Basic Cardiac Pacing
Claire Regan MSc
Chief Cardiac Physiologist
UHSM
2009
A Pacemaker!
What is a Pacemaker?
 A pacemaker is an electronic device
implanted in the body to regulate the heart
beat.
 It consists of a battery and electronic circuits
enclosed in a hermetically sealed can.
 The pacemaker delivers electrical stimuli over
leads with electrodes in contact with the
heart.

(‘Cardiac Pacemakers Step by Step’ – S.Serge Barold, Roland X. Stroobandt, Alfons F. Sinnaeve).
Atrial and Ventricular Leads
Lead Detail
RA and RV Leads
RA Septum/RVOT Leads
Pacemaker Code
Unipolar
Bipolar
Reasons for Implanting AAI
 Sinus Node Dysfunction.
 Sick Sinus Syndrome in the absence of
known or anticipated AV block.
Contraindications for AAI
 Heart Block known or anticipated.
 Atrial Tachyarrhythmias.
 Neurally Mediated Syncope.
AAI
AAIR
AAI Pacing
AAI Pacing
Reasons for Implanting VVI
 Chronic Atrial Tachyarrhythmias.
Contraindications for VVI
 Heart Failure.
 Left Ventricular Systolic or Diastolic
Dysfunction.
 Neurally Mediated Syncope.
VVI
VVIR
VVI Pacing
VVI Pacing (Bipolar – RVA)
Ventricular Pacing (Unipolar - RVOT)
Reasons for Implanting DDD
♥ AV block
♥ Chronic Bi/Trifascicular block
♥ Sinus Node Dysfunction
Contraindications for DDD
♥ Heart Failure
♥ Chronic Atrial Tachyarrhythmias
DDD
DDDR
AV (DDD) Pacing
AV (DDD) Pacing
References
• Barold, S. S., Stroobandt, R. X., Sinnaeve, A. F.
(2004). Cardiac Pacemakers Step by Step. USA:
Blackwell Futura.
• Bennett, D. H. (2007). Cardiac Arrhythmias.
London: Hodder Arnold.
• Ellenbogen, K. A., Wood, M. A. (2002). Cardiac
Pacing and ICD’s. USA: Blackwell Science.
• Hayes, D. L., Lloyd, M. A., Friedman, P. A. (2000).
Cardiac Pacing and Defibrillation: A Clinical
Approach. USA: Futura Publishing Company.
Any Questions?