Implantable Devices Flashcards
What are the different types of implantable devices
For rhythm control:-
Implantable cardioverter defibrillator (ICD)
Pacemaker
To support the heart and circulation:-
Left ventricular assist device (LVAD)
What is an implantable cardioverter device
A small device placed in the chest or abdomen.
It is able to perform cardioversion, defibrillation and pacing of the heart.
When is an ICD used
To prevent sudden cardiac death, either in patients who have already experienced an episode of VT or VF. Or for patients who are at risk for sustained VT or VF.
How many leads does an ICD have
One lead - in the right ventricle (single chamber ICD)
Two leads - in right atrium and right ventricle (dual chamber ICD)
Three leads - in the right atrium, right ventricle, outer wall of the left ventricle (biventricular ICD)
What is a pacemaker
A small device that’s placed in the chest or abdomen to help control abnormal heart rhythms.
What is biventricular pacing
Used for people with heart failure, in whom the left and right ventricles do not contract simultaneously.
It paces both the septum, and lateral walls of the left ventricle, resynchronizing ventricular contractions
What are the indications for a permanent pacemaker
Complete AV block
Mobitz type II block
Symptomatic bifascicular and trifascicular block
Symptomatic sinus bradycardia
Where are permanent pacemakers inserted
Into the cephalic of subclavian veins
Where does the pacemaker box sit in a permanent pacemaker
Under the fat and subcutaneous tissue overlying one of the pectoralis major muscles (usually on the non-dominant side)
What are the indications for temporary pacing
All of the indications for permanent pacing if permanent pacing is unavailable
Drug-induced bradyarrhythmias
Heart block after inferior MI if there is haemodynamic compromise
What are the 3 types of pacemakers
Fixed rate - work irrespective of the heart’s underlying activity
On demand - work only in certain circumstances
Rate responsive - which adapt to exertional needs of the patient by decreasing or increasing rate as appropriate
What are some complications of pacemaker insertion
Complications of wire insertion - pneumothorax, haemorrhage, brachial plexus injury
Complications of permanent pacemaker box positions - haematoma, infection, erosion of the box through the skin
Difficulties with the wire - wire displacement, fracture of the wire insulation
What is a left ventricular assist device
A mechanical pump used to support heart function and blood flow in people who have weakened hearts
It can be used
