Implantable and wearable devices Flashcards
what happens if the SA node fails to work
other areas of the conductive tissue will attempt to gain control of the heart creating inconsistent depolarization of the heart, arrhythmias, and decreased CO
How to diagnosis SA node dysfunction
- sinus bradycardia (less then 60 bmp)
- paroxysmal supra ventricular tachycardias (atrial fibrillation, atrial flutter)
what are the 3 types of temporary pacemakers
1) transcutaneous
2) transatrial
3) transvenus
what are temporary pacemakers indicated for
- acute MI
- post cardiac surgery
- drug toxicity
- bridge to permanent pacemaker
what is a permanent pacemaker
- small, lightweight battery operated device
- wires implanted into the heart
- device is implanted into the distal left clavicle area
- sends electrical stimulus directly to the heart muscle
indications for a permanent pacemaker
1) SA node dysfunction
2) 2nd degree AV block with symptomatic bradycardia
3) 3rd degree AV block with symptomatic bradycardia, CHF, atrial fibrillation/flutter, or documented periods of asystole greater then 3 secs or escape rates of less then 40 bpm
4) acute anterior MI with either 2nd degree AV block, 3rd degree AV block or severe bundle branch blocks
conditions that might warrant a pacemaker
1) syncope
2) Dizziness
3) CHF
4) metal confusions
5) palpatations
6) dyspnea
7) exercise intolerance
pacemaker in the atrium purpose
increased the atrial contribution to ventricular filling resulting in an increased CO
pacemaker in the ventrical purpose
increases the ventricular rate in presence of a heart block or symptomatic bradycardia
dual chamber pacemaker purpose
maintains timing between atrial and ventricular contractions, further increasing CO
fixed pacemaker mode of pacing
fires at a specific, preset rate
demand pacemaker mode of pacing
- fired only when the HR is below a present value
- has both a sensing mechanism and a pacing mechanism
rate-responsive pacemaker mode of pacing
- firing depends on pts level of activity and respiration
- automatically increases with increased CO
ICD (implantable Cardioverter Defibrillator) what is it?
- delivers a shock to the heart to cardiovert when a fatal arrhythmia is detected
- quick but painful
what are ICDs indicated for
life threatening arrhythmias
what are the PT implications for pts with pacemakers or ICD
1) know if the pt is dependent on temporary pacemaker
2) be careful with wires - put the box in a pocket and leads around the back of the neck to keep out of the way
Post pacemaker/ ICD implantation precausions
- bedrest for a few hours
- sling on left arm for 24 hrs
- use left UE functionally but avoid overhead movement above 90
- restrict lifting to 5 lbs
- no driving until cleared by electrophysiologists
what is a Holter Monitor?
- an ambulatory electrocardiography device
- a portable device for continuously monitoring the electrical activity of the heart for 24 hours or more
when would a holter monitor be indicated
for someone who it would be difficult to identify cardiac arrhythmias in a shorter time period
what is a VAD (left ventricular assist device)
mechanical pump that takes of the function of the damages ventricle of the heart to restore normal blood flow
purpose of the VAD
allows people with advanced heart failure to be able to return to a better quality of life
what are the 2 types of VAD
1) pulsatile
2) axial flow
what are the indication for VAD
1) bridge to transplant
2) destination therapy
criteria for a VAD implant
- at least 2 admissions to the hospital
- meds not working
- hyponatremic
- hypovolemic
- inotrope dependent
- EF less then 35%
