Heart devices
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This document discusses three types of heart devices: pacemakers, implantable cardioverter defibrillators (ICDs), and cardiac resynchronization therapy (CRT). Pacemakers use low level electrical pulses to treat abnormal heart rhythms by pacing the right atrium or ventricle. ICDs provide defibrillator shocks for shockable arrhythmias and also have pacemaker functions to treat tachy-arrhythmias. CRT devices are triple chamber pacemakers that treat severe heart failure by synchronizing contractions of both ventricles.
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Pacemakers
Pacemakers provide electrical stimulation to cause cardiac contraction when intrinsic cardiac activity is slow or absent. Pacing systems consist of a pulse generator and leads placed in the heart. Permanent systems use endocardial leads inserted transvenously into the right atrium and/or ventricle. Temporary systems use external pulse generators connected to transvenous or transcutaneous leads. Pacemakers can operate in asynchronous or synchronous modes and are used to treat symptomatic bradycardia. Complications include failure to output or capture pacing stimuli, oversensing, undersensing, and infection.
Pacemaker
The document discusses pacemakers, including that they deliver electrical stimulation to cardiac tissue. It describes the different types of pacemakers and their indications. It then discusses the four parts of the pacing system: the pulse generator, lead(s), programmer, and patient. It provides details on pulse generators, lead systems, programming codes, implantation labs and their personnel, pre-implant protocols, implantation approaches, parameters, post-procedure management, complications, and discharge advice.
Pacemaker
This document provides an overview of cardiac pacemakers. It discusses the anatomy of the heart, conduction pathways, history of pacemakers, pacemaker components, types of pacemakers including permanent and temporary, indications for pacemakers, procedures, pacing modes, complications, nursing management, and patient education. The key points are that pacemakers are electronic devices used to treat bradyarrhythmias, they consist of a pulse generator and leads that are placed transvenously, and nursing care involves monitoring function and educating patients.
Craig hore on emergency pacing
A 60-year-old man presented with syncope and went into asystolic cardiac arrest. After 20 minutes of CPR and adrenaline with no response, the clinical team considered stopping resuscitation efforts. However, upon closer examination of the ECG, small bumps were noticed on the rhythm strip that suggested pulseless electrical activity rather than true asystole. Transcutaneous pacing was successful in capturing the rhythm and the patient regained consciousness. A temporary transvenous pacemaker was then inserted, and the patient made a full recovery in the hospital. This case highlights the importance of not ignoring clinical hunches, providing electricity for haemodynamically unstable rhythm disturbances, and the lifesaving capabilities of temporary pacing.
Pacemaker Overview
The document provides an overview of pacemaker indications, functions, and operation. It discusses normal heart rhythm and conduction, abnormalities that can require pacing like sinus node dysfunction and AV block, pacemaker components, modes and how they work, factors in selecting an optimal pacing mode, and indications for various pacing therapies.
Defibrillation, cardioversion and pacing
This document discusses defibrillation, cardioversion, and pacing. It provides:
1) A brief history of defibrillation and its use for ventricular fibrillation and pulseless ventricular tachycardia.
2) An overview of cardioversion for treating unstable tachyarrhythmias with signs of low cardiac output, excessive heart rates, or chest pain. Synchronized cardioversion times shock delivery to the QRS complex.
3) Information on pacing for unstable bradyarrhythmias and symptomatic bradycardia, including complete heart block and Mobitz type II second-degree heart block.
Pacemaker and anaesthetic implications
This document discusses pacemakers and their implications for anesthesia. It provides a brief history of pacemaker development from large abdominal devices in 1980 to today's small pectoral devices. It covers pacemaker indications, types of pacing modes, factors affecting pacing thresholds, preoperative evaluation, intraoperative management considerations, and the effect of magnet application. Pacemaker dependent patients require ECG monitoring and backup pacing during anesthesia given risks of electromagnetic interference or inappropriate pacing inhibition or triggering.
Ventricular tachycardia by dr.muzahid
This presentation provides an overview of ventricular tachycardia (VT). VT is diagnosed based on an electrocardiogram showing three or more consecutive ventricular beats at a rate greater than 120 beats per minute with a wide QRS complex greater than 140 milliseconds. VT can be sustained for over 30 seconds or non-sustained for under 30 seconds. Causes of VT include myocardial infarction, cardiomyopathy, electrolyte abnormalities, and drugs. Treatment depends on hemodynamic stability and includes medications, cardioversion, ablation, or an implantable cardioverter defibrillator. Long term management focuses on underlying heart conditions, antiarrhythmic drugs, and reducing risk of sudden cardiac death.
Recommended
Pacemakers
Pacemakers provide electrical stimulation to cause cardiac contraction when intrinsic cardiac activity is slow or absent. Pacing systems consist of a pulse generator and leads placed in the heart. Permanent systems use endocardial leads inserted transvenously into the right atrium and/or ventricle. Temporary systems use external pulse generators connected to transvenous or transcutaneous leads. Pacemakers can operate in asynchronous or synchronous modes and are used to treat symptomatic bradycardia. Complications include failure to output or capture pacing stimuli, oversensing, undersensing, and infection.
Pacemaker
The document discusses pacemakers, including that they deliver electrical stimulation to cardiac tissue. It describes the different types of pacemakers and their indications. It then discusses the four parts of the pacing system: the pulse generator, lead(s), programmer, and patient. It provides details on pulse generators, lead systems, programming codes, implantation labs and their personnel, pre-implant protocols, implantation approaches, parameters, post-procedure management, complications, and discharge advice.
Pacemaker
This document provides an overview of cardiac pacemakers. It discusses the anatomy of the heart, conduction pathways, history of pacemakers, pacemaker components, types of pacemakers including permanent and temporary, indications for pacemakers, procedures, pacing modes, complications, nursing management, and patient education. The key points are that pacemakers are electronic devices used to treat bradyarrhythmias, they consist of a pulse generator and leads that are placed transvenously, and nursing care involves monitoring function and educating patients.
Craig hore on emergency pacing
A 60-year-old man presented with syncope and went into asystolic cardiac arrest. After 20 minutes of CPR and adrenaline with no response, the clinical team considered stopping resuscitation efforts. However, upon closer examination of the ECG, small bumps were noticed on the rhythm strip that suggested pulseless electrical activity rather than true asystole. Transcutaneous pacing was successful in capturing the rhythm and the patient regained consciousness. A temporary transvenous pacemaker was then inserted, and the patient made a full recovery in the hospital. This case highlights the importance of not ignoring clinical hunches, providing electricity for haemodynamically unstable rhythm disturbances, and the lifesaving capabilities of temporary pacing.
Pacemaker Overview
The document provides an overview of pacemaker indications, functions, and operation. It discusses normal heart rhythm and conduction, abnormalities that can require pacing like sinus node dysfunction and AV block, pacemaker components, modes and how they work, factors in selecting an optimal pacing mode, and indications for various pacing therapies.
Defibrillation, cardioversion and pacing
This document discusses defibrillation, cardioversion, and pacing. It provides:
1) A brief history of defibrillation and its use for ventricular fibrillation and pulseless ventricular tachycardia.
2) An overview of cardioversion for treating unstable tachyarrhythmias with signs of low cardiac output, excessive heart rates, or chest pain. Synchronized cardioversion times shock delivery to the QRS complex.
3) Information on pacing for unstable bradyarrhythmias and symptomatic bradycardia, including complete heart block and Mobitz type II second-degree heart block.
Pacemaker and anaesthetic implications
This document discusses pacemakers and their implications for anesthesia. It provides a brief history of pacemaker development from large abdominal devices in 1980 to today's small pectoral devices. It covers pacemaker indications, types of pacing modes, factors affecting pacing thresholds, preoperative evaluation, intraoperative management considerations, and the effect of magnet application. Pacemaker dependent patients require ECG monitoring and backup pacing during anesthesia given risks of electromagnetic interference or inappropriate pacing inhibition or triggering.
Ventricular tachycardia by dr.muzahid
This presentation provides an overview of ventricular tachycardia (VT). VT is diagnosed based on an electrocardiogram showing three or more consecutive ventricular beats at a rate greater than 120 beats per minute with a wide QRS complex greater than 140 milliseconds. VT can be sustained for over 30 seconds or non-sustained for under 30 seconds. Causes of VT include myocardial infarction, cardiomyopathy, electrolyte abnormalities, and drugs. Treatment depends on hemodynamic stability and includes medications, cardioversion, ablation, or an implantable cardioverter defibrillator. Long term management focuses on underlying heart conditions, antiarrhythmic drugs, and reducing risk of sudden cardiac death.
Emergency pacemaker and ICD issues
This document discusses emergency issues related to pacemakers and implantable cardioverter defibrillators (ICDs). It covers clinical cases, device components and functions, complications, and emergency department management strategies. Key points include descriptions of pacemaker modes and indications for pacemakers, cardiac resynchronization therapy, and ICDs. Common complications like infection, lead issues, and inappropriate shocks are reviewed. The document stresses the importance of obtaining a history, physical exam, ECG, and device interrogation in the ED. Magnet use and Sgarbossa criteria for diagnosing acute MI in paced patients are also summarized.
Defebrilation
This document discusses defibrillation, which is a treatment used to restore normal heart rhythm in patients experiencing ventricular fibrillation or pulseless ventricular tachycardia. It defines defibrillation and describes the different types of defibrillators, including manual external defibrillators, automated external defibrillators, implantable cardioverter defibrillators, and wearable cardiac defibrillators. It also covers how defibrillation works, the precautions that must be taken with the procedure, and the risks involved.
Arrhythmias general
The document discusses various types of arrhythmias and their mechanisms. It describes ectopic beats that originate from locations other than the sinoatrial node, and explains that they can cause single beats or take over the heart rhythm. The mechanisms of arrhythmias include altered automaticity, triggered activity, and reentry. Reentry involves unidirectional block and different conduction speeds that allow an impulse to circulate and repeat, creating a reentrant circuit. The document outlines several specific types of arrhythmias like atrial fibrillation, atrial flutter, atrioventricular nodal reentry, and Wolff-Parkinson-White syndrome.
Pacemaker ECGs. Yasmeen Kamal
The document provides information about interpreting electrocardiograms (ECGs) from patients with pacemakers. It discusses various pacemaker modes, assessing capture and sensing functions, underlying cardiac rhythms, and what follow up actions may be needed based on the ECG patterns. Examples are presented to illustrate dual chamber pacing, assessing atrial and ventricular sensing, pacemaker-mediated tachycardia, undersensing, failure of capture, and magnet mode behavior.
Defibrillation
Defibrillation is a process where an electronic device sends an electric shock to the heart to stop an extremely rapid, irregular heartbeat and restore normal rhythm. There are internal defibrillators like ICDs and external defibrillators like AEDs. A defibrillator can deliver a shock to treat ventricular fibrillation or pulseless ventricular tachycardia, or it can perform cardioversion to convert non-sinus rhythms like SVT to normal sinus rhythm. The appropriate use and procedures for defibrillation or cardioversion are outlined.
Cardiac defibrilation
A complete Theoretical as well as practical aspects of Cardiac defibrillation with the definition,history,defibrillator and cardiovesrsion,Equipments,pre procedural consideration,care of patient before and after defibrillation,cardiac defibrillation procedure steps with rationale,complications,documentation and legal aspects
Pacemaker & cabg
This document discusses pacemakers, including their history, components, types, functions, programming, complications, and clinical management. It provides details on pacemaker technology, how they treat arrhythmias, and considerations for patients with pacemakers during medical procedures or surgery.
Ventricular tachycardia
This document describes the case of a 77-year-old male who was found unconscious on the street by EMS with a heart rate of 250 beats per minute. He has a history of atrial fibrillation, hypertension, diabetes, and had a pacemaker inserted in 2014. Initial workup found ventricular tachycardia. He received amiodarone and cardioversion with temporary success. Over the following days he experienced recurrent arrhythmias and heart failure exacerbation. Angiography found no obstructive coronary artery disease. An ICD was implanted for secondary prevention of further lethal arrhythmias given his cardiomyopathy and recurrent instabilities.
Patients with pacemaker anaesthetic implications
This document provides information on cardiac implanted electronic devices (CIEDs) such as pacemakers and implantable cardioverter defibrillators (ICDs). It discusses the basics of CIED functions, indications for use, and anesthetic management in the preoperative, intraoperative and postoperative periods. Special considerations for CIED patients include monitoring, preventing device malfunction from electrosurgery or other sources, and having temporary pacing equipment available.
Anesthesia and cardiac pacemaker
The document discusses cardiac pacemakers and implantable cardioverter defibrillators (ICDs). It covers the history, components, functions, types of pacing modes, indications for use, problems that can occur, and considerations for anesthetic management of patients with these devices. The key points are that pacemakers are used to treat bradycardia while ICDs treat tachycardia/fibrillation. Care must be taken with electromagnetic interference and device function needs to be considered for any procedures.
Holter
Holter monitoring involves using a portable electrocardiography device to record a patient's heart rhythm over a period of 24 to 72 hours. The device uses electrodes attached to the skin to track the heart's electrical activity. A Holter monitor can detect abnormal heart rhythms and help diagnose conditions like unexplained palpitations, syncope, or evaluate pacemaker function. The report provides summaries of heart rate, arrhythmias detected, heart rate variability, and 24-hour trends to help clinicians identify abnormal rhythms and understand their clinical significance. Holter monitoring can play a role in evaluating patients with known heart disease, suspected ischemia, cryptogenic stroke, and pacemaker function.
Anethesia and cardiac implantable electronic devices
The document discusses cardiac implantable electronic devices (CIEDs) such as pacemakers, implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices. It covers how each device functions, their indications for use, and programming options. When providing anesthesia for patients with CIEDs, special precautions must be taken to avoid electromagnetic interference that could disrupt device function or sensing. This includes reprogramming devices if needed and monitoring patients closely during and after procedures.
ECG guide for uk
This document provides an overview of electrocardiography and the interpretation of electrocardiograms. It discusses the anatomy and electrical conduction system of the heart and defines the key components of the ECG including the P wave, QRS complex, ST segment, and T wave. It explains how ECGs are used to diagnose cardiac rhythm disorders, coronary artery disease, and other heart conditions. The document emphasizes that the ECG should be interpreted in the context of the patient's clinical presentation and history.
Dr hardik temporary pacemaker preview (1)
The document discusses temporary cardiac pacing, including what a pacemaker is, indications for temporary pacing such as sinus node dysfunction and various types of heart block, pacing modalities like transvenous or external pacing, how to insert temporary pacemakers and set pacing parameters like rate, output threshold, and sensing threshold.
Pacemakers
This document provides information about pacemaker circuits and their components. It begins by defining key terms:
- Voltage is the "push" that causes electrons to move through a circuit and is measured in volts. In pacemakers, it is provided by the battery.
- Current is the flow of electrons through a completed circuit and is measured in milliamps. It is determined by the number of electrons moving through the circuit.
- Impedance is the opposition to current flow and is measured in ohms. In pacemakers, it represents the sum of all resistance to current flow.
- These components are interdependent based on Ohm's Law, where voltage, current, and impedance influence one another
Ecg & arrhythmias
The document discusses electrocardiograms (ECGs) and cardiac arrhythmias. It begins by explaining how the heart generates electrical currents that can be recorded as ECG tracings. It then covers ECG basics like normal sinus rhythm, heart rate calculation, and the cardiac conduction system. The document discusses various types of arrhythmias including premature beats, tachycardias, fibrillation, and heart blocks. It provides examples of ECG tracings of normal and abnormal rhythms. In summary, the document provides an overview of ECGs, how to analyze rhythms, and examples of common arrhythmias.
Pacemaker and anaesthesia
This document provides an overview of pacemakers and defibrillators, including their history, types, indications for use, important terminology, factors to consider from an anesthesia perspective, preoperative evaluation, intraoperative management, and specific perioperative considerations. It discusses the development of pacemakers from early external versions to modern implantable devices, and covers defibrillator components and codes.
Cardiac Pacemaker
This document discusses cardiac pacemakers. It defines a pacemaker as a medical device that provides support to the heart's pacemaking system when it is not functioning adequately. It explains that pacemakers are needed when the sinoatrial node or atrioventricular node cannot generate a sufficient heartbeat. The document outlines the components of a pacemaker including electrodes, a power source, pulse generator, timing control, output driver, and sensing amplifier. It describes the different types of pacemakers such as internal, external, fixed rate, demand, and atrial or ventricular triggered models. Complications from pacemakers like pacemaker syndrome and embolism are also mentioned.
Artificial Cardiac Pacemaker
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.
心臟植入性電子儀器(CIED )之歷史”CIED Overview “_20130914中區
This document provides a history and overview of cardiac implantable electronic devices (CIEDs) such as pacemakers and implantable cardioverter defibrillators (ICDs). It discusses the evolution of cardiac pacing from early external stimulation experiments to modern implantable devices. Key components of modern pacemakers and ICDs like leads, generators, batteries and programming functions are described. The document also reviews cardiac resynchronization therapy delivered by biventricular pacemakers and ICDs.
Taller Trauma Torácico
Este documento presenta el caso de un paciente de 23 años que sufrió heridas de bala en el tórax posterior derecho. Fue tratado inicialmente en el HILT donde se le colocaron tubos pleurales por hemotórax bilateral. Luego fue trasladado al HST para más evaluaciones. Las pruebas mostraron fractura de vértebra T6 y contusiones pulmonares. Se aplicaron procedimientos como drenaje pleural. El paciente permaneció estable y fue trasladado a neurocirugía.
Úlceras por Presión
Este documento describe el caso de una paciente anciana que fue referida al hospital con úlceras por presión en varias partes del cuerpo, incluidas las regiones trocantéricas y sacra. Presentaba úlceras de grado III y IV con secreción purulenta e infección. Se diagnosticó con neumonía asociada a los cuidados de la salud. Fue tratada con curación y desbridamiento de las úlceras, antibióticos para la infección de Pseudomonas y la neumonía, y medidas de soporte. Su pronóstico es mal
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Emergency pacemaker and ICD issues
This document discusses emergency issues related to pacemakers and implantable cardioverter defibrillators (ICDs). It covers clinical cases, device components and functions, complications, and emergency department management strategies. Key points include descriptions of pacemaker modes and indications for pacemakers, cardiac resynchronization therapy, and ICDs. Common complications like infection, lead issues, and inappropriate shocks are reviewed. The document stresses the importance of obtaining a history, physical exam, ECG, and device interrogation in the ED. Magnet use and Sgarbossa criteria for diagnosing acute MI in paced patients are also summarized.
Defebrilation
This document discusses defibrillation, which is a treatment used to restore normal heart rhythm in patients experiencing ventricular fibrillation or pulseless ventricular tachycardia. It defines defibrillation and describes the different types of defibrillators, including manual external defibrillators, automated external defibrillators, implantable cardioverter defibrillators, and wearable cardiac defibrillators. It also covers how defibrillation works, the precautions that must be taken with the procedure, and the risks involved.
Arrhythmias general
The document discusses various types of arrhythmias and their mechanisms. It describes ectopic beats that originate from locations other than the sinoatrial node, and explains that they can cause single beats or take over the heart rhythm. The mechanisms of arrhythmias include altered automaticity, triggered activity, and reentry. Reentry involves unidirectional block and different conduction speeds that allow an impulse to circulate and repeat, creating a reentrant circuit. The document outlines several specific types of arrhythmias like atrial fibrillation, atrial flutter, atrioventricular nodal reentry, and Wolff-Parkinson-White syndrome.
Pacemaker ECGs. Yasmeen Kamal
The document provides information about interpreting electrocardiograms (ECGs) from patients with pacemakers. It discusses various pacemaker modes, assessing capture and sensing functions, underlying cardiac rhythms, and what follow up actions may be needed based on the ECG patterns. Examples are presented to illustrate dual chamber pacing, assessing atrial and ventricular sensing, pacemaker-mediated tachycardia, undersensing, failure of capture, and magnet mode behavior.
Defibrillation
Defibrillation is a process where an electronic device sends an electric shock to the heart to stop an extremely rapid, irregular heartbeat and restore normal rhythm. There are internal defibrillators like ICDs and external defibrillators like AEDs. A defibrillator can deliver a shock to treat ventricular fibrillation or pulseless ventricular tachycardia, or it can perform cardioversion to convert non-sinus rhythms like SVT to normal sinus rhythm. The appropriate use and procedures for defibrillation or cardioversion are outlined.
Cardiac defibrilation
A complete Theoretical as well as practical aspects of Cardiac defibrillation with the definition,history,defibrillator and cardiovesrsion,Equipments,pre procedural consideration,care of patient before and after defibrillation,cardiac defibrillation procedure steps with rationale,complications,documentation and legal aspects
Pacemaker & cabg
This document discusses pacemakers, including their history, components, types, functions, programming, complications, and clinical management. It provides details on pacemaker technology, how they treat arrhythmias, and considerations for patients with pacemakers during medical procedures or surgery.
Ventricular tachycardia
This document describes the case of a 77-year-old male who was found unconscious on the street by EMS with a heart rate of 250 beats per minute. He has a history of atrial fibrillation, hypertension, diabetes, and had a pacemaker inserted in 2014. Initial workup found ventricular tachycardia. He received amiodarone and cardioversion with temporary success. Over the following days he experienced recurrent arrhythmias and heart failure exacerbation. Angiography found no obstructive coronary artery disease. An ICD was implanted for secondary prevention of further lethal arrhythmias given his cardiomyopathy and recurrent instabilities.
Patients with pacemaker anaesthetic implications
This document provides information on cardiac implanted electronic devices (CIEDs) such as pacemakers and implantable cardioverter defibrillators (ICDs). It discusses the basics of CIED functions, indications for use, and anesthetic management in the preoperative, intraoperative and postoperative periods. Special considerations for CIED patients include monitoring, preventing device malfunction from electrosurgery or other sources, and having temporary pacing equipment available.
Anesthesia and cardiac pacemaker
The document discusses cardiac pacemakers and implantable cardioverter defibrillators (ICDs). It covers the history, components, functions, types of pacing modes, indications for use, problems that can occur, and considerations for anesthetic management of patients with these devices. The key points are that pacemakers are used to treat bradycardia while ICDs treat tachycardia/fibrillation. Care must be taken with electromagnetic interference and device function needs to be considered for any procedures.
Holter
Holter monitoring involves using a portable electrocardiography device to record a patient's heart rhythm over a period of 24 to 72 hours. The device uses electrodes attached to the skin to track the heart's electrical activity. A Holter monitor can detect abnormal heart rhythms and help diagnose conditions like unexplained palpitations, syncope, or evaluate pacemaker function. The report provides summaries of heart rate, arrhythmias detected, heart rate variability, and 24-hour trends to help clinicians identify abnormal rhythms and understand their clinical significance. Holter monitoring can play a role in evaluating patients with known heart disease, suspected ischemia, cryptogenic stroke, and pacemaker function.
Anethesia and cardiac implantable electronic devices
The document discusses cardiac implantable electronic devices (CIEDs) such as pacemakers, implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices. It covers how each device functions, their indications for use, and programming options. When providing anesthesia for patients with CIEDs, special precautions must be taken to avoid electromagnetic interference that could disrupt device function or sensing. This includes reprogramming devices if needed and monitoring patients closely during and after procedures.
ECG guide for uk
This document provides an overview of electrocardiography and the interpretation of electrocardiograms. It discusses the anatomy and electrical conduction system of the heart and defines the key components of the ECG including the P wave, QRS complex, ST segment, and T wave. It explains how ECGs are used to diagnose cardiac rhythm disorders, coronary artery disease, and other heart conditions. The document emphasizes that the ECG should be interpreted in the context of the patient's clinical presentation and history.
Dr hardik temporary pacemaker preview (1)
The document discusses temporary cardiac pacing, including what a pacemaker is, indications for temporary pacing such as sinus node dysfunction and various types of heart block, pacing modalities like transvenous or external pacing, how to insert temporary pacemakers and set pacing parameters like rate, output threshold, and sensing threshold.
Pacemakers
This document provides information about pacemaker circuits and their components. It begins by defining key terms:
- Voltage is the "push" that causes electrons to move through a circuit and is measured in volts. In pacemakers, it is provided by the battery.
- Current is the flow of electrons through a completed circuit and is measured in milliamps. It is determined by the number of electrons moving through the circuit.
- Impedance is the opposition to current flow and is measured in ohms. In pacemakers, it represents the sum of all resistance to current flow.
- These components are interdependent based on Ohm's Law, where voltage, current, and impedance influence one another
Ecg & arrhythmias
The document discusses electrocardiograms (ECGs) and cardiac arrhythmias. It begins by explaining how the heart generates electrical currents that can be recorded as ECG tracings. It then covers ECG basics like normal sinus rhythm, heart rate calculation, and the cardiac conduction system. The document discusses various types of arrhythmias including premature beats, tachycardias, fibrillation, and heart blocks. It provides examples of ECG tracings of normal and abnormal rhythms. In summary, the document provides an overview of ECGs, how to analyze rhythms, and examples of common arrhythmias.
Pacemaker and anaesthesia
This document provides an overview of pacemakers and defibrillators, including their history, types, indications for use, important terminology, factors to consider from an anesthesia perspective, preoperative evaluation, intraoperative management, and specific perioperative considerations. It discusses the development of pacemakers from early external versions to modern implantable devices, and covers defibrillator components and codes.
Cardiac Pacemaker
This document discusses cardiac pacemakers. It defines a pacemaker as a medical device that provides support to the heart's pacemaking system when it is not functioning adequately. It explains that pacemakers are needed when the sinoatrial node or atrioventricular node cannot generate a sufficient heartbeat. The document outlines the components of a pacemaker including electrodes, a power source, pulse generator, timing control, output driver, and sensing amplifier. It describes the different types of pacemakers such as internal, external, fixed rate, demand, and atrial or ventricular triggered models. Complications from pacemakers like pacemaker syndrome and embolism are also mentioned.
Artificial Cardiac Pacemaker
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.
心臟植入性電子儀器(CIED )之歷史”CIED Overview “_20130914中區
This document provides a history and overview of cardiac implantable electronic devices (CIEDs) such as pacemakers and implantable cardioverter defibrillators (ICDs). It discusses the evolution of cardiac pacing from early external stimulation experiments to modern implantable devices. Key components of modern pacemakers and ICDs like leads, generators, batteries and programming functions are described. The document also reviews cardiac resynchronization therapy delivered by biventricular pacemakers and ICDs.
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Anethesia and cardiac implantable electronic devices
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Este documento presenta el caso de un paciente de 23 años que sufrió heridas de bala en el tórax posterior derecho. Fue tratado inicialmente en el HILT donde se le colocaron tubos pleurales por hemotórax bilateral. Luego fue trasladado al HST para más evaluaciones. Las pruebas mostraron fractura de vértebra T6 y contusiones pulmonares. Se aplicaron procedimientos como drenaje pleural. El paciente permaneció estable y fue trasladado a neurocirugía.
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The Electrocardiogram - Physiologic Principles
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Artificial Intelligence Symposium (THAIS)
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A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Cell Therapy Expansion and Challenges in Autoimmune Disease
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
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Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
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Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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Heart devices
- 2. Pacemaker Single Chamber Pacemaker -Right atrium (AV normal) -Right ventricle (AV abnormal) Dual Lead Pacemaker Low level electrical pulses Indications Tresholds
- 3. ICD Defibrillator shocks in shockable arrhythmias Pacemaker activity Tachy-arrhythmias Low and high level electrical pulses Sudden death
- 4. CRT Biventricular/Triple Chamber pacemaker -Severe Heart Failure
Editor's Notes
- Un marcapasos de doble cámara establece el ritmo de la aurícula y el ventrículo. Un marcapasos biventricular establece el ritmo de ambos ventrículos. Un desfibrilador cardioversor implantable puede funcionar de la misma manera que lo hace un marcapasos. Además, si este dispositivo detecta una fibrilación o taquicardia ventricular, envía una descarga para restablecer el ritmo cardíaco normal. Un marcapasos permanente tiene dos componentes: Un generador de pulsos que tiene una batería de litio hermética y un sistema de circuitos electrónicos. El generador produce las señales eléctricas que hacen que el corazón lata. La mayoría generadores de pulsos son capaces también de recibir las señales que envía el propio corazón y de responder a ellas. Uno o mas cables (también llamados conductores). Los conductores son cables flexibles aislados que llevan las señales eléctricas desde el generador de impulsos hasta el corazón, y que también transmiten señales desde el corazón hasta el generador de pulsos. Uno de los extremos del conductor está unido al generador de pulsos y el extremo del conductor donde está el electrodo se sitúa en la aurícula (la cavidad superior del corazón) o en el ventrículo derecho (la cavidad inferior del corazón). En el caso de un marcapasos biventricular, los electrodos se colocan en ambos ventrículos. electrodos en cada derivación
- Se utiliza para fast y low rates. Mas comúnmente para low rates Pulse generator: its the battery Control center Electrodes Types: -external or transcutaneous (Pads en la piel)– se usa en casos de emergencia -epicardico temporal (se usa en heart surgery) -endocardico temporal (transvenoso) -permanente