This is actually interesting for multiple reasons. One is the technology. The other is the positive outcome rate for cardiac arrest after 30 days is so low.
The percentage of cardiac arrest survivors with positive outcomes 30 days after release depends on the type of cardiac arrest, and can range from 40% to 82%:
In-hospital cardiac arrest (IHCA)
The 30-day survival rate for IHCA is around 25% in the United States and up to 35% in European countries. *In one study, the 30-day survival rate was 40%, with 34% of survivors having good neurological outcomes*.
Out-of-hospital cardiac arrest (OHCA)
The probability of survival after OHCA can be increased by providing immediate cardiopulmonary resuscitation (CPR) and using an automated external defibrillator (AED). In one study, *10% of people who experienced OHCA survived with a favorable neurological outcome*.
My father survived this. No brain damage. Lived a few more years, until 74. The heart wasn't pumping at normal rates because of damage. Do to hip problems (arthritis) also had problems walking. Eventually Developed a blood clot in a leg. Initially survived the blood clot. But the medication given to thin out the blood clot caused bleeding on his liver. Somehow the Hospital missed the bleeding until it was too late. The operating room was also busy (Canada), so no intervention could be performed. Wasn't allowed to see him because of covid rules. Possibly been able to advocate for him if I was in his room, and saw his worsening condition.
They can save your life in a hospital, but just as easily kill you by mistake or side effect of whatever intervention they are doing. Also, walking (or being able to walk) is very important for longevity.
But the speed of the first response of the cardiac arrest is what matters. Since the brain is without oxygen.
Assuming the person makes it to a hospital alive, they'll cool off the body to prevent brain damage.
For every minute you survive, your odds get better.
>The 30-day survival rate for IHCA is around 25% in the United States and up to 35% in European countries.
If it wasn't for those meddling Europeans and their stupid taxes, we could get those down to 25, and, and, an errrr....very respectable 'Irish' 14% respectively.
Similar results have been observed in 2d simulations for more than 20 years, no one had managed to translate them to application.
One of the problems is, that 2 d and 3d reaction-diffusion systems are very different when it comes to so-called topological charge conservation. One can show that interactions of the applied electrical field can be described by its influence on the topological charges.
In 2d these topological charges are limited to points in 3d they form curves.
Points are limited to drifting and colliding, lines can twist, self collide, form rings and so on making translating 1d results to 3d quite difficult.
The article is about internal defibrillators. External ones are still the same as (good grief) 35 years ago (well maybe down from 300J to 200J). The only change I've noticed is moving from a gel for the pads to a gel pad (which feel like a frog, chuck one in your partners bed and let them find it!) which reduced the possibility of burning and odd smells in your ambulance. Fortunately my sense of smell wasn't great and often had a partner who smoked (and was allowed to in the olden days) in the ambulance to dull it. You kids don't know how it was having to actually manually read the trace instead of all this new-fangled automation that guides you through it.
I remember playing with spiral waves using the VIRUS element in Powder Game (2), and didn't know that heartbeat disturbances were caused by the same patterns on cardiac muscle.
> Energy reduction in defibrillation devices is an active area of research. While defibrillators are often successful at ending dangerous arrhythmias in patients, they are painful and cause damage to the cardiac tissue.
I thought this was about needing a smaller battery in defibrillators and was wondering if that is really a problem, but this makes more sense.
They’re already commercializing this. I’m due for a new implanted defibrillator because of a needed battery change. My current one is 5in x 4in. Depending on when I get it, my electrophysiologist says next one should be smaller due to a smaller required charge to jump start the heart.
Worth researching perhaps, lower power is much safer for a lot of other parts of the body, but is there reason to believe that this is correct? Are these models really that good?
Less than low energy antitachycardia pacing (LEAP), which is itself a lower-energy alternative to the typical 1-shock defibrillation. Their "1000 times less" means three orders of magnitude. From the abstract of the paper:
We find that, rather counter-intuitively, a single, properly timed, biphasic pulse can be more effective in defibrillating the tissue than low energy antitachycardia pacing (LEAP), which employs a sequence of such pulses, succeeding where the latter approach fails. Furthermore, we show that, with the help of adjoint optimization, it is possible to reduce the energy required for defibrillation even further, making it three orders of magnitude lower than that required by LEAP
Important to note that the study uses:
"an electrophysiological computer model of the heart's electrical circuits "
and
"a simple two-dimensional model of cardiac tissue"
This is actually interesting for multiple reasons. One is the technology. The other is the positive outcome rate for cardiac arrest after 30 days is so low.
The percentage of cardiac arrest survivors with positive outcomes 30 days after release depends on the type of cardiac arrest, and can range from 40% to 82%:
In-hospital cardiac arrest (IHCA) The 30-day survival rate for IHCA is around 25% in the United States and up to 35% in European countries. *In one study, the 30-day survival rate was 40%, with 34% of survivors having good neurological outcomes*.
Out-of-hospital cardiac arrest (OHCA) The probability of survival after OHCA can be increased by providing immediate cardiopulmonary resuscitation (CPR) and using an automated external defibrillator (AED). In one study, *10% of people who experienced OHCA survived with a favorable neurological outcome*.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8359113/
My father survived this. No brain damage. Lived a few more years, until 74. The heart wasn't pumping at normal rates because of damage. Do to hip problems (arthritis) also had problems walking. Eventually Developed a blood clot in a leg. Initially survived the blood clot. But the medication given to thin out the blood clot caused bleeding on his liver. Somehow the Hospital missed the bleeding until it was too late. The operating room was also busy (Canada), so no intervention could be performed. Wasn't allowed to see him because of covid rules. Possibly been able to advocate for him if I was in his room, and saw his worsening condition.
They can save your life in a hospital, but just as easily kill you by mistake or side effect of whatever intervention they are doing. Also, walking (or being able to walk) is very important for longevity.
But the speed of the first response of the cardiac arrest is what matters. Since the brain is without oxygen. Assuming the person makes it to a hospital alive, they'll cool off the body to prevent brain damage. For every minute you survive, your odds get better.
>The 30-day survival rate for IHCA is around 25% in the United States and up to 35% in European countries.
If it wasn't for those meddling Europeans and their stupid taxes, we could get those down to 25, and, and, an errrr....very respectable 'Irish' 14% respectively.
There are too many variables involved in these outcomes to make such a comment.
This appears to be a simulation study done in 2d.
Similar results have been observed in 2d simulations for more than 20 years, no one had managed to translate them to application.
One of the problems is, that 2 d and 3d reaction-diffusion systems are very different when it comes to so-called topological charge conservation. One can show that interactions of the applied electrical field can be described by its influence on the topological charges.
In 2d these topological charges are limited to points in 3d they form curves.
Points are limited to drifting and colliding, lines can twist, self collide, form rings and so on making translating 1d results to 3d quite difficult.
The article is about internal defibrillators. External ones are still the same as (good grief) 35 years ago (well maybe down from 300J to 200J). The only change I've noticed is moving from a gel for the pads to a gel pad (which feel like a frog, chuck one in your partners bed and let them find it!) which reduced the possibility of burning and odd smells in your ambulance. Fortunately my sense of smell wasn't great and often had a partner who smoked (and was allowed to in the olden days) in the ambulance to dull it. You kids don't know how it was having to actually manually read the trace instead of all this new-fangled automation that guides you through it.
I think the biggest change with external defibrillators has been placement. It's now front and back instead of two on the front.
I remember playing with spiral waves using the VIRUS element in Powder Game (2), and didn't know that heartbeat disturbances were caused by the same patterns on cardiac muscle.
> Energy reduction in defibrillation devices is an active area of research. While defibrillators are often successful at ending dangerous arrhythmias in patients, they are painful and cause damage to the cardiac tissue.
I thought this was about needing a smaller battery in defibrillators and was wondering if that is really a problem, but this makes more sense.
This is more about implanted defibrillators than AEDs. In implanted devices, the size of the battery absolutely does matter.
They’re already commercializing this. I’m due for a new implanted defibrillator because of a needed battery change. My current one is 5in x 4in. Depending on when I get it, my electrophysiologist says next one should be smaller due to a smaller required charge to jump start the heart.
>[in an] electrophysiological computer model
Worth researching perhaps, lower power is much safer for a lot of other parts of the body, but is there reason to believe that this is correct? Are these models really that good?
1k less than what?
Whoever wrote this headline is illiterate.
Less than low energy antitachycardia pacing (LEAP), which is itself a lower-energy alternative to the typical 1-shock defibrillation. Their "1000 times less" means three orders of magnitude. From the abstract of the paper:
We find that, rather counter-intuitively, a single, properly timed, biphasic pulse can be more effective in defibrillating the tissue than low energy antitachycardia pacing (LEAP), which employs a sequence of such pulses, succeeding where the latter approach fails. Furthermore, we show that, with the help of adjoint optimization, it is possible to reduce the energy required for defibrillation even further, making it three orders of magnitude lower than that required by LEAP
Important to note that the study uses:
"an electrophysiological computer model of the heart's electrical circuits "
and
"a simple two-dimensional model of cardiac tissue"
I assume it means 1/1000th because the phrase makes zero sense.
Than other defibrillation devices, is my default interpretation, because I know they use electricity and there are no other subjects in the sentence.
So: reading comprehension and common knowledge.
Well you got it wrong since there are no "other defibrillation devices" since these are computer models.