Implantables Flashcards
_____ are Devices designed to improve cardiac function, detect & terminate lethal dysrhythmias
automated implantable cardiac device
o ALL ICD’s are AICDs but NOT all AICDs are ____
ICDs
All devices subject to complications from what things?
infection, bleeding, migration, power failure, fracture of components or complete failure
pacemaker has what 2 components?
generator and leads
what is the generators function?
produces electrical impulse that travels through leads to depolarize myocardial tissue
Guidelines for pacemaker implantation
o Atrial arrhythmias not controlled with medical therapy
o AV Node dysfunction causing hemodynamic compromise not controlled with medical therapy
o End-stage cardiomyopathy with or without arrhythmia and nodal dysfunction
o Autonomic nervous system dysfunction that results in arrhythmia or nodal dysfunction (not very common)
Pacemaker Implantation Requires fluoroscopic placement of leads into chamber(s) of heart , generator typically in______chest
subcutaneous left
Pacemaker Implantation- Single chamber lead in either ___ or ___
RA or RV
dual chamber pacemaker placement of leads
o Dual chamber: one lead in atrium, other in ventricle
Biventricular pacemaker/Cardiac Resynchronization Therapy (CRT) paces _____
both ventricles
_________ pacemakers are Useful in paitents that have AV blocks since their ventricles or atrium are not beating at the same time
o Dual chamber
patients with pacemakers should have in their possession a ______ at ask timed
Device ID card with name of manufacturer/serial #
for pacemakers, ___will show location, integrity of leads and may ID the device
chest x-ray
Interrogation of pacemaker checks what?
battery status, current mode (tells if you are in pacing mode or if its cut off), rate, past rhythms (very important to know incase the patient is coming in with symptoms that may be related to the pacemaker), parameters to detect malignant rhythms & therapeutics settings
A RV paced ECG will show _____
LBBB
what on the EKG indicates that the pacemaker is firing,
spikes (pacemaker spikes)
on an EKG, A _____pacemaker will have discharge and then have a wide QRS after
Ventricular- SINGLE CHAMBER
In _____ pacemaker, on the EKG you will have spike then a P wave and then you will have another spike and then wide QRS (2spikes!)
dual chamber
in an ____ pacemaker the EKG will show one spike before a P wave and then normal QRS following (narrow QRS)
Atrial
Pacemaker Work Up
o ECG, CIP, CBC, Chemistries, CXR, device interrogation
what is treatment for pacemaker Failure to capture( insufficient generator impulse)
temp pacing, replacement
what is treatment for Runaway pacemaker( generator malfunction causing pacer mediated tachycardia )
Tx: magnet, emergent reprogram, surgical disconnection
ALL PTs should have a magnet for when their pacemaker is shocking at the wrong time and the magnet will slow it down to the original programing rate
Pacemaker syndrome treatment (Discharging but not at the right time or its over pacing )
Tx: dual chamber pacer
treatment for pacemaker Oversensing
(Pacemaker is picking up signals that are not real (oversensing) so it feels that the heart is pacing at the right rate so it’s not firing like it should )
Tx: magnet, temp pacing, reprogramming
