Cardiac Implantable Electronic Devices Flashcards
Identify the type of implanted device in the X-ray
Pacemaker
Determine whether the placement of the leads are a proper placement or an improper placement
Identify the chamber placement of the leads in the X-ray
Select all of the correct statements that apply to pacemakers
Interrogation is the process of programming or reprogramming a pacemaker
When a pacemaker lead is damaged it can be left in patient and a new lead can be placed
Lead tips are held in the heart by either active or passive fixation
Choose all the features that apply to an internal cardiac defibrillator.
When a shock is delivered it is painless
The leads must be changed at the same time as the pulse generator
Device can be identified on X-ray by presence of a coiled lead
Device can also be used as a pacemaker
Can be programmed remotely
Describe the common clinical causes of patient’s needing implanted pacemakers.
3rd degree or advanced 2nd degree (Mobitz II) AV block with any of the following
Symptomatic bradycardia
Ventricular dysrhythmia resulting from block
Symptomatic bradycardia secondary to necessary drugs for dysrhythmia management
Symptomatic bradycardia resulting from 2nd degree AV block
Chronic bifascicular or trifascicular block with intermittent 3rd degree or 2nd degree AV block
Exertional 2nd or 3rd degree AV block
Pacemakers are required for which of the following common conditions?
2nd degree AV II with symptoms
Chronic bisfasicular or trifasicular block with intermittent 3rd degree av block
Patients with pacemakers generally face problems that can be grouped into the following 3 categories:
1) Failure to pace the appropriate cardiac chamber:
Output failure
Capture failure
2) Problem with detecting intracardiac signals:
Undersensing
Oversensing
3) Pseudomalfunction:
Crosstalk with resultant safety pacing
Pacemaker-mediated tachycardia
Sensor-induced tachycardia
Runaway pacemaker
Lead-displacement dysrhythmia
Twiddler syndrome
D
Determine the common clinical causes of patient’s needing an ICD?
An ICD is often recommend in which of the following patients.
LVEF < 35@ with CAD
History of sustained Vtach
Hypertrophic Cardiomyopathy
Explain the common causes and clinical presenations of a malfunction ICD?
Unexplained syncope with significant LV dysfunction with a nonischemic cardiomyopathy
Syncope or VT while receiving beta-blockers with long Q–T syndrome
Sustained VT with normal or near-normal ventricular function
Syncope or sustained VT with Brugada syndrome
Syncope or sustained VT with catecholaminergic polymorphic VT receiving beta-blockers
Syncope with advanced structural heart disease with investigations failing to find the cause of syncope.
You are dispatched to transfer a patient who has a malfunction ICD. What should you be considered before transporting this patient?
How does a magnet affect the functions of various cardiac devices
use of a magnet to inhibit sensing of electromagnetic interference (EMI) for specific medical procedures.
Magnet application may also be used to check for elective replacement indicators (ERI) in IPG and CRT‐P devices.
What are the effects of the magnet when placed over and ICD / CRT-D?
