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?