8: Rehab after Pacemaker Flashcards
What is a pacemaker?
Electronic pulse generator is implanted and used to create an artificial action potential to control certain arrhythmias. Can be unipolar or bipolar systems
What are 6 indications for a pacemakers?
- Sinus bradycardia
- Sinus arrest
- SA node block
- A-fib with slow ventricular response
- Tachy-brady syndrome
- Heart block
What type of lead is shown in the diagram?
Unipolar
What type of lead is shown in the diagram?
Bipolar
What side will the pacemaker likely be implanted into?
Usually left, try to insert in the non-dominant side
What are the pacemaker leads attached to?
Heart - can be single or dual chamber
What are the 6 causes of non-capture of a pacemaker?
- Lead perforation or fracture
- Lead displacement
- MI
- Tissue changes
- Metabolic imbalance
- Generator component failure
What does the first letter of pacemaker code stand for?
Indicated the chamber being paced
What does the second letter of pacemaker code stand for?
Indicated the chamber being sensed
What does the third letter of pacemaker code stand for?
Indicates the response to sensing
What does the fourth letter of pacemaker code stand for?
Indicated the programmability
What does the fifth letter of pacemaker code stand for?
Indicated an anti-tachyarrhythmia function
What are goals for PT following implantation of a pacemaker?
- Improve mobility, endurance, and function
- Assist medical staff in setting parameters
- Assess functioning
When should you initiate mobility following a pacemaker?
The day after surgery or as soon as able
What are the restrictions following pacemaker implantation?
Shoulder flexion and ABD less than 90 to allow for adherence of lead wire to muscle tissue. Also pushing and pulling in bed mobility
What are signs of non-capture of a pacemaker?
Poor HR response, excessive fatigue, SOB, dizziness
What is the purpose of the CAEP?
Evaluation of rate-responsive pacemakers
Describe the protocol for the CAEP
Begin with 1.5 METS, and increase every two minutes by 1 MET for 10 minutes
When should you initiate resistance training following pacemaker implantation?
2 months to allow for lead to significantly scar to the heart tissue
Describe subacute or outpatient rehab following a pacemaker
Intervals with more rest, aerobic and resistance exercise with the goal of 40-60 minutes at 11-13 RPE
What do you have to be mindful of during warm-up and cool down with a pt with a pacemaker?
They require longer time, 15 minutes usually
