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High-Voltage Sources for AC Cell Electroporation
Folprecht, Martin ; Drábek,, Pavel (referee) ; Damec,, Vladislav (referee) ; Červinka, Dalibor (advisor)
This doctoral thesis deals with an application of power converters in experimental medicine. Contemporary knowledge about a relatively new electroporation method and present solutions of power converters used for this method are analyzed at this work. The main part of the thesis is focused on a design and development of a new high-voltage generator proposed to AC electroporation. The last part documents an experimental verification of its function.
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High-Voltage Sources for AC Cell Electroporation
Folprecht, Martin ; Drábek,, Pavel (referee) ; Damec,, Vladislav (referee) ; Červinka, Dalibor (advisor)
This doctoral thesis deals with an application of power converters in experimental medicine. Contemporary knowledge about a relatively new electroporation method and present solutions of power converters used for this method are analyzed at this work. The main part of the thesis is focused on a design and development of a new high-voltage generator proposed to AC electroporation. The last part documents an experimental verification of its function.
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Using of non-invasive cardiac imaging for precise evaluation of atrium size and prediction of atrial wall fibrosis in patients with atrial fibrillation
Fingrová, Zdeňka ; Havránek, Štěpán (advisor) ; Kittnar, Otomar (referee) ; Skála, Tomáš (referee)
Atrial fibrillation is the most prevalent arrhythmia worldwide and remains one of the major causes of morbidity and mortality. Atrial fibrillation is an arrhythmia that has a various etiology and takes number of clinical forms. Due to the heterogenity of atrial fibrillation, it is necessary to individualize the optimal treatment strategy, ie conservative pharmacological therapy or interventional therapy as catheter ablation. Inncorrect indication of catheter ablation of atrial fibrillation leads to low success rate of the procedure and increases the risk of the procedure. The success rate of catheter ablation of atrial fibrillation depends on many clinical parameters, including the size and volume of the left atrium and the presence of pathological tissue in the atrial myocardium. In everyday practice, echocardiography (2D-echocardiography) is the most dominant method in estimation of the left atrial parameters, for it's simplicity, non- invasiveness, financial costs and the absence of ionizing radiation. Different methods for assesment of left atrial parameters are cardiac CT, cardiac magnetic resonance imaging and methods of 3-D echocardiography or 3-D angiography. The results of the present studies show that in patients with non-valvular atrial fibrillation who are indicated for catheter...
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Quality of life in patiens after catheter ablation
KOCMICHOVÁ, Jana
Theoretical Foundations Catheter ablation is an intervention focused on targeted removal of or damage to an area that causes arrhythmias. This intervention began to be performed at the turn of the 1980s and 1990s because it had been found that treatment with antiarrhythmic drugs was expensive and the drugs had to be taken throughout patients' lives. Thanks to its high success rate and low risk of complications, it has been used in the treatment of supraventricular tachyarrhythmias. At present, the success rate is around 75 %, and the intervention sometimes needs to be repeated to achieve its desired effect. Objectives of the thesis The first objective was to find out whether patients with a history of catheter ablation changed their personal and professional lives. The second objective was to map out which areas of the patients' live were affected most by the catheter ablation treatment. The third objective was to find out about differences in the patients' lives before and after catheter ablation. Research questions V1: In what areas are the patients' lives limited most? V2: What changes have occurred in their lives after catheter ablation? Methodology The research part of the thesis was carried out using a qualitative survey conducted by means of semi-structured interviews with patients suffering from arrhythmias. The total of 9 respondents, 5 males and 4 females, were interviewed. The information obtained was processed using programme Atlas.ti. The results are presented as networks created in this programme. Results The research questions can be answered using the data obtained from the respondents suffering from arrhythmias. The first research question was aimed at finding out in what areas the patients' lives were limited most. It was found out, through the semi-structured interviews, that the most limited area was personal life, in which arrhythmia caused most difficulties to the respondents during sports activities. Because of their health problems, most of the respondents limited their sports activities or abandoned them altogether in favour of their health. Other problems are caused during physical strain and under physical load. That was also the thing that the addressed respondents preferred to avoid. The respondents are also limited in the performance of their work, when the main cause of their problems is psychological stress, mental stress resulting in arrhythmia symptoms in the respective respondents. The second research question examined what changes occurred in their lives after catheter ablation. The changes that occurred related to the care of the family and the household in which they are able to engage in multiple activities. The respondents were able to pay more attention to their families by whom they are encouraged in the treatment. There was an overall improvement in their health, enabling better integration into everyday life. The most frequently mentioned area of changes was sport. During the period after catheter ablation, the respondents began to return gradually to their hobbies. Conclusion The thesis describes the restrictions that arrhythmia caused to the respondents and also the changes that have occurred in the individual respondents after catheter ablation treatment. The results can be used in practice in the education of patients who wait for the catheter ablation treatment and in subsequent measures using the prepared mind maps.
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Nursing care of patients before and after catheter ablation
KMETKOVÁ, Monika
Catheter ablation is the ultimate non-pharmacological treatment of heart rhythm disorders, allowing the destruction i.e. ablation of abnormal tissue in the heart, which has resulted in the emergence of this disorder. This is a procedure which can be targeted pathologic affect the electrical activity of a precinct of cardiac infarction. This work is dedicated to the nursing care of patients before and after catheter ablation, the level of patient awareness, the level of communication between the nurse and patient and monitors the needs of the respondents after myocardial performance. Up to date of this issue we see even that several prospective randomized trials have shown significantly higher ablation efficiency in long-term maintenance of sinus rhythm than during treatment with ant arrhythmic drugs. Furthermore, the quality of life after catheter ablation increases and its improvement is significantly higher than with ant arrhythmic drugs. The theoretical part deals in the introduction with the history of discoveries in other chapters include anatomy and function of the heart. It also provides information about heart rhythm problems, describes the clinical picture of the disease and treatment options. At the end of the theoretical part is to work preparing a patient for power, the act itself, potential complications, nursing care after surgery and the role of the nurse in her. The aim of this passage is a summary of existing knowledge about resolved issue. This section has been prepared on the basis of relevant literature sources. The aim of this work is to determine the specifics of nursing care before and after the performance of catheter ablation. To achieve this objective were in the empirical part used the qualitative research methods. In this section were collected answers to three research questions. What is the awareness of patients undergoing catheter ablation performance? What is nurse communication with the patient? What are the needs of the patient after surgery catheter ablation? The survey was conducted in patients undergoing catheter ablation performance. Interviews took place in the hospital České Budějovice and in the Institute for Clinical and Experimental Medicine (IKEM) in Prague cardiology department. The survey was included in a group of ten respondents. Their choice was determined by the willingness of respondents to participate in the research and work on it. For each of the participants used non - standardized form of interview. The results of the survey were analyzed and entered into categories. In view of the results of our work we want the work and its results as much as possible open up to the public of professional nursing. We hope that results of the work will increase the interest of the professional public about this issue and ask other workers willing to contribute to their solution.
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Treatment of cardiac arrhythmias related to nursing care
NOVÁKOVÁ, Jaroslava
Nursing care continuing the treatment of cardiac arrhythmias is an inseparable part of the patient?s care. As there are various types of arrhythmias and different types of treatment, similarly, the subsequent nursing care has its specifics as well. It relates not only to the post-treatment care but also to pre-surgery preparation and subsequent education. The theoretical part of the thesis contains the information on arrhythmias, their development and treatment. Organizations associating nurses working in arrhythmologic centres are mentioned as well. The practical part consists of the survey research. The quantitative enquiry is conducted in arrhythmologic centres by means of questionnaires addressing the nurses. The qualitative part contains interviews with patients who underwent some of the types of cardiac arrhythmia treatment. The objective of the thesis was to find out whether the nurses are aware of the specifics of the nursing care that follows the treatment of cardiac arrhythmia, in which stage the treatment is the most demanding for nurses and whether they can apply standardized nursing procedures in their work. Another objective is focused on mapping of the educative activity within the nursing care. Interviews with the patients are aimed at the areas of admission, prior to surgery, after surgery and during education. They should outline the view from ?the other side?. All the defined hypotheses were confirmed. The cardinal hypothesis of the thesis was the assumption that nurses, when providing nursing care to patients undergoing treatment of cardiac arrhythmias, do not work according to standardized nursing procedures. Subsequently, a draft of standardized nursing procedure focused on nursing care of patients undergoing implantation of a permanent cardiostimulator was prepared ? it could be applied in the University Hospital in Plzeň where most of the enquiry was conducted.
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