Medtronic Flashcards
Over sensing causes ___
under pacing
The magnet will pace asynchronously at ____
85 BPM
Order of pacemaker identification code
PSSP or PaSeR (Paced, Sensed, Response)
Paced
Sensed
(response to) Sensed event
Programmability
Indications for pacemakers
SA or AV node disease (symptomatic disease of impulse formation or conduction)
Long QT syndrome
Dilated CMP
HOCM
Syncope
Tachybrady syndrome
Post transplant
Post surgery
Asynchronous pacing characteristics (DOO, VOO, AOO)
Delivers at a constant rate
There can be a competitive underlying rhythm
Can cause R on T
Single chamber demand pacing characteristics (AAI, VVI)
Think of this as a “back up” mode
Only fires when native HR falls below predetermined HR
Dual chamber AV sequential demand pacing (DDD) characteristics
Most common
Ensures atrium contrsact then the ventricles
Improves AV synchrony
What can cause a pacemaker not to capture?
Hypothermia
Hypocarbia -> hypokalemia
Hyperkalemia
MI
Antiarrhythmics
Fibrotic tissue around pacing leads
What does a magnet do to a pacemaker?
Converts pacemaker to asynchronous mode (usually)
What does a magnet do to ICD?
Suspends ICD and shock
What does a magnet do to a pacemaker + ICD?
Suspends ICD shock
No effect on pacemaker function
Might need to be reprogrammed by manufacturer
Failure to sense can cause ___
R on T -> v fib
Asynchronous pacing
A monopolar cautery causes ___ EMI than bipolar
More
The risk of EMI is highest when the electrocautery tip is within ____ CMs
15
Indications for ICD
Vtac
Vfib
EF <30%
CMP EF <35%
H CMP
Awaiting heart transplant
Long QT syndrome
Structural or congenital heart disease
ICD codes
1- Shock chambers
2- Anti-tachycardia pacing chambers
3- Tachycardia detection
4- Anti-brady pacing chambers
An ICD cardioverts V tach with ___, and V fib with ____
Vtac 1-30 J
V fib 10-30 J
What is the most prevalent source of EMI in the OR?
Electrocautery
2- MRI
___ cautery has LESS chance of EMI
Bipolar
___ cautery requires a grounding pad
Monopolar
Magnet on a pacer will ___
Magnet on an ICD will ___
Magnet on a dual pacer/ ICD will ___
asynchronous pacing
Disable Shock
Only disables shock
Disadvantages of magnet (compared to reprogramming)
Does not produce asynchronous pacing for medtronic pacer/ICD patients
May not be possible due to obesity or position
No continuous audible (only for ten seconds)
No physician order needed
Disadvantages of reprogramming
Drains battery life
Programmer is not readily available
Human error may lead to an error in programming
Charges to insurance
When electrocautery is used, the __ setting causes more EMI than the ___ setting
coagulation
cutting
If the surgeon insists on using monopolar, then you insist that he use ___bursts
Short <0.5 seconds
What are the contraindications of a patient with a pace maker?
MRI
Thats all
