Scribd
Upload
8 views

Pacing

Uploaded by

karan Singh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
8 views

Pacing

Uploaded by

karan Singh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

Modes for Pacing

Temporary pacemaker is for emergent situations.


Emergent situations such as severe bradycardia
associated with dig toxicity, or AVB d/t an MI,
ischemia, provides prophylactic therapy (cardiac
Sx) • to override tachyarrhythmia’s (really fast
rhythms like VT)
Permanent pacemaker is for long term therapy: for
unresolved rhythms or conditions in which
clinical symptoms are present and in which for
long term pacing is indicated e.g. large AWMI
affecting the LAD.

Indications for pacing


• SA node dysfunction: extreme SB, Sinus arrest, sinus block with long
pauses, & SSS (tachybrady syndrome) atrial fib/flutter, &
chronotropic incompetence - SA node is not capable of increasing
HR when it needs to e.g. exercise.
• AV block: second degree Mobitz II & 3rd degree with symptomatic
bradycardia which is directly responsible for syncope, dizziness,
fatigue, low exercise tolerance, confusion, dyspnea, hypotension.
Chronic bifasicular block
• After an acute phase of MI.
• Also to detect & terminate tachyarrythmias
• Patients with CHF, hypertrophic cardiomyopathy who develop
arrhythmias, are implanted with a biventricular pacemaker to
restore synchrony between ventricles and improves ejection
fraction and cardiac output.
• Post cardiac transplantation, congenital HD
Single & Dual chamber
pacemakers/CIED
Single chamber - one lead inserted into either the right atrium or the
right ventricle. This type is used for temporary pacing.
Dual chamber - Most commonly used in permanent pacemakers. One
lead going into the right atrium and the other going into the right
ventricle & some require leads placed in the right ventricle & left
ventricular.
• Dual chamber pacemakers restore conduction problems, improve
cardiac output via AV synchrony (synchronize the contraction),
restore atrial kick, improve ejection fraction is patients with HF
• Dual chamber pacemakers are also called AV sequential pacemakers
because of their ability to stimulate the atria and ventricles in
sequence (first the atria then the ventricles) mimicking the normal
heartbeat so the atrial kick is preserved.

Pacemaker Modes
Fixed rate mode or asynchronous: pacing means that the pacemaker will
deliver a stimulus at a programmed rate regardless of any intrinsic activity
in the myocardium.
There is a danger that VT or VFIB may be induced with fixed rate if the pacing
stimulus falls on the vulnerable period (relative refractory period). These
are uncommon now but all pacemakers can be placed on fixed rate mode.
Demand mode or Synchronous: This demand pacing means that the
pacemaker will only deliver a stimulus in the absence of intrinsic activity.
Demand pacemakers have a sensing mechanism that senses the patient own
rhythm & inhibits discharge if the patient's rate is adequate. The
pacemaker will also pace when the intrinsic HR falls within a preset
period.

Understanding Pacemakers. (2017 February 27). Pacemaker codes and modes -


Explained [YouTube Video File]. Retrieved from https://youtu.be/L-lMhDQTq7w

You might also like