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 pacemakers are electronic devices that provide electrical impulses to stimulate the heart and restore or maintain a regular heartbeat. Modern pacemakers are fully programmable and can store patient data. Pacemakers have leads that connect to the pulse generator and heart. Indications for pacemakers include sinus node dysfunction, AV block, and bundle branch block. Follow up is needed after implantation to check for complications like infection or lead issues and reprogram the pacemaker settings.
This document describes equipment, catheters, and basic intervals used in electrophysiology (EP) studies. It discusses radiographic tables, EP equipment like cardiac stimulators and mapping/ablation catheters. Patient preparation includes fasting, IV access, monitoring equipment. EP catheters come in different sizes and have electrodes for recording electrical activity. Basic intervals measured include P wave to atrial interval, atrial-His bundle interval, His-ventricular interval, and sinus node recovery time. Drive train stimulation with single, double, or triple extra stimuli is used. The document continues with further discussions of EP protocols, arrhythmias, ablation, and pre-excitation pathways.
This document provides information about percutaneous transvenous mitral commissurotomy (PTMC), a procedure used to treat mitral stenosis. It discusses the stages and severity of mitral stenosis, indications and contraindications for PTMC, assessment of valve morphology, the PTMC procedure technique, instruments used, balloon size selection, post-procedure evaluation, complications, follow-up care, and long-term prognosis. PTMC is performed to improve the opening of a stenosed mitral valve by splitting the fused commissures using a balloon catheter, and is an important therapeutic option for treating symptomatic mitral stenosis.
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.
The document provides an overview of basic pacing concepts including:
- Types of pacemakers such as single chamber, dual chamber, and triple chamber systems.
- Components of a pacemaker system including the pulse generator, leads, and electrical concepts such as voltage, current, and impedance.
- Factors that can affect pacing thresholds and how to test the pacemaker circuit including identifying high and low impedance conditions.
Cardiac resynchronization therapy (CRT) involves implanting electrodes in the left and right ventricles of the heart to coordinate their contractions and improve heart function in patients with heart failure. CRT works by delivering electrical pulses that resynchronize the timing of the ventricles' contractions. Studies show CRT can improve symptoms, exercise capacity, quality of life and reduce mortality and hospitalizations in heart failure patients. CRT devices include a pacemaker or defibrillator and leads placed in the heart to deliver electrical pulses. Doctors program the devices to optimize timing between the ventricles. CRT is effective for treating ventricular dyssynchrony seen in conditions like left bundle branch block.
Echo assessment of lv systolic function and swmaFuad Farooq
This document discusses various techniques for assessing left ventricular systolic function using echocardiography, including:
- Visual assessment of endocardial motion and wall thickening to evaluate global and regional function
- Quantitative measures like fractional shortening, ejection fraction, and volumes
- Tissue Doppler imaging of mitral annular velocities
- Tissue tracking and strain imaging to evaluate timing and extent of myocardial contraction
- Wall motion scoring to characterize regional abnormalities
This document discusses various implantable cardiac devices including pacemakers, implantable cardioverter-defibrillators (ICDs), cardiac resynchronization therapy (CRT), and cardiac assist devices. It describes the components, indications, and complications of pacemakers and ICDs. It also covers topics such as pacemaker/ICD terminology, programming, interactions with defibrillation, and transcutaneous pacing. Cardiac assist devices are briefly discussed, noting examples like LVADs, BiVADs, and total artificial hearts.
Cardiac pacemakers are electronic devices that provide electrical impulses to stimulate the heart and restore or maintain a regular heartbeat. Modern pacemakers are fully programmable and can store patient data. Pacemakers have leads that connect to the pulse generator and heart. Indications for pacemakers include sinus node dysfunction, AV block, and bundle branch block. Follow up is needed after implantation to check for complications like infection or lead issues and reprogram the pacemaker settings.
This document describes equipment, catheters, and basic intervals used in electrophysiology (EP) studies. It discusses radiographic tables, EP equipment like cardiac stimulators and mapping/ablation catheters. Patient preparation includes fasting, IV access, monitoring equipment. EP catheters come in different sizes and have electrodes for recording electrical activity. Basic intervals measured include P wave to atrial interval, atrial-His bundle interval, His-ventricular interval, and sinus node recovery time. Drive train stimulation with single, double, or triple extra stimuli is used. The document continues with further discussions of EP protocols, arrhythmias, ablation, and pre-excitation pathways.
This document provides information about percutaneous transvenous mitral commissurotomy (PTMC), a procedure used to treat mitral stenosis. It discusses the stages and severity of mitral stenosis, indications and contraindications for PTMC, assessment of valve morphology, the PTMC procedure technique, instruments used, balloon size selection, post-procedure evaluation, complications, follow-up care, and long-term prognosis. PTMC is performed to improve the opening of a stenosed mitral valve by splitting the fused commissures using a balloon catheter, and is an important therapeutic option for treating symptomatic mitral stenosis.
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.
The document provides an overview of basic pacing concepts including:
- Types of pacemakers such as single chamber, dual chamber, and triple chamber systems.
- Components of a pacemaker system including the pulse generator, leads, and electrical concepts such as voltage, current, and impedance.
- Factors that can affect pacing thresholds and how to test the pacemaker circuit including identifying high and low impedance conditions.
Cardiac resynchronization therapy (CRT) involves implanting electrodes in the left and right ventricles of the heart to coordinate their contractions and improve heart function in patients with heart failure. CRT works by delivering electrical pulses that resynchronize the timing of the ventricles' contractions. Studies show CRT can improve symptoms, exercise capacity, quality of life and reduce mortality and hospitalizations in heart failure patients. CRT devices include a pacemaker or defibrillator and leads placed in the heart to deliver electrical pulses. Doctors program the devices to optimize timing between the ventricles. CRT is effective for treating ventricular dyssynchrony seen in conditions like left bundle branch block.
Echo assessment of lv systolic function and swmaFuad Farooq
This document discusses various techniques for assessing left ventricular systolic function using echocardiography, including:
- Visual assessment of endocardial motion and wall thickening to evaluate global and regional function
- Quantitative measures like fractional shortening, ejection fraction, and volumes
- Tissue Doppler imaging of mitral annular velocities
- Tissue tracking and strain imaging to evaluate timing and extent of myocardial contraction
- Wall motion scoring to characterize regional abnormalities
This document discusses various implantable cardiac devices including pacemakers, implantable cardioverter-defibrillators (ICDs), cardiac resynchronization therapy (CRT), and cardiac assist devices. It describes the components, indications, and complications of pacemakers and ICDs. It also covers topics such as pacemaker/ICD terminology, programming, interactions with defibrillation, and transcutaneous pacing. Cardiac assist devices are briefly discussed, noting examples like LVADs, BiVADs, and total artificial hearts.
The history of echocardiography began in the 18th century with discoveries about echo reflection and uses of ultrasonic waves. The first application of ultrasound to examine the heart was in 1953 by Paul Edler and Hellmuth Hertz in Sweden. Edler identified structures like the mitral valve but echocardiography was advanced significantly by Harvey Feigenbaum in the 1960s. The development of real-time 2D echocardiography in the 1960s-1970s, including devices created by Bom, Griffith and Henry, further improved cardiac imaging abilities. Contrast echocardiography was also described in 1968.
1) Pressure tracing of the left ventricle involves using fluid-filled catheters connected to pressure transducers to record intracardiac pressures. Factors such as catheter size, damping, and natural frequency determine recording quality.
2) Sources of error in pressure measurements include catheter whip, end-pressure artifacts, and deterioration of frequency response. Invasive monitoring is useful for evaluating conditions like aortic stenosis and mitral stenosis when noninvasive data is discrepant or unclear.
3) Distinguishing constrictive pericarditis from restrictive cardiomyopathy involves assessing ventricular interdependence, pulmonary pressures, and left ventricular pressure tracings. Hemodynamic data aids in diagnosis and management of many conditions.
BMV,PTMC,BALLOON MITRAL VALVOTOMY, BAL, VIRBHAN BALAI, DR VIRBHANDr Virbhan Balai
This document discusses balloon mitral valvuloplasty (BMV) and balloon aortic valvuloplasty (BAV). It describes the indications for BMV as symptomatic or asymptomatic severe mitral stenosis. The Inoue technique for BMV is explained in detail, including transseptal puncture and sequential balloon inflation. Complications of BMV include severe mitral regurgitation, mortality, and cardiac perforation. BAV was used historically but was abandoned due to high restenosis rates and no improvement in patient survival.
This document discusses coronary guidewires used in percutaneous coronary intervention (PCI). It begins by outlining the history of angioplasty and guidewire development. It then covers the purpose, components, classifications, and appropriate uses of guidewires. The main components include the core, tip, coils, covers, and coatings. Guidewires are classified based on flexibility, device support, and clinical usage. Complications like vessel perforation, pseudolesions, and entrapment are also discussed. Proper guidewire manipulation and strategies for difficult lesions are outlined to maximize safety and efficacy.
A pacemaker is an electronic device that is used to pace the heart when the normal conduction pathway is damaged or diseased. It has three main components: a pulse generator, pacing leads, and healthy myocardium. A pacemaker has three main functions - pacing, sensing, and capture. There are two main types - permanent pacemakers, which are implanted inside the body, and temporary pacemakers, which have an external power source. Pacemakers can operate in either a fixed rate mode, firing constantly, or a demand mode, firing only when the heart rate drops below a preset level. Nursing care for a patient with a pacemaker involves monitoring the heart rate and rhythm, vital signs, bleeding, and infection risk, as
Temporary cardiac pacing is used to treat temporary heart rhythm issues and stabilize the heart until a permanent pacemaker can be implanted. It involves inserting wires through veins or during heart surgery to connect to the heart and deliver electrical stimulation from an external pulse generator. Temporary pacing can be used for days or weeks to treat bradyarrhythmias or tachyarrhythmias until the underlying cause is resolved or a permanent pacemaker is needed. The external pulse generator is monitored closely and dressing changes are required to prevent infection at the insertion site while the temporary pacing is in place.
Stress echocardiography uses ultrasound imaging during exercise or pharmacologic stress testing to detect ischemia-induced changes in heart wall motion. It has several advantages over nuclear stress testing including better visualization of cardiac structures and no radiation exposure. Various stress agents can be used including exercise, dobutamine, dipyridamole, and adenosine. Detection of new or worsening wall motion abnormalities or improvement after revascularization indicates viable myocardium. Factors like image quality, timing of acquisition, and operator experience can impact test sensitivity. Stress echo is an established technique for diagnosing coronary artery disease and assessing myocardial viability.
Catheters used in Angiography & angioplastySatya Shukla
Guide catheters are essential tools for Pecutaneous
Coronary Intervention
• Understanding construction, design & performance
characteristics facilitate their appropriate selection
• Selection of Guide catheters seems elementary but
makes the difference between a successful and failed
PCI procedure
This document discusses ECG artifacts and pitfalls in interpretation. It outlines 10 commandments for proper ECG acquisition to avoid artifacts. Artifacts are classified as internal (physiological) or external (non-physiological). Common artifacts include limb and precordial lead reversals, tremor artifact, computer averaging errors, and electromagnetic interference. Differentiating artifacts from true arrhythmias like ventricular tachycardia is important. Characteristics that can help differentiate include absence of hemodynamic effects, normal complexes within the artifact, and association with movement. Proper electrode placement and equipment grounding can help reduce artifact occurrence.
The document provides an overview of pacemaker components, physiology, and programming. It discusses the basic hardware components of pacemakers including the pulse generator, leads, and electrodes. It then covers pacing and sensing principles such as capture, impedance, and sensing thresholds. The remainder summarizes various pacing modes and algorithms for managing arrhythmias, rate response, and minimizing ventricular pacing.
This document summarizes the echocardiographic assessment of mitral stenosis (MS). It describes the anatomy of the mitral valve and causes of MS. Methods for assessing MS severity include measuring the pressure gradient, mitral valve area using planimetry and pressure half-time, and pulmonary artery pressure. Suitability for percutaneous transvenous mitral commissurotomy is evaluated. Concomitant valve lesions are also identified. Stress echocardiography may be used when symptoms are equivocal. Transesophageal echocardiography is recommended in some cases.
Pacemakers are electronic devices that initiate heartbeats when the heart's intrinsic electrical system cannot generate an adequate heart rate. They are indicated for slow heart rates that cause hemodynamic compromise, such as sick sinus syndrome or heart block. Pacemakers have a pulse generator and pacing leads that are placed transvenously, usually in the right ventricle. They sense intrinsic cardiac activity and pace the heart if needed, with functions including sensing, pacing, and adjustable settings for rate, output, and sensitivity. Complications can include infection, arrhythmias, and loss of capture.
Electrophysiologic studies use pacing techniques like programmed electrical stimulation (PES) to evaluate cardiac properties. PES involves pacing the heart with drive trains and extrastimuli to measure refractory periods, conduction dynamics, and induce arrhythmias. Pacing can be unipolar or bipolar, and incremental, decremental, or with extrastimuli. Refractory periods like the effective refractory period and relative refractory period are measured using premature extrastimuli during pacing. These techniques provide important information about normal cardiac function and arrhythmia mechanisms.
This document provides an overview of cardiac catheterization procedures. It discusses indications, contraindications, techniques, views obtained, and interpretation of pressure waveforms. Key points include that cardiac catheterization guides treatment decisions by measuring pressures, outputs, and obtaining images. It is now often used therapeutically for procedures like angioplasty and device closures. The document outlines patient preparation, access methods, catheters used, views obtained, and complications that can occur.
This document provides an overview of cardiac pacemakers, including:
- A brief history of the development of pacemakers from the first implant in 1958 to modern devices.
- The components, functions, and types of pacemakers including single vs dual chamber and permanent vs temporary pacing.
- Measurements taken during pacemaker implantation like impedance, sensing threshold, and pacing threshold to ensure proper function.
- Modes of pacing like VVI, DDD and indications for different modes. Potential complications of pacemaker therapy are also outlined.
The document serves as an introduction to pacemaker terminology, components, functions and the implantation process.
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.
The document summarizes cardiovascular physiology and the anatomy of the heart. It describes that the heart is composed of three layers and two main cell types: autorhythmic cells and contractile cardiac muscle cells. Autorhythmic cells form the intrinsic conductive system and initiate electrical impulses, while contractile cells contract in response to electrical signals. Gap junctions electrically couple the cells so that the myocardium contracts in a coordinated manner. Other topics covered include the cardiac cycle, factors regulating heart rate and stroke volume, and how cardiac output is calculated.
Denoising of ECG -- A discrete time approach using DWTIJERA Editor
This paper is about denoising of ECG signal using DWT transform. In this paper, ECG signals are denoised using DWT transform.Ecg signals are taken and noise at different frequencies are generated which are superimposed on this original ecg signal.High frequency noise is of 4000 hertz and power line interference is of 50 hertz.Decomposition of noisy signal is achieved through wavelet packet .wavelet packets are reconstructed and appropriate wavelet packets are combined to obtain a signal, very similar to original ecg signal.This technique results in the minimization of mean square error in the filtered signals.
The history of echocardiography began in the 18th century with discoveries about echo reflection and uses of ultrasonic waves. The first application of ultrasound to examine the heart was in 1953 by Paul Edler and Hellmuth Hertz in Sweden. Edler identified structures like the mitral valve but echocardiography was advanced significantly by Harvey Feigenbaum in the 1960s. The development of real-time 2D echocardiography in the 1960s-1970s, including devices created by Bom, Griffith and Henry, further improved cardiac imaging abilities. Contrast echocardiography was also described in 1968.
1) Pressure tracing of the left ventricle involves using fluid-filled catheters connected to pressure transducers to record intracardiac pressures. Factors such as catheter size, damping, and natural frequency determine recording quality.
2) Sources of error in pressure measurements include catheter whip, end-pressure artifacts, and deterioration of frequency response. Invasive monitoring is useful for evaluating conditions like aortic stenosis and mitral stenosis when noninvasive data is discrepant or unclear.
3) Distinguishing constrictive pericarditis from restrictive cardiomyopathy involves assessing ventricular interdependence, pulmonary pressures, and left ventricular pressure tracings. Hemodynamic data aids in diagnosis and management of many conditions.
BMV,PTMC,BALLOON MITRAL VALVOTOMY, BAL, VIRBHAN BALAI, DR VIRBHANDr Virbhan Balai
This document discusses balloon mitral valvuloplasty (BMV) and balloon aortic valvuloplasty (BAV). It describes the indications for BMV as symptomatic or asymptomatic severe mitral stenosis. The Inoue technique for BMV is explained in detail, including transseptal puncture and sequential balloon inflation. Complications of BMV include severe mitral regurgitation, mortality, and cardiac perforation. BAV was used historically but was abandoned due to high restenosis rates and no improvement in patient survival.
This document discusses coronary guidewires used in percutaneous coronary intervention (PCI). It begins by outlining the history of angioplasty and guidewire development. It then covers the purpose, components, classifications, and appropriate uses of guidewires. The main components include the core, tip, coils, covers, and coatings. Guidewires are classified based on flexibility, device support, and clinical usage. Complications like vessel perforation, pseudolesions, and entrapment are also discussed. Proper guidewire manipulation and strategies for difficult lesions are outlined to maximize safety and efficacy.
A pacemaker is an electronic device that is used to pace the heart when the normal conduction pathway is damaged or diseased. It has three main components: a pulse generator, pacing leads, and healthy myocardium. A pacemaker has three main functions - pacing, sensing, and capture. There are two main types - permanent pacemakers, which are implanted inside the body, and temporary pacemakers, which have an external power source. Pacemakers can operate in either a fixed rate mode, firing constantly, or a demand mode, firing only when the heart rate drops below a preset level. Nursing care for a patient with a pacemaker involves monitoring the heart rate and rhythm, vital signs, bleeding, and infection risk, as
Temporary cardiac pacing is used to treat temporary heart rhythm issues and stabilize the heart until a permanent pacemaker can be implanted. It involves inserting wires through veins or during heart surgery to connect to the heart and deliver electrical stimulation from an external pulse generator. Temporary pacing can be used for days or weeks to treat bradyarrhythmias or tachyarrhythmias until the underlying cause is resolved or a permanent pacemaker is needed. The external pulse generator is monitored closely and dressing changes are required to prevent infection at the insertion site while the temporary pacing is in place.
Stress echocardiography uses ultrasound imaging during exercise or pharmacologic stress testing to detect ischemia-induced changes in heart wall motion. It has several advantages over nuclear stress testing including better visualization of cardiac structures and no radiation exposure. Various stress agents can be used including exercise, dobutamine, dipyridamole, and adenosine. Detection of new or worsening wall motion abnormalities or improvement after revascularization indicates viable myocardium. Factors like image quality, timing of acquisition, and operator experience can impact test sensitivity. Stress echo is an established technique for diagnosing coronary artery disease and assessing myocardial viability.
Catheters used in Angiography & angioplastySatya Shukla
Guide catheters are essential tools for Pecutaneous
Coronary Intervention
• Understanding construction, design & performance
characteristics facilitate their appropriate selection
• Selection of Guide catheters seems elementary but
makes the difference between a successful and failed
PCI procedure
This document discusses ECG artifacts and pitfalls in interpretation. It outlines 10 commandments for proper ECG acquisition to avoid artifacts. Artifacts are classified as internal (physiological) or external (non-physiological). Common artifacts include limb and precordial lead reversals, tremor artifact, computer averaging errors, and electromagnetic interference. Differentiating artifacts from true arrhythmias like ventricular tachycardia is important. Characteristics that can help differentiate include absence of hemodynamic effects, normal complexes within the artifact, and association with movement. Proper electrode placement and equipment grounding can help reduce artifact occurrence.
The document provides an overview of pacemaker components, physiology, and programming. It discusses the basic hardware components of pacemakers including the pulse generator, leads, and electrodes. It then covers pacing and sensing principles such as capture, impedance, and sensing thresholds. The remainder summarizes various pacing modes and algorithms for managing arrhythmias, rate response, and minimizing ventricular pacing.
This document summarizes the echocardiographic assessment of mitral stenosis (MS). It describes the anatomy of the mitral valve and causes of MS. Methods for assessing MS severity include measuring the pressure gradient, mitral valve area using planimetry and pressure half-time, and pulmonary artery pressure. Suitability for percutaneous transvenous mitral commissurotomy is evaluated. Concomitant valve lesions are also identified. Stress echocardiography may be used when symptoms are equivocal. Transesophageal echocardiography is recommended in some cases.
Pacemakers are electronic devices that initiate heartbeats when the heart's intrinsic electrical system cannot generate an adequate heart rate. They are indicated for slow heart rates that cause hemodynamic compromise, such as sick sinus syndrome or heart block. Pacemakers have a pulse generator and pacing leads that are placed transvenously, usually in the right ventricle. They sense intrinsic cardiac activity and pace the heart if needed, with functions including sensing, pacing, and adjustable settings for rate, output, and sensitivity. Complications can include infection, arrhythmias, and loss of capture.
Electrophysiologic studies use pacing techniques like programmed electrical stimulation (PES) to evaluate cardiac properties. PES involves pacing the heart with drive trains and extrastimuli to measure refractory periods, conduction dynamics, and induce arrhythmias. Pacing can be unipolar or bipolar, and incremental, decremental, or with extrastimuli. Refractory periods like the effective refractory period and relative refractory period are measured using premature extrastimuli during pacing. These techniques provide important information about normal cardiac function and arrhythmia mechanisms.
This document provides an overview of cardiac catheterization procedures. It discusses indications, contraindications, techniques, views obtained, and interpretation of pressure waveforms. Key points include that cardiac catheterization guides treatment decisions by measuring pressures, outputs, and obtaining images. It is now often used therapeutically for procedures like angioplasty and device closures. The document outlines patient preparation, access methods, catheters used, views obtained, and complications that can occur.
This document provides an overview of cardiac pacemakers, including:
- A brief history of the development of pacemakers from the first implant in 1958 to modern devices.
- The components, functions, and types of pacemakers including single vs dual chamber and permanent vs temporary pacing.
- Measurements taken during pacemaker implantation like impedance, sensing threshold, and pacing threshold to ensure proper function.
- Modes of pacing like VVI, DDD and indications for different modes. Potential complications of pacemaker therapy are also outlined.
The document serves as an introduction to pacemaker terminology, components, functions and the implantation process.
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.
The document summarizes cardiovascular physiology and the anatomy of the heart. It describes that the heart is composed of three layers and two main cell types: autorhythmic cells and contractile cardiac muscle cells. Autorhythmic cells form the intrinsic conductive system and initiate electrical impulses, while contractile cells contract in response to electrical signals. Gap junctions electrically couple the cells so that the myocardium contracts in a coordinated manner. Other topics covered include the cardiac cycle, factors regulating heart rate and stroke volume, and how cardiac output is calculated.
Denoising of ECG -- A discrete time approach using DWTIJERA Editor
This paper is about denoising of ECG signal using DWT transform. In this paper, ECG signals are denoised using DWT transform.Ecg signals are taken and noise at different frequencies are generated which are superimposed on this original ecg signal.High frequency noise is of 4000 hertz and power line interference is of 50 hertz.Decomposition of noisy signal is achieved through wavelet packet .wavelet packets are reconstructed and appropriate wavelet packets are combined to obtain a signal, very similar to original ecg signal.This technique results in the minimization of mean square error in the filtered signals.
Denoising of ECG -- A discrete time approach using DWT.IJERA Editor
This paper is about denoising of ECG signal using DWT transform. In this paper, ECG signals are denoised using DWT transform.Ecg signals are taken and noise at different frequencies are generated which are superimposed on this original ecg signal.High frequency noise is of 4000 hertz and power line interference is of 50 hertz.Decomposition of noisy signal is achieved through wavelet packet .wavelet packets are reconstructed and appropriate wavelet packets are combined to obtain a signal, very similar to original ecg signal.This technique results in the minimization of mean square error in the filtered signals.
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 arrhythmias and abnormalities by providing examples of different arrhythmia patterns and their corresponding ECG presentations. The document is intended to educate medical practitioners and students on electrocardiogram basics and interpretation.
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.
The document summarizes the electrical conduction system of the heart and electrocardiography. It describes the key components of the cardiac conduction system including the sinoatrial node, atrioventricular node, bundle of His, bundle branches, and Purkinje fibers. It explains the phases of the cardiac action potential and how electrocardiography is used to record and assess the heart's electrical activity through the placement of electrodes on the skin and analysis of waves in the electrocardiogram.
The cardiac action potential normally originates in the sinoatrial node and is then conducted throughout the heart in a specific sequence. The action potential causes cardiac muscle cells to contract. In cardiac muscle, the action potential has a long plateau phase due to calcium ion influx through L-type calcium channels. This calcium triggers further calcium release from the sarcoplasmic reticulum, initiating muscle contraction. The cardiac action potential has distinct phases including upstroke, initial repolarization, plateau, final repolarization, and resting potential.
this is dealt about the pacemaker temporary and permanent its aim and basic indication for pacemaker breif history of pacemaker development its design and detailed indication of both temporary and permanent pacemaker then method of pacing which should be based on the patient ECG its parts and procedure and complication
This document provides information about heart block, including its definition, types, causes, characteristics, and significance. It begins with an introduction to heart block and the electrical conduction system of the heart. It then defines and describes the three types of heart block - first, second, and third degree heart block - and provides details about their characteristics, causes, and clinical significance. Mobitz types I and II are discussed as subtypes of second degree heart block. The document aims to explain heart block and its different classifications to nursing students.
ORIGIN OF THE HEARTBEAT & THE ELECTRICAL ACTIVITY OF THE HEART.pptxshreya730959
The heartbeat originates in the sinoatrial (SA) node, which acts as the heart's natural pacemaker. Impulses from the SA node spread through the conduction system to the atria and ventricles. The SA node discharges spontaneously at the fastest rate, setting the heartbeat. Impulses pass from the SA node through the atria to the atrioventricular (AV) node and bundle of His, then via Purkinje fibers to ventricular muscle. Vagal stimulation slows the heartbeat by inhibiting the SA and AV nodes, while sympathetic stimulation increases the heart rate by facilitating impulse propagation. Digitalis depresses the conduction system like vagal stimulation and is used clinically to improve heart function and control
The cardiac conduction system generates and coordinates the contraction of the heart muscle. It is made up of specialized cardiac muscle cells located in the sinoatrial node, atrioventricular node, bundle of His, and Purkinje fibers. The sinoatrial node initiates each heartbeat by spontaneously generating an electrical impulse. This impulse then travels through the internodal pathways and atria to the atrioventricular node, which slows conduction before passing the impulse to the ventricles via the bundle of His and Purkinje fibers, causing synchronized ventricular contraction and pumping of blood. Defects or damage to the conduction system can lead to cardiac arrhythmias.
Artificial Cardiac pacemaker |medical device that generates electrical impulses NEHA MALIK
A pacemaker is a device that sends small electrical impulses to the heart muscle to maintain a suitable heart rate or to stimulate the lower chambers of the heart (ventricles). A pacemaker may also be used to treat fainting spells (syncope), congestive heart failure and hypertrophic cardiomyopathy.
The document summarizes the anatomy and physiology of the cardiac conduction system and mechanisms of arrhythmia formation. It describes:
1) The key structures of the cardiac conduction system including the sinoatrial node, atrioventricular node, bundle of His, bundle branches and Purkinje fibers.
2) The electrophysiology of the cardiac action potential and the roles of ion channels and intracellular calcium handling.
3) The two main mechanisms that can cause arrhythmias - disorders of impulse formation from abnormal automaticity or triggered activity, and disorders of impulse conduction from conduction block or reentry. Abnormalities in calcium regulation are implicated in several arrhythmia conditions.
The cardiac conduction system sends signals through specialized cardiac muscle cells to coordinate the rhythmic contraction of the heart. It includes the sinoatrial node, atrioventricular node, bundle of His, and Purkinje fibers. The sinoatrial node acts as the pacemaker by spontaneously generating electrical impulses that spread through the internodal pathways and cause the atria to contract. The impulse then travels to and through the atrioventricular node and bundle of His before reaching the Purkinje fibers, which trigger fast, coordinated ventricular contraction.
The cardiovascular system consists of the heart and circulation, which transports blood throughout the body. The heart is a double pump with four chambers that uses electrical signals and muscle contraction to circulate blood in two loops. Cardiac muscle cells generate action potentials via ion channels that trigger coordinated contractions and allow the heart to function as a syncytium. The cardiac cycle is regulated to supply the body's needs.
Pacemakers are electronic devices that are implanted to initiate heartbeat when the heart's intrinsic electrical system cannot generate an adequate rate. They consist of a pulse generator, leads, and electrodes. Pacemakers have evolved significantly from early external and bulky models to current miniaturized implantable devices with enhanced functions. Nursing care involves assessing for pacemaker function and complications as well as educating patients.
The document provides information about electrocardiography (ECG), including how an ECG works, the parts of an ECG recording, how to position a patient, standardization of readings, the 12 standard ECG leads and additional leads, artifacts that can appear on readings, abnormalities in cardiac rhythm including extrasystoles, tachycardias and fibrillations, and bibliographic references. It describes the device used, details of the recording paper, how leads are obtained and interpreted, and classifications of different cardiac arrhythmias and their characteristics on ECG readings.
The document discusses the electrical activity of the heart, including:
1) Cardiac action potentials are longer than skeletal muscle potentials, allowing the heart to contract as a whole rather than through summation.
2) Depolarization during a cardiac action potential results from an increase in sodium conductance, followed by a plateau phase from high calcium conductance.
3) Excitation spreads from the pacemaker region through gap junctions between cardiomyocytes, traveling through specialized conduction pathways to coordinate atrial and ventricular contractions.
4) The electrocardiogram reflects the summed electrical activity of the heart, with distinct waves associated with atrial and ventricular depolarization and repolarization.
Heart’s pace maker, the sinoatrial nodeMinhaz Ahmed
This document summarizes the sinoatrial node, which acts as the heart's natural pacemaker by generating electrical impulses that trigger contractions. It is located in the right atrium and contains specialized cardiomyocytes. These cells use resting potential, depolarization, and repolarization to generate action potentials that conduct through the heart's conduction system and cause coordinated contractions of the atria and ventricles. If the sinoatrial node fails, secondary pacemakers in the atrioventricular node or bundle of His can maintain a slower heart rate. An artificial pacemaker can also regulate heart rate electrically if the natural pacemaker is insufficient.
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
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6. DEFINITION:
A CARDIAC PACEMAKER IS AN ELECTRONIC DEVICE,
THAT DELIERS, DIRECT ELECTRICAL STIMULATION TO
STIMULATE THE MYOCARDIUM TO DEPOLARIZE,
INITIATING A MECHANICAL CONTRACTION.
THE PACEMAKER INITIATES AND MAINTAINS THE HEART
RATE WHEN THE HEART’S NATURAL PACEMAKER IS
UNABLE TO DO SO.
7. TYPES OF PACEMAKERS:
PERMANENT PACEMAKERS:
SURGICALLY PLACED
LEADS ARE PLACED TRANVENOUSLY, IN APPROPRIATE CHAMBER
OF THE HEART, AND THEN ANCHORED TO THE ENDOCARDIUM
PULSE GENERATOR PLACE IN A POCKET IN THE SUBCUTANEOUS
TISSUE UNDER THE CLAVICLE OR ABDOMEN.
MOSTLY USED FOR LONG-TERM , PATIENTS WITH CHRONIC HEART
CONDITIONS.
9. METHODS OF PLACEMENT OF A
TEMPORARY PACEMAKER:
TRANSVENOUS PACEMAKERS:
INSERTED TRANSVENOUSLY( USUALLY
SUBCLAVIAN, INTERNAL JUGULAR,
ANTECUBITAL OR FEMORAL), INTO THE
RIGHT VENTRICLE( OR RIGHT ATRIUM)
AND RIGHT VENTRICLE FOR DUAL-
CHAMBER PACING. AND THEN ATTACHED
TO AN EXTERNAL PULSE GENERATOR.
PROCEDURE DONE BEDSIDE OR UNDER
FLUROSCOPY.
10. EPICARDIAC PACEMAKERS:
IN THIS CASE, THE WIRES ARE
ATTACHED TO THE ENDOCARDIUM,
AND ARE BROUGHT OUT THROUGH
A SURGICAL INCISION IN THE
THORAX.
THESE WIRES ARE CONNECTED TO
AN EXTERNAL PULSE GENERATOR.
COMMONLY SEEN AFTER CARDIAC
SURGERY.
12. TRANSCUTANEOUS PACING:
NON- INVASIVE, MULTIFUNCTIONAL, ELECTRODE PADS ARE PLACED.
PLACEMENT: ANTERIOR- POSTERIORLY, ANTERIOR- LATERALLY
MULTIFUNCTIONAL ELECRODE PADS ARE THEN CONNECTED TO AN
EXTERNAL SOURCE( DEFIBRILLATOR WITH PACING ABILITY).
THE EXTERNAL IMPULSE FLOWS THROUGH THE ELECTRODE PADS
AND SUBCUTANEOUS SKIN TO THE HEART.
THUS PACING THE HEART.
13. TRANSTHORACIC PACING:
PLACED IN EMERGENCY, VIAA
LONG NEEDLE, USING A
SUBXYPHOID APPROACH.
THE WIRE IS THEN PLACED
DIRECTLY INTO THE RIGHT
VENTRICLE.
14. BIVENTRICULAR PACEMAKERS:
ALSO KNOWN AS CARDIAC RESYNCHRONIZATION.
USED TO TREAT MODERATE TO SEVERE HEART FAILURE AS A RESULT
OF LEFT VENTRICULAR DYSSYNCHRONY.
INTRAVENTRICULAR CONDUCTION DEFECTS RESULT IN AN
UNCORDINATED CONTRACTION OF THE LEFT AND RIGHT
VENTRICLE, WHICH CAUSES A WIDE QRS COMPLEX AND IS
ASSOCIATED WITH WORSENING HEART FAILURE AND MORTALITY.
BIVENTRICULAR PACEMAKERS CAN INCORPORATE IMPLANTABLE
CARDIO-VERTER DEFIBRILLATORS OR CAN BE USED ALONE.
18. PULSE GENERATOR:
IT CONSISTS OF A CIRCUITRY AND BATTERIES.
IN A PPI, IT IS ENCAPSULATED IN A METAL BOX, EMBEDDED UNDER THE
SKIN.
THE BOX PROTECTS THE GENERATOR FROM ELECTROMAGNETIC
INTERFERENCE AND TRAUMA.
PPI USE LITHIUM BATTRIES. LIFE SPAN= 8-12 YRS.
IN A TPM, THE GENERATOR IS A SMALL BOX WITH DIALS FOR
PROGRAMMING.TRANSCUTANEOUS PACING SYSTEMS, USE EXTERNAL
SOURCE LIKE DEFIBRILLATOR WITH PACING ACTIVITY.
TPM USE BATTERIES WHICH NEED REPLACEMENT AS PER THE USE OF THE
DEVICE.
TRANSCUTANEOUS SYSTEMS USE RECHARGEABLE BATTERY CIRCUITRY.
20. TYPES OF PACEMAKER LEADS:
SINGLE CHAMBER PACEMAKER:
1 LEAD, EITHER IN ATRIAL OR
VENTRICULAR CHAMBER.
SENSING AND PACING FUNCTIONS
ARE CONFINED TO THE CHAMBER
WHERE THE LEAD IS PLACED.
21. CONTD..
DUAL- CHAMBER PACEMAKER:
2 LEADS
ONE LEAD IN ATRIUM, OTHER IN
VENTRICLE.
PACING AND SENSING OCCUR IN
BOTH HEART CHAMBERS, MIMICKING
THE PHYSIOLOGICAL PACING.
23. CONTD..
IN SINGLE RIGHT VENTRICLE PACING, THERE IS SLIGHT DELAY OF THE
LEFT VENTRICLE CONTRACTING, AS THE ELECTRICAL IMPULSE BEGINS IN
THE RIGHT VENTRICLE AND MOVES IN THE LEFT VENTRICLE, GIVING A
LEFT BUNDLE BRANCH BLOCK APPEARANCE.
BY PACING BOTH VENTRICLES AT THE SAME TIME,THE PACEMAKER CAN
RESYNCHRONIZE THE HEART.
24. CONTD..
APPROACH:
LEADS MAY BE INSERTED VIAA VEIN, INTO THE RT. ATRIUM/ RT.
VENTRICLE, OR DIRECT PENETRATION INTO THE CHEST WALLAND
ATTACHED TO THE LT. VENTRICLE OR RT. ATRIUM.
FIXATION DEVICE:
LOCATED AT THE END OF THE PACEMAKER LEAD, ALLOW FOR
SECURE ATTACHMENT TO THE HEART, REDUCING THE POSSIBILITY OF
LEAD DISLODGEMENT.
TEMPORARY LEADS:
CONNECTED TO EXTERNAL PULSE GENERATOR AND
PROTRUDEFROM THE INCISION.PERMANENT LEADS ARE CONNECTED
TO PULSE GENERATOR IMPLANTED UNDER THE SKIN.
25. INDICATIONS:
SYMPTOMATIC BRADYDYSRTHYTHMIAS.
SINUS BRADYCARDIA DUE TO DRUG THERAPY.
HEART BLOCK
HYPERSENSITIVE CAROTID SINUS SYNDROME AND NEUROCARDIOGENIC
SYNCOPE.
PROPHYLAXIS( PRIOR CARDIAC SX, POST ACUTE MI)
DIAGNOSTIC TESTS:
CARDIAC CATHETERIZATION
PTCA/ STRESS TEST/ PRIOR TO PERMANENT PACING
TACHYDYSRHYTHMIAS( SVT, VT)
26. FUNCTIONS OF A PACEMAKER:
CARDIAC PACING STIMULATES EITHER THE ATRIUM, VENTRICLE OR
BOTHIN SEQUENCE, AND INITIATES ELECTRICAL DEPOLARIZATION AND
CARDIAC CONTRACTIONS.
CARDIAC CONTRACTIONS ARE EVEDENCED ON THE ECG BY THE
PRESENCE OF “A SPIKE”, OR “PACING ARTIFACT”.
27. PACING FUNCTIONS:
1. ATRIAL PACING:
DIRECT STIMULATION OF THE RT.
ATRIUM, PRODUCING A “SPIKE” ON
THE ECG PRECEDING A P WAVE.
28. 2. VENTRICULAR PACING:
DIRECT STIMULATION TO OF THE
RIGHT OR LEFT VENTRICLE
PRODUCING A “SIPKE”, ON THE ECG
PRECEEDING A QRS COMPLEX.
29. 3. AV PACING:
DIRECT STIMULATION TO THE RIGHT
ATRIUM, AND EITHER VENTRICLE IN
SEQUENCE; MIMICS NORNAL
CARDIAC CONDUCTION, ALLOWING
THE ATRIA TO CONTRACT
BEFORETHE VENTRICLES TO
INCREASE CARDIAC OUTPUT.
30. SENSING FUNCTIONS:
CARDIAC PACEMAKERS SENSE THE INTRINSIC CARDIAC ACTIVITY.
1. DEMAND:
ABILITY TO “ SENSE” INTRINSIC CARDIAC ACTIVITY AND DELIVER A PACING
STIMULUS ONLY IF THE HEART RATE FALLS BELOW THE PRESET RATE.
2. FIXED:
NO ABILITY TO “SENSE” INTRINSIC CARDIAC ACTIVITY. THE PACEMAKER CANT “”
WITH THE HEARTS NATURAL ACTIVITY AND CONTINOUSLY DE LIVERS ASYNCHRONIZE
PACING STIMULUS AT A PRESET RATE.
3. TRIGGERED:
ACTIVITY TO DELIVER PACING STIMULI IN A RESPONSE TO “ SENSING” A
CARDIAC EVENT.
31. CONTD..
1. “SEES”---ATRIAL ACTIVITY AND DELIVERS A PACING SPIKE TO THE VENTRICL
AFTER AN APPROPRIATE DELAY(0.16 SEC).
2. MAINTAIN AV SYNCHRONY AND INCREASE HEART RATE BASED ON INCREASES
IN THE BODY DEMANDS,THAT OCCUR DURING EXERCISE OR DURING STRESS.
3. “PHYSIOLOGICAL” SENSORSARE BEING DEVELOPED AS ALTERNATIVES TO
“TRIGGER” A VENTRICULAR RESPONSE BECAUSE MANY PATIENTS HAVE ATRIAL
DYSFUNCTION.
4. “ SENSOR- DRIVEN” RATE RESPONSIVE PACEMAKERS DO NOT SENSE ATRIAL
ACTIVITY, A TRIGGERED VENTRICULAR BEAT OCCURS WHEN THE PACEMAKER
SENSES EITHER INCREASE IN MUSCLE ACTIVITY, TEMPERATURE, O2
UTILIZATION,OR CHANGES IN BLOOD PH.
32. CAPTURE FUNCTIONS:
THE PACEMAKERS ABILITY TO GENERATE A RESPONSE FROM THE HEART
(CONTRACTION), AFTER ELECTRICAL STIMULATION IS REFFERED TO AS
CAPTURE.
CAPTURE IS DETERMINED BY THE STRENGTH OF THE ELECTRICAL
STIMULUS, MEASURED IN mA, THE AMOUNT OF TIME THE STIMULUS IS
APPLIED T THE HEART AND BY CONTACT OF THE DISTAL TIP OF THE
PACING LEAD TO THE MYOCARDIAL TISSUE.
(A) ELECTRICAL: INDICATED BY A P WAVE OR QRS FOLLOWED BY A
PACEMAKER SPIKE.
(B) MECHANICAL: PALPABLE PULSE CORRESPONDING TO THE ELECTRIC
EVENT.
34. PACEMAKER CODES:
THE INTESOCIETY COMMISSION FOR HEART DISEASE(ICHD) HAS
ESTABLISHED A 5- LETTER CODE TO DESCRIBE THE NORMAL FUNCTIONIN
OF THE PACE MAKER
35.
36. COMPLICATIONS:
1. ASYSTOLE FOLLOWING ABRUPT CESSATION OF PACING.
2. ACCELARATION OF EXISTING TACCHYCARDIABOR FIBRILLATION.
3. DISCONNECTION OF LEAD SYSTEM.
4. BREACH IN THE LEAD SYSTEM– THUS CAUSING LOSS OF CAPTURE OR
SENSING---- CAUSING FIBRILLATION--- PERICARDITIS.
37. RESEARCH:
Johns Hopkins heart researchers are unravelling the mystery of how a
modified pacemaker used to treat many patients with heart failure, known
as cardiac resynchronization therapy (CRT), is able to strengthen the heart
muscle while making it beat in a coordinated fashion.
The researchers also identified an enzyme that mimics this effect of CRT
without use of the device.
By studying isolated muscle tissue and muscle cells, they examined the
relationship between contraction and the calcium that triggers it. In the
hearts that beat out of sync, force from the muscle cells and the level of
calcium needed to generate contractions were very much reduced. CRT
improved contraction force more than calcium, and this led to the
discovery that CRT had increased the sensitivity of the muscle to calcium.
38. CONTD..
Working with heart muscle and isolated cells from the same animal
models, the researchers found that the enzyme turned out to be GSK-3
beta, which was able to convert the behavior of muscle cells from a heart
that was beating out of sync to what looked like heart cells that had
received CRT, essentially mimicking the effect of CRT.
GSK-3 beta was inactive in muscle from a failing and dyssynchronous
heart, it was reactivated by CRT. When that happened, the enzyme altered
the motor proteins so that they generated greater force using the same
amount of calcium- based activation.
Nearly all existing medications for heart failure increase heart contraction
by enhancing levels of calcium available to muscle cells, but over time,
these higher levels can be toxic to the heart.
39. RESEARCH 2:
. In a study published in 2011, Kass and colleagues also showed that CRT
enables heart muscle to respond to hormones, such as adrenaline, which
stimulates pumping ability, in a similar way to what happens during
exercise.
40. ASSIGNMENT:
“A”
TACHYDYSRHYTHMIA
DISCONNECTION OF LEAD
INTERSOCIETY COMMISSION FOR
HEART DISEASE.
ONE LEAD IN RA, RV LV
SPIKE ON ECG PRECEEDING QRS
COMPLEX
5mA
“B”
BIVENTRICULAR PACEMAKER
OUTPUT OF TEMPORARY
PACEMAKER
SVT AND VT
COMPLICATION OF PACEMAKER
PACEMAKER CODES
VENTRICULAR PACING.
TRIGGER FUNCTION
41. BIBLIOGRAPHY:
NETTINA M. SANDRA, LIPPINCOTT MANUAL OF NURSING PRACTICE, 10TH
EDITION, WOLTERS KLUWER (INDIA), PVT LTD, NEW DELHI, 2014, PG NO:
248-256.
BLACK M. JOYCE, HAWKS HOKANSON JANE, MEDICAL- SURGICAL
NURSING: CLINICAL MANAGEMENT OF POSITIVE OUTCOME, 7TH EDITION,
SAUNDERS ELSEIVER PUBLICATIONS, NEW DELHI, 2005, PG NO: 1548-
1559.
SCHEETZ LINDA, EDITOR, CRITICAL CARE NURSING SECRETS, NEW JERSEY,
MOSBY, 2006, PG NO:28-34.
JACOB ANNAMMA, EDITOR, CRITICAL CARE PROCEDURE: THE ART OF
NURSING PRACTICE, 2ND EDITION, NEW DELHI, JAYPEE BROTHERS
MEDICAL PUBLISHERS, 2010, PG NO: 381-386.
INTERNET SOURCES: www.emedicine.Medscape.com
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