Pacemakers

Question 1

What do pacemakers do?

Answer 1

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”

Question 2

What are some benefits of pacing?

Answer 2

improved HR, increased CO, increased perfusion, treats symptoms,

Question 3

Why do patients need pacemakers?

Answer 3

sick sinus syndrome (HR too slow), AV block(2 and 3 degree), prophylactically, tachydysrhythmias, congenital or degenerative HF

Question 4

What are the types of temporary pacing systems?

Answer 4

transcutaneous (external pacing), transvenous, epicardial

Question 5

What are the types of permanent pacing systems?

Answer 5

interrogatable, programmable

Question 6

What are some indications of external pacing transcutaneous?

Answer 6

emergency, symptomatic unstable patients, symptomatic bradycardias, asystole

Question 7

Where can the transvenous pacing be inserted?

Answer 7

thru femoral vein or subclavian to R atrium, R ventricle or both

Question 8

Where is epicardial pacing inserted?

Answer 8

directly on or thru the epicardium; used in cardiac surgery and outer surface of heart is easy to reach

Question 9

What are some important things to know after getting a pacemaker?

Answer 9

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,

Question 10

True or False pacemaker only functions when it needs to, otherwise your heart beats on its own.

Answer 10

TRUE

Question 11

How long to pacemakers usually last?

Answer 11

7-10 years

Question 12

What does the first letter in pacemaker code mean? 2? 3? 4? 5?

Answer 12

chamber paced; chamber sensed; response to sensed event; programmable functions; anti-tachycardia

Question 13

What do the 1st and 2nd letters of pacemaker stand for:

O, A, V, D, S.

Answer 13

O: none, A: Atrium, V: Ventricle, D: Dual(atria and ventricles), S: manufacturer’s designation.

Question 14

What does the third letter of pacemaker code stand for:

O, T, I, D?

Answer 14

O: none, T: Triggers the pacemaker to fire, I: Inhibits the pacemaker from firing, D: Dual (T and I)

Question 15

What does the fourth letter of pacemaker code stand for:

O, P, M, R?

Answer 15

O: none, P: simple program, M: multi program, R: rate responsive

Question 16

What does the fifth letter of pacemaker code stand for:

O, P, S, D?

Answer 16

O: none, P: pacing, S: shock, D: P and S

Question 17

VVI?

Answer 17

paces only in ventricle, senses only in ventricle, is inhibited by ventricular rhythms of the pts own heart.

Question 18

AAI?

Answer 18

paces in the atrium, senses in the atrium, doesn’t do anything w. ventricles.

Question 19

DDD?

Answer 19

paces in both atrium and ventricles, senses in both, most benefit from this bc it mimics AV synchrony.

Question 20

What does a rate responsive pacemaker do?

Answer 20

senses pts activity and increases their HR if the patient is unable to increase their own HR.

Question 21

What happens when pacemaker fails to sense?

Answer 21

sees more or less than is there.

Question 22

What could failure to capture mean?

Answer 22

lead fracture, increase in pt threshold, new onset MI

Question 23

What are some cautions with pacemakers?

Answer 23

MRI will cancer out pacemaker programming, electrocautery in OR pacemaker maybe programmed off, metal detector airport

Question 24

What is an implanted cardiovertor defibrillator used for?

Answer 24

to tx heart rhythm disorders in which the pts heart beats too fast and ventricular in origin.

Question 25

What is the most common pacemaker code?

Answer 25

DDD

Question 26

Explain failure to sense

Answer 26

Pacemaker can’t sense HR: so abnormal complexes. Can be caused by deteriorating battery or damaged wire.

Question 27

Why should you avoid putting defibrillator paddles over pulse generator?

Answer 27

Bc it could burn them