Sudden cardiac death can be considered as a major health problem that is being faced by most of the heart patients across the world. It is also being regarded as one of the major cause of death in the western world (Lezcano and et al., 2009). In most of the cases, the process of onset is found to be ventricular tachycardia. It is regarded as a fast heart rhythm that basically originates from one of the ventricles that is present in the heart. Ventricles are of the major pumping chambers that are present in the heart of human body (Koul, 2004).
This is a life threatening arrhythmia as it may further lead to development of ventricular fibrillation and sudden death. In this respect, ventricular fibrillation is a heart rhythm problem that is found to occur when the heart start beating by rapid and erratic electrical pulses. This causes the pumping chambers of heart namely ventricles to tremble uselessly instead of performing their sole activity of pumping. It is also a known fact that ventricular fibrillation may trigger a heart attack (Silver, and et.al., 2009).
In order to stop the development of ventricular fibrillation as well as ventricular tachycardia, there should be a timely employment of a defibrillator. In this respect, an Implantable Cardioverter Defibrillator (ICD) can be defined as a small device that is placed in the chest or abdomen region. Doctors are found to use this device so as to help in the treatment of irregular heartbeats (Otmani, 2004). The device basically makes use of electrical pulses or shocks so as to help in controlling of life threatening arrhythmias especially the ones that are found to cause a sudden cardiac arrest. The above mentioned devices also play a key role towards the analysis of the Electro Cardio Gram (ECG) in patients so as to recognize whether shocks must be should be delivered to the patient or not (Srivathsan and et al., 2008). It is essentially important that the prevailing Electro Cardio Gram analysis system is able to differentiate between VF as well as presence of a stable but fast sinus rhythm (SR). In this regard, the basis of such an ECG analysis systems happens to be the usage of one or more kinds of mathematical electrocardiogram analysis algorithms (Morris and et.al., 2002).
The given research proposal is based on the idea of developing a new algorithm so as to prevent development of Ventricular Fibrillation Tachycardia in-patient which have an implantation of ICD (Implantable Cardioverter Defibrillator). It is a well known fact that the algorithm provides for general management principles thereby emphasizing in the clinical situations which happens to be unique (Jekova, 2000). They also aid in the direction of creating a diagnostic and therapeutic plan that must be customized according to the needs and requirement of patients. It is further assists in the process of carrying out an outline care to combat certain emergency situations.
The development of these algorithms is essential on account of inappropriate therapy and poor discrimination of supra ventricular tachycardia (SVT) from ventricular tachycardia (VT). This issue remains a major problem in the patients that have got the presence of an implantable Cardioverter defibrillator (ICD). Hence the research basically deals with development of an algorithm as well as further testing of its efficiency in all accords (Steinberg and et al., 2005).
The report has also been based on understanding of T over sensing algorithm that utilizes the amplitude of T wave to avoid inappropriate shocks from an Implantable Cardioverter Defibrillator to the patient. This T wave over sesnsing produced by an Implantable Cardioverter Defibrillator is a very serious problem that is suffered by some of the patients. It is basically found to cause an overestimation of the heart rate, causes an inappropriate detection of tachyarrhythmia thereby affecting the proper delivery of therapy (Dennis and et.al., 2004).
Hence, the fundamental idea of this investigation is usually in conjugation with development of an algorithm so as to use the present amplitude T wave from Medtronic, setting up a prescribed limit after which the device may start responding to high T wave amplitude as well as pacing in short cycle length. All this is basically being done so as to avoid any Ventricular Fibrillation/ Ventricular Tachycardia events that are found to preceded the high T wave amplitudes (Gunderson and et.al., 2007). Hence the first step of this report would be an investigation towards development /alternation of the algorithm followed by testing the efficacy of the procedure.
The major aim of this research study happens to be development of a new algorithm so as to prevent the Ventricular Fibrillation Tachycardia in patients where ICD has been implemented. In this regard, the objectives of this study happens to be Investigating the development/ alternation of the new algorithm.
Testing the efficacy of the proposed algorithm
It is a well known fact that Cardiac arrhythmias are one of the most common precursors that lead to setting up of an acute myocardial infarction. This may further be followed by development of ventricular fibrillation consequently leading to deaths. In this regard, there is a requirement to develop a new algorithm for carrying out the emergent resuscitation of ventricular arrhythmias (Lauer, 2013). Till now there have been many developments as well as introduction of varied kinds of advanced as well as sophisticated detection and discrimination algorithms on Implantable Cardioverter Defibrillator. But still a significant number of patients have been found to receive inappropriate therapy which is not found to be safe for their health (Klein and et al., 2006). This is on account of the possible under detection of the ventricular arrhythmias that are in itself life threatening in nature.
Hence, there is an urgent need to develop, investigate as well as test the efficacy of the algorithm. These algorithms are basically designed to enable the doctors as well as heath care professionals to treat the patient in one of the most efficient as well as safe manner. Hence, the need is to keep them as simple as possible (Friedman and et. al., 2006). The complications pf previous algorithms that have been set in this direction have basically been found to be under detected. They are also distinct from under sensing. These have also been found to delay or events prevent the recognition of ventricular tachycardia even though electro grams have been found to sense accurately (Bansch and et.al., 2004). Hence, the new algorithms are required to be developed as well as investigated for their efficacy so as to enhance specificity cause under detection of ventricular tachycardia. Optimal programming is also required to be undertaken so as to reduce the under detections.
Hence, the present research study is significant as will aid in the process of managing the health of patients and also assist the health care professionals towards undertaking of decisions in terms of restoring as well as maintaining the sinus rhythm, controlling of the ventricular rate as well the anticoagulation processes (Hayes, Asirvatham and Friedman, 2012). Along with this the detailed knowledge about algorithm will act as a necessary basis for any health care professional like a cardiologist to program the devices that have been individualized for each patient. The careful evaluation of episodes in terms of efficiency will further aid in the direction of bringing improvements towards discrimination carried out between SVTs and VTs (Wang and et.al., 2009).
Introduction to methodological approach
The research methodology basically concentrates on supplying theoretical figures and facts, which have laid strong bedrock for the overall research procedure. All through this process of research, several tools and techniques will be used. Various techniques and strategies for conducting this research will be discussed in the section of research methodology. The research methodology develops on the main aim to analyze the potential as well as limitations of the research (Weiss and Daoud, 2011). The key objective of this particular chapter of thesis is to collect germane and genuine information, which can be used for achieving the aims and objectives of research. These collected data then can be deployed for both practical and theoretical intentions. Further, this section of the dissertation writing will comprise explanation and justification of research methods that will be used in the entire process of study.
The phase of research design is most important in study and most critical decision is in relation to selection of an appropriate research design. The particular section holds essential worth, as the method with which pertinent data will be obtained. The adequate means of analyzing information are determined by the obtainable information nature in addition to interest variables and their allocation (Bansch and et.al., 2004). There are mainly three types of research design, such as exploratory, descriptive and casual. Casual research is conduct to indentify variables, which result in definite behavior type and then define the cause and effect connection among the related elements.
Descriptive research is basically an analytical and statistical research design as it explains the phenomenon being studies and features of population. It simply gives factual description of information but does not account for the main reason of the issue. Thus, it cannot be deployed for developing casual relationships. On the contrary, exploratory research is generally undertaken when the topic is not exactly defined or when the actual potential in unknown. This design of research is most appropriate tool for collecting and analyzing data. It is also informative in nature as well as based on qualitative approaches, such as discussions, focus group and interview with professionals, experts or secondary data gathering like reviewing available literature, etc (Antman, 2007). This research design is specifically used for attaining in depth about particular event for creating a more exact problem statement.
Data collection method
In the present research report methods so as to undertake a brief analysis about the development of a new algorithm for the prevention of Ventricular Fibrillation Tachycardia in-patients who have been provided with implantable Cardioverter defibrillator (ICD). In this regard, there has been a usage of both primary as well as secondary methods of research study (Lauer, 2013).
It is that kind of data which has been collected by researcher by referring to the works carried out by different authors. In this regard, there has been an assessment of various research papers that have been published by scholars in diverse literature sources specifically being journals. They will aid in getting a key understanding about the given research topic by assessing of the previous work accomplished by scholars in the same field. Other than this various books, online articles etc. has also been referred so as to gain an understanding about the heart diseases, Ventricular Fibrillation Tachycardia, Implantable Cardioverter Defibrillator implantation, T wave over sensing etc. These research articles also gave a complete insight towards various algorithms that have previously been developed in this field. The selected method of data collection can be justified on basis of the fact that it is a key requirement
This method usually involve for the collection of first hand information by the researcher. The data is compiled by the research so as to meet a specific aim an objective that pertains to a particular research study. These are the most original form of data. In present scenario, the data has been collected form the patients who are suffering from heart disorders in terms of Ventricular Fibrillation Tachycardia and have got an implantation of Implantable Cardioverter Defibrillator formerly known as ICD (Primary and Secondary Sources for Science, 2012).
All the documented episodes of spontaneous arrhythmia were analyzed in the patients. The method has thus been selected so as to be in tune with the research aim that happens to be development of a new algorithm in order to prevent the Ventricular Fibrillation Tachycardia in patients that have received a with an Implantable Cardioverter Defibrillator. In this regard, the primary data will aid towards prompt collection followed by quick assessment of patients. The primary study will further assist towards the development of new algorithm methods.
The proposed research study undertaken by me definitely complement towards my previous experiences related to the research study. My present doctoral program deals with the development of a new algorithm so as to prevent Ventricular Fibrillation Tachycardia in-patient in whom an Implantable Cardioverter Defibrillator has been implanted (Grubb and Olshansky, 2008). With the help of this program I wish to contribute myself towards the advancement in technologies in the area of therapy planning, interventional guidance and advanced screening of neuro and cardiovascular diseases. I have also laid an immense focus towards electrical activities that take place in the heart (Weiss and Daoud, 2011).
I have undertaken many kinds of specialized training in the field of advanced level medical technologies. These have been related to Cardiac Physiologist, Stress Test, Electrocardiography and electrophysiology, Echocardiography, Cardiac Radiology and Cardio-Respiratory Physiology among others. I have also undertaken intense training in the area of electrophysiology (Iaizzio, 2009). I underwent a lot many practical training sessions related to professional medical practices. I also have specializations in device therapy as well as Implantable Cardioverter Defibrillators and pacemaker implantation.
Hence, through my previous practical experiences gained via the procedural administration of implanted pacemakers and other Implantable Cardioverter Defibrillator devices as well as the related technologies, I am well aware about the issues associated with the same. My previous experiences in the area of implantations and cardiac related problems have been immense. These will aid in the direction of developing a deep understanding as well as focusing on the flaws associated with the current set of algorithms being used for heart patients. They will thus allow me to develop a keen focus so as to develop a new algorithm as well as investigate towards the procedural intricacies in a complete manner (Kramme and et.al., 2011). The experiences gained during my own study as well practical training sessions will help me in testing the efficiency of the algorithm that can play an essential role towards the overall effectiveness of patient’s life. They will also aid in the direction of undertaking a quality doctorate program (Raviele, 2003).
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The above research proposal was prepared with an idea in mind towards the development of a new algorithm so as to prevent the Ventricular Fibrillation Tachycardia in-patient with a ICD implanted. The first step happens to be carrying out of a thorough investigation towards the development or alternation of the algorithm. This will further be followed by testing of the efficacy associated with the proposed algorithm (Beyerbach, 2012).