophysiology to improve the prevention, diagnosis, and treatment of CHF.;The core issue of this thesis is pulmonary edema monitoring since severe CHF necessitates meticulous identification and control of fluid retention. First, the feasibility of monitoring pulmonary edema using noninvasive or minimally invasive mid-thoracic impedance measurements was evaluated. In view of the fact that defibrillation is a commonly used electrical therapy for CHF and pulmonary edema is the most severe manifestation of CHF, the effect of pulmonary edema on active-can single-coil defibrillation efficacy was explored. Finally, the electrode arrangement in active-can single-coil implantable cardioverter defibrillator (ICD) was optimized in term of defibrillation efficacy.