Pacemakers Flashcards
What do pacemakers do?
sends electrical impulses to a patients heart to stimulate it to beat, assists the patient’s own electrical system when it is unable to “keep up”
What are some benefits of pacing?
improved HR, increased CO, increased perfusion, treats symptoms,
Why do patients need pacemakers?
sick sinus syndrome (HR too slow), AV block(2 and 3 degree), prophylactically, tachydysrhythmias, congenital or degenerative HF
What are the types of temporary pacing systems?
transcutaneous (external pacing), transvenous, epicardial
What are the types of permanent pacing systems?
interrogatable, programmable
What are some indications of external pacing transcutaneous?
emergency, symptomatic unstable patients, symptomatic bradycardias, asystole
Where can the transvenous pacing be inserted?
thru femoral vein or subclavian to R atrium, R ventricle or both
Where is epicardial pacing inserted?
directly on or thru the epicardium; used in cardiac surgery and outer surface of heart is easy to reach
What are some important things to know after getting a pacemaker?
Avoid getting wet for at least 48 hours, report any swelling, tenderness, or warmth, caution w. arm movement, avoid golf and tennis for 4-6 wks,
True or False pacemaker only functions when it needs to, otherwise your heart beats on its own.
TRUE
How long to pacemakers usually last?
7-10 years
What does the first letter in pacemaker code mean? 2? 3? 4? 5?
chamber paced; chamber sensed; response to sensed event; programmable functions; anti-tachycardia
What do the 1st and 2nd letters of pacemaker stand for:
O, A, V, D, S.
O: none, A: Atrium, V: Ventricle, D: Dual(atria and ventricles), S: manufacturer’s designation.
What does the third letter of pacemaker code stand for:
O, T, I, D?
O: none, T: Triggers the pacemaker to fire, I: Inhibits the pacemaker from firing, D: Dual (T and I)
What does the fourth letter of pacemaker code stand for:
O, P, M, R?
O: none, P: simple program, M: multi program, R: rate responsive
What does the fifth letter of pacemaker code stand for:
O, P, S, D?
O: none, P: pacing, S: shock, D: P and S
VVI?
paces only in ventricle, senses only in ventricle, is inhibited by ventricular rhythms of the pts own heart.
AAI?
paces in the atrium, senses in the atrium, doesn’t do anything w. ventricles.
DDD?
paces in both atrium and ventricles, senses in both, most benefit from this bc it mimics AV synchrony.
What does a rate responsive pacemaker do?
senses pts activity and increases their HR if the patient is unable to increase their own HR.
What happens when pacemaker fails to sense?
sees more or less than is there.
What could failure to capture mean?
lead fracture, increase in pt threshold, new onset MI
What are some cautions with pacemakers?
MRI will cancer out pacemaker programming, electrocautery in OR pacemaker maybe programmed off, metal detector airport
What is an implanted cardiovertor defibrillator used for?
to tx heart rhythm disorders in which the pts heart beats too fast and ventricular in origin.
What is the most common pacemaker code?
DDD
Explain failure to sense
Pacemaker can’t sense HR: so abnormal complexes. Can be caused by deteriorating battery or damaged wire.
Why should you avoid putting defibrillator paddles over pulse generator?
Bc it could burn them
