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A study to determine chest wall vibratory attachment interface locations for a low frequency sonic vibrator in treatment of acute coronary thrombosis

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Abstract

Our institution is developing a non-invasive Diastolic Timed Vibrator (DTV) to enhance emergency clearance of acute coronary thrombosis. Sonic frequency diastolic vibro-percussion (i.e. 50 Hz, 2 mm amplitude) applied upon the rib-spaces of the left sternal border has shown to improve left ventricular performance and coronary flow in human volunteers. However, therapeutic acoustic penetrability cannot be assumed depending on varying chest size and lung position which attenuates acoustic transmissions. Furthermore, chest locations enabling a direct lung free pathway overlying the base of the heart (wherein the coronaries arise) should be promoted, while locations overlying the left ventricular apex (site of potential thrombus formation) should be avoided. We therefore set out to determine preferred chest wall placement positions for a vibratory interface suitable for treatment of ST Elevation Myocardial Infarction (STEMI). Inter-Costal Space (ICS) positions to the left or right of the sternum were interrogated in 90 adults following routine Echocardiography to ascertain whether the base of the heart could be imaged (hence inferring acoustic transmissibility), and to determine over what part of the heart each transducer position was overlying. The third and fourth ICS proximate the left sternal border provided acoustic transmissibility in 96 and 100% of cases respectively, with only one unwanted occurrence from the fourth ICS where the transducer overlaid the apical third of the left ventricle. Acoustic transmissibility from third and fourth ICS right sternal border was documented in 53 and 85% of cases respectively. A vibration interface in STEMI treatment should allow for contact overlying the left and right third and fourth ICS generally proximate the sternal borders. As vibration transmission to the cardiac apex and/or left atrium cannot be completely avoided, vibration therapy should be contra-indicated in late presenters for antero-septal apical STEMI, and in cases of new onset atrial fibrillation persisting greater than 48 h which have not been adequately anti-coagulated.

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Notes

  1. More information on how diastolic timed vibration can be achieved including for irregular heart rhythms can be found in Journal of Cardiovascular Engineering [19], and through a report issued from the department of Engineering Science, Simon Fraser University [20].

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Disclaimer

The Author’s caution the public that the technique of using a low frequency vibrator applied to the upper torso in treatment of heart attack is purely experimental and still requiring clinical trials, and hence cannot be warranted at this time for safe clinical use.

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Authors and Affiliations

  1. Division of Research and Development, Ahof Biophysical Systems Inc. (ABS Inc), 3858 Regent St, Burnaby, BC, V5C4G8, Canada

    Andrew Kenneth Hoffmann & Harjit Gill

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  1. Andrew Kenneth Hoffmann
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  2. Harjit Gill
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Correspondence to Andrew Kenneth Hoffmann.

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Disclosure: Various patents and patents pending relating to use of low frequency vibration to assist thrombolysis in the setting of acute arterial thrombosis, including preferred vibration chest wall vibratory interfaces, are owned and controlled by Simon Fraser University in a revenue sharing partnership with Ahof Biophysical Systems Inc. The novel engineering concepts disclosed in this article have been published in patent application(s) prior to the submission and publication date of this article.

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Hoffmann, A.K., Gill, H. A study to determine chest wall vibratory attachment interface locations for a low frequency sonic vibrator in treatment of acute coronary thrombosis. J Thromb Thrombolysis 32, 167–176 (2011). https://doi.org/10.1007/s11239-011-0589-2

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  • DOI: https://doi.org/10.1007/s11239-011-0589-2

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