This document provides guidance on troubleshooting issues with Cardiovascular Implantable Electronic Devices (CIEDs) in hospital rooms and cardiac care units. It discusses potential acute and chronic problems including loose connections, sensing issues due to lead maturation or inappropriate programming, and pacing issues from lead insulation breaks or conductor coil fractures. Four main problems are outlined - failure to capture, loss of output, oversensing, and undersensing. Troubleshooting tips are provided for addressing each issue. The key point emphasized is that pacemakers are designed to pace and sense cardiac signals effectively.
This document discusses indications for cardiac implantable electronic devices (CIEDs) such as pacemakers, cardiac resynchronization therapy (CRT), and implantable cardioverter defibrillators (ICDs) according to guidelines. It covers classifications of bradyarrhythmias and indications for pacing in various conditions such as persistent bradycardia. Indications for CRT and ICDs are also outlined based on left ventricular ejection fraction, heart failure class, and other factors. Current health insurance reimbursement policies in Taiwan for these devices are also summarized.
This document provides guidance on troubleshooting issues with Cardiovascular Implantable Electronic Devices (CIEDs) in hospital rooms and cardiac care units. It discusses potential acute and chronic problems including loose connections, sensing issues due to lead maturation or inappropriate programming, and pacing issues from lead insulation breaks or conductor coil fractures. Four main problems are outlined - failure to capture, loss of output, oversensing, and undersensing. Troubleshooting tips are provided for addressing each issue. The key point emphasized is that pacemakers are designed to pace and sense cardiac signals effectively.
This document discusses indications for cardiac implantable electronic devices (CIEDs) such as pacemakers, cardiac resynchronization therapy (CRT), and implantable cardioverter defibrillators (ICDs) according to guidelines. It covers classifications of bradyarrhythmias and indications for pacing in various conditions such as persistent bradycardia. Indications for CRT and ICDs are also outlined based on left ventricular ejection fraction, heart failure class, and other factors. Current health insurance reimbursement policies in Taiwan for these devices are also summarized.
1. The document discusses the basic principles and settings of cardiovascular implantable electronic devices (CIEDs), including pacemakers.
2. It covers topics such as pacing and sensing functions, parameters like lower and upper rates, pacing modes, and refractory and blanking periods.
3. The optimal settings aim to ensure cardiac pacing meets patients' needs while avoiding unnecessary pacing and maximizing battery longevity.
植入性心臟電子儀器地基本原理與設定
This document discusses the basic principles and settings of implantable cardiac electronic devices. It covers topics such as voltage, current, impedance, pacing modes, detection zones, cardioversion, defibrillation, anti-tachycardia pacing, and challenges in reducing inappropriate therapies. Key points include an overview of Ohm's Law and its application to pacemakers, examples of different pacing modes like VVI and DDD, considerations for programming detection zones and therapy levels in ICDs, and the use of ATP to terminate VT episodes.
This document describes the technique of radiofrequency ablation for atrioventricular nodal reentrant tachycardia (AVNRT). It discusses catheter positioning between the coronary sinus os and tricuspid valve for ablation. The areas targeted for slow and fast pathway ablation are shown. Progression of ablation sites from the coronary sinus os inferiorly and superiorly on the septum are presented. Acceptable ablation areas between the His catheter and roof of the coronary sinus are outlined to minimize heart block risks. A case of successful AVNRT ablation in a 73-year old woman is then presented, demonstrating induction of the arrhythmia and pace mapping to identify the slow pathway for ablation.
This document discusses transvenous lead extraction. It begins by providing background on the history of pacemakers and leads. It then defines various terms related to lead removal, extraction, and the different tools and techniques used. It discusses recommendations for operator training and facility requirements. Finally, it outlines the Heart Rhythm Society guidelines for indications for lead removal, including infection, pain, thrombosis, functional and non-functional leads. The guidelines classify recommendations as Class I, IIa, IIb or III based on evidence levels.
This document discusses pacemaker function and follow up. It outlines the sequence of events in the cardiac cycle for single chamber and dual chamber pacemakers. It describes programmable parameters such as pacing mode, rates, and refractory periods. The document details how to interpret pacemaker rhythm strips and identify malfunctions based on unexpected pacing spikes, pauses, or absent pacing. Pacemaker follow up aims to verify function and optimize settings through regular interrogation and testing of parameters like lead impedance, sensing thresholds and capture thresholds.
An artificial cardiac pacemaker is an implantable medical device that generates electrical impulses to stimulate the heart and regulate its rhythm. The first pacemaker was implanted in 1958 and since then pacemaker technology has advanced significantly. Modern pacemakers are smaller, more durable, and can synchronize with the heart's natural rhythm. A pacemaker consists of a pulse generator and battery housed in a casing connected to pacing leads that are placed into the heart chambers. Pacemakers treat abnormal heart rhythms by sensing the heart's activity and delivering electrical pulses when needed to maintain a regular rhythm.
This document provides information about pacemakers. It defines a pacemaker as an electronic device that delivers electrical stimulation to stimulate the myocardium and initiate contractions when the heart's natural pacemaker is unable to do so. It describes the different types of pacemakers including permanent, temporary, and biventricular pacemakers. It outlines the parts of a pacemaker including the pulse generator and leads. It discusses pacemaker functions such as pacing, sensing, and capture. It also covers pacemaker indications, complications, and recent research on pacemakers.
Cardiac arrhythmias and mapping techniquesSpringer
This document provides an overview of clinical cardiac electrophysiology. It discusses the history and development of the field, including the first recordings of intracardiac electrograms in the 1940s-1960s and the development of programmed electrical stimulation in the 1960s-1970s which allowed investigation of arrhythmia mechanisms. It describes the methodology used in electrophysiology studies, including equipment for recording cardiac activity and electrical stimulation, as well as study protocols for evaluating conduction intervals, refractory periods, and inducing/terminating arrhythmias. It outlines the diagnostic and therapeutic indications for electrophysiology studies in evaluating bradycardias, tachycardias, guiding catheter ablation and medical therapy, and risk stratification of conditions like WPW
The document discusses electrocardiography (ECG) and the interpretation of different cardiac rhythms and conditions. It provides information on:
1) The basics of ECG including what it measures and its role in detecting conditions like heart attacks, arrhythmias, and enlargement.
2) Different types of supraventricular tachycardia (SVT) like AV nodal reentrant tachycardia, AV reciprocating tachycardia, atrial flutter and fibrillation.
3) How to analyze ECGs to differentiate SVTs from ventricular tachycardia and identify the specific type of SVT based on P wave morphology, PR interval and other factors.
Pacemaker | Implantable Cardiac Devices For Heart FailuresYashodaHospitals
Implantable cardiac devices are electronic, battery-operated medical devices that are implanted to restore the heart's normal rhythm and prevent sudden cardiac death. Implantable cardioverter-defibrillator, Pacemaker and LAVD are such devices that help to maintain rhythm and pumping. A pacemaker is a small implantable cardiac device that is placed under the skin in the chest to help control the heartbeat, improve quality of life and for longevity. It is used to help the heart beat more regularly for irregular heartbeat also known as arrhythmia.
What does it help with?
Pacemaker helps in controlling the rhythm and of the heart by either:
Resynchronizing the rhythm
Correcting the rhythm
Facilitating adequate circulation to support a failing heart
This document discusses electrical testing of pacemakers and pacemaker complications. It describes the components of a pacemaker including the battery, pacing impedance, pulse generator, and modes and mode switching. It then discusses testing various aspects of the pulse generator including output circuit, sensing circuit, timing circuit, and rate responsive pacing. Finally, it briefly outlines some common pacemaker complications such as pocket complications, lead issues, infections, and device malfunctions.
This document discusses pacemakers and their management during anesthesia. It begins by describing the components of the heart's conducting system and types of pacemakers. It then discusses indications for pacemakers and implantable cardioverter defibrillators. The key points regarding anesthetic management are to have the device interrogated preoperatively, monitor it closely intraoperatively, and avoid potential electromagnetic interference from devices like electrocautery or defibrillation. Regional anesthesia is usually safe but general anesthesia requires avoiding drugs that could interfere with pacemaker function.
How to puncture the atrial septum (lectures for residents)Daisuke Yakabe
あらゆる循環器系手技に必須である、心房中隔穿刺について解説したスライドです。
動画もありますがupできなかったため、欲しい方はご連絡ください。
国立病院機構 九州医療センター 矢加部 大輔
This slide is E-learning for cardiology residents. Atrial septal puncture (Brockenbrough method) is essential procedure to perform catheter ablation and intervention of structure heart disease. Movie is available if you contact me by e-mail.
This document provides an introduction to echocardiography (cardiac ultrasound). It describes the standard transthoracic echocardiogram procedure and various views obtained, including the parasternal long axis, parasternal short axis, and apical views. It also discusses the anatomy and function of the heart valves and different modalities used in echocardiography, such as two-dimensional, M-mode, and Doppler ultrasound. Echocardiography allows assessment of both the structure and function of the heart.
Amplifiers, filters and digital recording systemsBenjamin Jacob
The document describes the key components of a cardiac electrophysiology (EP) lab, including recording systems, amplifiers, filters, catheters, and other equipment. It discusses the purpose and function of diagnostic and ablation catheters, signal processing components like amplifiers, filters, and A/D conversion. It also covers topics like appropriate gain and filter settings, sources of noise, and the functions of an EP recording system including real-time monitoring, review capabilities, and additional analysis tools.
1. The document discusses the basic principles and settings of cardiovascular implantable electronic devices (CIEDs), including pacemakers.
2. It covers topics such as pacing and sensing functions, parameters like lower and upper rates, pacing modes, and refractory and blanking periods.
3. The optimal settings aim to ensure cardiac pacing meets patients' needs while avoiding unnecessary pacing and maximizing battery longevity.
植入性心臟電子儀器地基本原理與設定
This document discusses the basic principles and settings of implantable cardiac electronic devices. It covers topics such as voltage, current, impedance, pacing modes, detection zones, cardioversion, defibrillation, anti-tachycardia pacing, and challenges in reducing inappropriate therapies. Key points include an overview of Ohm's Law and its application to pacemakers, examples of different pacing modes like VVI and DDD, considerations for programming detection zones and therapy levels in ICDs, and the use of ATP to terminate VT episodes.
This document describes the technique of radiofrequency ablation for atrioventricular nodal reentrant tachycardia (AVNRT). It discusses catheter positioning between the coronary sinus os and tricuspid valve for ablation. The areas targeted for slow and fast pathway ablation are shown. Progression of ablation sites from the coronary sinus os inferiorly and superiorly on the septum are presented. Acceptable ablation areas between the His catheter and roof of the coronary sinus are outlined to minimize heart block risks. A case of successful AVNRT ablation in a 73-year old woman is then presented, demonstrating induction of the arrhythmia and pace mapping to identify the slow pathway for ablation.
This document discusses transvenous lead extraction. It begins by providing background on the history of pacemakers and leads. It then defines various terms related to lead removal, extraction, and the different tools and techniques used. It discusses recommendations for operator training and facility requirements. Finally, it outlines the Heart Rhythm Society guidelines for indications for lead removal, including infection, pain, thrombosis, functional and non-functional leads. The guidelines classify recommendations as Class I, IIa, IIb or III based on evidence levels.
This document discusses pacemaker function and follow up. It outlines the sequence of events in the cardiac cycle for single chamber and dual chamber pacemakers. It describes programmable parameters such as pacing mode, rates, and refractory periods. The document details how to interpret pacemaker rhythm strips and identify malfunctions based on unexpected pacing spikes, pauses, or absent pacing. Pacemaker follow up aims to verify function and optimize settings through regular interrogation and testing of parameters like lead impedance, sensing thresholds and capture thresholds.
An artificial cardiac pacemaker is an implantable medical device that generates electrical impulses to stimulate the heart and regulate its rhythm. The first pacemaker was implanted in 1958 and since then pacemaker technology has advanced significantly. Modern pacemakers are smaller, more durable, and can synchronize with the heart's natural rhythm. A pacemaker consists of a pulse generator and battery housed in a casing connected to pacing leads that are placed into the heart chambers. Pacemakers treat abnormal heart rhythms by sensing the heart's activity and delivering electrical pulses when needed to maintain a regular rhythm.
This document provides information about pacemakers. It defines a pacemaker as an electronic device that delivers electrical stimulation to stimulate the myocardium and initiate contractions when the heart's natural pacemaker is unable to do so. It describes the different types of pacemakers including permanent, temporary, and biventricular pacemakers. It outlines the parts of a pacemaker including the pulse generator and leads. It discusses pacemaker functions such as pacing, sensing, and capture. It also covers pacemaker indications, complications, and recent research on pacemakers.
Cardiac arrhythmias and mapping techniquesSpringer
This document provides an overview of clinical cardiac electrophysiology. It discusses the history and development of the field, including the first recordings of intracardiac electrograms in the 1940s-1960s and the development of programmed electrical stimulation in the 1960s-1970s which allowed investigation of arrhythmia mechanisms. It describes the methodology used in electrophysiology studies, including equipment for recording cardiac activity and electrical stimulation, as well as study protocols for evaluating conduction intervals, refractory periods, and inducing/terminating arrhythmias. It outlines the diagnostic and therapeutic indications for electrophysiology studies in evaluating bradycardias, tachycardias, guiding catheter ablation and medical therapy, and risk stratification of conditions like WPW
The document discusses electrocardiography (ECG) and the interpretation of different cardiac rhythms and conditions. It provides information on:
1) The basics of ECG including what it measures and its role in detecting conditions like heart attacks, arrhythmias, and enlargement.
2) Different types of supraventricular tachycardia (SVT) like AV nodal reentrant tachycardia, AV reciprocating tachycardia, atrial flutter and fibrillation.
3) How to analyze ECGs to differentiate SVTs from ventricular tachycardia and identify the specific type of SVT based on P wave morphology, PR interval and other factors.
Pacemaker | Implantable Cardiac Devices For Heart FailuresYashodaHospitals
Implantable cardiac devices are electronic, battery-operated medical devices that are implanted to restore the heart's normal rhythm and prevent sudden cardiac death. Implantable cardioverter-defibrillator, Pacemaker and LAVD are such devices that help to maintain rhythm and pumping. A pacemaker is a small implantable cardiac device that is placed under the skin in the chest to help control the heartbeat, improve quality of life and for longevity. It is used to help the heart beat more regularly for irregular heartbeat also known as arrhythmia.
What does it help with?
Pacemaker helps in controlling the rhythm and of the heart by either:
Resynchronizing the rhythm
Correcting the rhythm
Facilitating adequate circulation to support a failing heart
This document discusses electrical testing of pacemakers and pacemaker complications. It describes the components of a pacemaker including the battery, pacing impedance, pulse generator, and modes and mode switching. It then discusses testing various aspects of the pulse generator including output circuit, sensing circuit, timing circuit, and rate responsive pacing. Finally, it briefly outlines some common pacemaker complications such as pocket complications, lead issues, infections, and device malfunctions.
This document discusses pacemakers and their management during anesthesia. It begins by describing the components of the heart's conducting system and types of pacemakers. It then discusses indications for pacemakers and implantable cardioverter defibrillators. The key points regarding anesthetic management are to have the device interrogated preoperatively, monitor it closely intraoperatively, and avoid potential electromagnetic interference from devices like electrocautery or defibrillation. Regional anesthesia is usually safe but general anesthesia requires avoiding drugs that could interfere with pacemaker function.
How to puncture the atrial septum (lectures for residents)Daisuke Yakabe
あらゆる循環器系手技に必須である、心房中隔穿刺について解説したスライドです。
動画もありますがupできなかったため、欲しい方はご連絡ください。
国立病院機構 九州医療センター 矢加部 大輔
This slide is E-learning for cardiology residents. Atrial septal puncture (Brockenbrough method) is essential procedure to perform catheter ablation and intervention of structure heart disease. Movie is available if you contact me by e-mail.
This document provides an introduction to echocardiography (cardiac ultrasound). It describes the standard transthoracic echocardiogram procedure and various views obtained, including the parasternal long axis, parasternal short axis, and apical views. It also discusses the anatomy and function of the heart valves and different modalities used in echocardiography, such as two-dimensional, M-mode, and Doppler ultrasound. Echocardiography allows assessment of both the structure and function of the heart.
Amplifiers, filters and digital recording systemsBenjamin Jacob
The document describes the key components of a cardiac electrophysiology (EP) lab, including recording systems, amplifiers, filters, catheters, and other equipment. It discusses the purpose and function of diagnostic and ablation catheters, signal processing components like amplifiers, filters, and A/D conversion. It also covers topics like appropriate gain and filter settings, sources of noise, and the functions of an EP recording system including real-time monitoring, review capabilities, and additional analysis tools.
1) The digital ESC Congress 2020 attracted over 116,000 healthcare professionals from 211 countries, focusing on new knowledge in arrhythmias and device therapy.
2) New guidelines and studies provided updates on atrial fibrillation screening and management, showing benefits of early rhythm control and new anticoagulants.
3) Studies explored new pacing approaches like His bundle and left bundle pacing to improve effectiveness and reduce fluoroscopy time.
A meeting was held on August 10, 2019 (Saturday) in room 803 of the Taipei Chang Yung-fa International Convention Center. The meeting location and date are provided.
7. NBG Code – The Usual Pacing Modes
I
II
III
IV
V
Chamber(s)
Paced
Chamber(s)
Sensed
Response to
Sensing
Rate
Multisite
Modulation Pacing
O = None
O = None
O = None
O = None
O = None
A = Atrium
A = Atrium
T = Triggered
R = Rate
A = Atrium
V = Ventricle
V = Ventricle
I = Inhibited
D = Dual (A + V)
D = Dual (A + V)
D = Dual (T + I)
S = Single (A or
S = Single (A or V)
V)
• Examples
– DDD
– VVI
– DDDR
– VVIR
– DDIR
– AAI
modulation
V = Ventricle
D = Dual (A + V)
Student Notes
Here are typical pacing modes.
Instructor Notes
Say: To keep from becoming overwhelmed, let’s limit our discussion to those modes found in everyday clinical practice. We will spend most of our time discussing and interpreting ECG strips that demonstrate these operations. Learn these operations, and the less typical modes will be easy.
Ask: What modes have you heard of?
Expected replies: DDD, VVI, VVIR, DDDR
Say: These will be some of the modes of operation that we cover in the coming slides.
With the assistance of the Pacemaker Code and Rate and Interval Conversion Pocket Reference card, ask learners to state functional abilities of DDD, DDDR, DDIR, VVI, VVIR, and AAI.