Cardiac Implantable Devices Flashcards
NBG Code 1
Chamber paced
NBG Code 2
Chamber sensed
NBG Code 3
Mode of Response
NBG Code 4
Rate Responsiveness
NBG Code 5
Multisite pacing
Lead impedance is lower than the last device check, what could this mean?
Lead insulation break
Pacemaker was implanted and patient complains of dyspnea, facial swelling cough, and distorted vision
SVC Syndrome
Patient receives an ICD because he was previously resuscitated from cardiac arrest this is primary or secondary?
Secondary prevention, this is to prevent a second incident
What is EOL?
End of life; Pacemaker fails to function or dies
What pacemaker is associated with pacemaker syndrome?
VVI
Explain ACC/AHA Class I
There is supportive evidence that procedure is useful
Explain ACC/AHA Class II
There is conflicting evidence about the usefulness of the procedure
Explain ACC/AHA Class III
There is evidence about the procedure that is is not useful
What is the advantage for a bipolar lead pacemaker?
Less suseptable to EMI noise
Explain active fixation
Helical Screw
Explain passive fixation
Winged
What adjustment changes a pacemaker from demand Mose to asynchronous?
Decrease sensitivity
Chronaxie is defined as?
2 x rheobase
At what time is a PP’s stimulation threshold the lowest?
At the time of initial implant
A patient receives and ICD with indications of only low EF and increased risk of SCD IS this primary or secondary?
Primary prevention
What is it called when the pacemaker to ICD leads are twisted?
Twiddlers syndrome
What are the benefits of SICDs?
No floor needed, Easy to explant, No risk for vascular injury
People that receive a biventricular pacemaker usually get what else?
ICD
What are hiccups suggestive of?
Phrenic nerve or diaphragm stimulation
What is the most common reason for cardiac implanted lead removal?
Device infection
What equipment is most important to have on hand when doing a lead wire extraction?
pericardiocentesis
What kind of battery is a pacemaker?
Lithium iodine
How long do the batteries last?
10-15 years
What is normal impedance?
300-1500
Ohms is greater than 1500
Lead wire fracture
Change of 700 ohms
Lead wire fracture
Ohms less than 300
Insulation break
What is mA set to?
2x the diastolic threshold
What is the safety margin set at?
2x the capture threshold to 1 mA above
What kind of pacemaker is prone to cross talk issues?
Dual chamber
What side is the pacemaker implanted?
Patients non dominant side
What side is the IV placed on for PPI?
On the side on the device placement
Placing a magnet over a pacemaker/ ICD will do what?
In pacemakers it will change to magnet mode and it will go asynchronous pacing. In ICD it will stop shocking.
Which lead is placed first?
RV
pacemaker signals are evaluated through what?
pacing system analyzer (PSA)
What is the atrial sensing value?
1.5 mV
What is the ventricular sensing value?
7 mV
What is the atrial threshold value?
1 V
What is the ventricular threshold value?
3 V
How is the pocket sutured?
Fascia, Dermis, Epidermis
What is done after a device placement?
Chest Xray to confirm lead placement, pneumothorax
Signs of pacemaker malfunction
Syncope, Angina, SOB, Hyperventilation, Hiccoughs
For an ICD what should the DFT be set to?
10 J higher
The benefit of the intervention/ procedure far exceeds the risk (Recommended)
Class I
The benefit of the intervention/ procedure moderately exceeds the risk (Moderate)
Class IIa
The benefit of the intervention/ procedure may not exceed the risk (No benefit)
Class IIb
The benefit of the intervention/ procedure is equivalent to or is exceeded by the risk (Harmful)
Class III
