The pacemaker

1. The Pacemaker
Presented by :
Mahmoud Ali Ebada 51015325
 Supervised by :
Dr. Doaa Talhaa
& Eng.Nada Hegazy
& Eng. Abdallah Samir
FACULTY ALLIED OF MEDICAL SCIENCE
REGULATION OF MEDICAL DEVICES AND
DAIGNOSTICS
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2. What is a pacemaker?
• A pacemaker (or artificial pacemaker) is a
medical device which uses electrical impulses,
delivered by electrodes contracting the heart
muscles, to regulate the beating of the heart
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4. History of pacemakers
• In 1838 Carlo Matteucci a Professor of Physics
at the University of Pisa - discovered that an
electric current accompanies each heartbeat.
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5. • 1926- Dr. Albert Hyman created an
electromechanical instrument which many
believe may be the first successful pacemaker
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6. • 1950 a Canadian electrical engineer - John
Hopps paired with Dr. Wilfred Bigelow
• The new pacemaker was a great advancement
but still had some shortcomings like large and
heavy
• The externally placed electrode sent electric
impulses great deal of pain for the patient.
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7. • 1951-Dr. Paul Zoll a cardiologist from Boston
The pacemaker used modern transistors but
still was large, heavy and relied on AC power.
• In 1957 - A part time TV repairmen Earl
Bakken.,developed a smaller pacemaker that
could be worn around the neck
• Less pain for patients,he leads were surgically
attached to the outside of the myocardium.
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8. • In 1956 bekkan read an article related to
amplification of sound
• He started to work on amplification of battery
for the power to pacemaker
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9. • Created pacemaker with mercury battery
that supplied 9.4 volts and co founded
medtronics company
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10. • After these period with the size of
pacemakers and the short battery life,
the idea of implanting a pacemaker into
a patient was unthinkable
• Greatbatch -an electrical engineer
founded a implanting pacemaker
• Greatbatch joined with medtronics and
created lithium iodine battery that still
using in pacemakers
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11. • In 1958 Dr. Ake Senning and team done
first succesful pacemaker implantation to a
patient named “Arne larsson with stoke –
adam syndrome
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12. • There was some problems with pacemakers so
he required 5 different lead systems and 22
pulse generators of 11 different models in his
lifetime
• lived to be 86 years old
dying in December 28
2001 of cancer.
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13. Types
• Implantable pulse generators with
endocardial or myocardial electrodes for long-
term or permanent use( permenant
pacemakers)
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• External, miniaturized, transistorized, patient
portable, battery-powered, pulse generators
with exteriorized electrodes for temporary
transvenous endocardial or transthoracic
myocardial pacing. (temporary pacemakers)
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15. what is a permenant pacemaker
• A permenant pacemaker is an electronic
device, approximately the size of a pocket
watch, that senses intrinsic heart rhythms and
provides electrical stimulation when indicated
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16. Parts of a pacemaker system
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18. Pulse generator
• Lithium batteries lasting 6 years or more are
used in most pacemakers.
• Nuclear powered pacemakers (Plutonium238
source) can last 20 years or more.
• It controls energy output, heart rate and
pacing node.
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19. Energy output
• It refers to the intensity of the electrical
impulse delivered by the pulse generator to
the myocardium.
• Measured in milliampers(M.A)
• A setting of 1.5 MA usually is sufficient to
cause depolarization
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20. PACEMAKER LEADS
• Pacemaker leads are electrical conductors
(wires), covered with insulation. They transmit
the electrical impulses from the pulse
generator to the heart, and from the heart to
the pulse generator.
• They will attach to the heart in different ways
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21. Rate response
• Most of the pacemekers available today are
rate responsive ,it have various sensors that
will active while patient during activities and
adjust the rate .
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22. Active fixation
• in active fixation a screw (also known as a
helix) is used to fix the lead to the heart.
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23. Passive fixation
• In passive fixation the lead has tines ,which
are designed to engage the trabeculae on the
inner surface of the heart
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24. APPROACHES OF PACING
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25. Single Chamber pacing
• With this device, 1 pacing lead is implanted in
the right atrium or ventricle
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26. Double chamber pacing
With this device, 2 pacing leads are implanted
(1 in the right ventricle and 1 in the right
atrium); this is the most common type of
implanted pacemaker
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27. Implantable Cardioverter-
Defibrillator( ICD)
• An implantable cardioverter-defibrillator (ICD)
is a specialized device designed to directly
treat a cardiac tachydysrhythmia
• ICDs have revolutionized the treatment of
patients at risk for sudden cardiac death due
to ventricular tachyarrhythmias
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28. •
TEMPORARY PACEMAKERS
Temporary cardiac pacing involves electrical
cardiac stimulation to treat a bradyarrhythmia
or tachyarrhythmia until it resolves or until
long-term therapy can be initiated
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29. • Turn the pacemaker on, and choose the
pacing mode
• The demand mode is usually preferable and
should be used initially
• the pacing threshold is usually less than 80
mA
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30. BENEFITS TO HEART FAILURE PATIENTS
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Reduction in ventricular electromechanical delay
Improved ventricular function
Reduced metabolic costs
Improved functional mitral regurgitation
Favorable remodeling
Reduction of cardiac chamber dimensions
Improved exercise capacity
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