Temporary pacemaker 삼성서울병원 심장혈관센터심장검사실 박정왜 RN, CCDS
|
|
- Valentine Ellis
- 6 years ago
- Views:
Transcription
1 Temporary pacemaker 삼성서울병원 심장혈관센터심장검사실 박정왜 RN, CCDS
2 NBG Codes 1st Letter 2nd Letter 3rd Letter A V D Chamber(s) Paced = atrium = ventricle = dual (both atrium and ventricle) Chamber(s) Sensed A = atrium V = ventricle D = dual O = none Response to Sensing I = inhibit (Demand mode) T = triggered D = dual O = none (Asynch) Chamber paced Chamber sensed Action or response to a sensed event V V I D D D
3 Temporary pacemaker is Acute management of medically refractory bradyarrhythmias Management of certain tachyarrhythmias
4 Kind of Temporary pacemaker Transcutaneous cardiac pacing Transvenous pacing Epicardial pacing Transesophageal pacing
5 Temporary pacemaker indication In Acute Myocardial Infarction Medically refractory symptomatic sinus node dysfunction Mobitz II second-degree AV block with acute anterior infarction Third-degree AV block with anterior infarction New bifascicular block Alternation bundle branch block Alternating Wenckebach block New bundle branch block with anterior infarction Bundle branch block of indeterminate age with anterior or indeterminate location infarct Medically refractory AV block with bradycardia and symptoms regardless of infarct location In Absense of Acute Myocardial Infarction Medically refractory symptomatic bradycardia -sinus node dysfunction -second or third degree AV block Third-degree AV block with wide QRS escape or ventricular rate <50bpm Prophylactic Swan-Ganz catheterization or endocardial biopsy in patient with left bundle branch block Cardioversion in setting of sick sinus syndrome New AV or bundle branch block with acute enddocarditis ( especially aortic valve endocarditis) Perioperatively in patient with bifascular block and history of syncope To allow pharmacilogic treatment with drugs that worsen bradycardias Treatment of Tachyarrhythmias Termination of recurrent ventricular or supraventricular tachycardia Suppression of bradycardia-dependant ventricular tachyarrhyhmia including torsades de pointes
6 Transcutaneous cardiac pacing :external pacemaker Transcutaneous cardiac pacing has emerged as the preeminent initial mode of cardiac pacing for brady-asystolic arrest situations and prophylactic pacing application Transcutaneous cardiac pacing produces depolarization of myocardial tissue by pulsed electrical current conducted through the chest between electrodes adherent to the skin Coughing and discomfort from cutaneous nerve and skelectal muscle stimulation are the most frequent problems.
7 External pacemaker Skin preparation Shave/clip hair at electrode sites, if necessary Clean and abrade the skin at the electrode sites Dry the skin Location 전부에두개전극판이위치한경우 : 오른쪽쇄골하방, 상부흉골의오른쪽에위치, 심첨부의약간바깥쪽 전부에한개, 후부에한개위치한경우 : 앞쪽은우심실위를감싸면서흉골의왼쪽에위치, 뒤쪽은척추의왼쪽
8 Transvenous cardiac pacing Transvenous pacing provides the consistent and reliable means of temporary cardiac pacing in clinical practice. Transvenous pacing uses intravenous catheter electrodes to stimulate atrial or ventriclar myocardial tissue directly with electrical current pulses provides by an external generator. Decisions regarding the site of venous access for pacing should take into consideration the urgency to initiate pacing, desired lead stability, need to avoid specific complication, and anticipated duration of pacing.
9 Insertion site Without fluoroscopy : external jugular vein, brachial vein With fluoroscopy : cephalic vein, internal jugular vein, subclavian vein Femoral vein : risk of thrombosis, phlebitis, and infection
10 Epicardial pacing Transthoracic pacing is possible using temporary pacing wires passively fixed to the atrial and ventricular epicardium at the time of cardiac surgery or thoracotomy. They are exposed through the skin in the subxiphoid region. Transesophageal pacing The anatomic proximity of the esophagus to the posterior left atrium makes transesophageal atrial pacing possible in nearly all patients. The technique is relatively noninvasive and virtually free of serious complication.
11
12 Temporary pacemaker Model 5388 operation
13 Model 5388 Dual Chamber Temporary Pacemaker 1. Pace/Sense LEDs 2. Lock/Unlock Key 3. Lock Indicators 4. Rate Dial 5. Atrial Output Dial 6. Ventricular Output Dial 7. Menu Parameter Dial 8. Parameter Selection Key 9. Menu Selection Key 10. Pause Key 11. Power On Key 12. Power Off Key 13. Emergency/Asynchronous Pacing Key 14. Lower Screen 15. Ventricular Output Graphics 16. Atrial Output Graphics 17. Upper Screen 18. Rate Graphics 19. Setup Indicators 20. DDI Indicator 21. Low Battery Indicator 22. Setup Labels
14 ON/OFF keys Values at Power-On RATE A OUTPUT V OUTPUT A SENSITIVITY V SENSITIVITY UPPER RATE AV INTERVAL PVARP 80 ppm 10 ma 10 ma 0.5 mv 2.0 mv 110 ppm 170 ms 300 ms
15 Demand Pacing Dual Chamber Demand Pacing (DDD) Demand Pacing in the Atrium (AAI) Demand Pacing in the Ventricle (VVI) Pace Sense Pace Sense Pace Sense A + V A + V A A V V
16 Rate and Output Adjustments Rate Dial Atrial Output Dial Ventricular Output Dial
17 1. Set RATE at least 10 ppm above patient s intrinsic rate. 2. Decrease OUTPUT: Slowly turn OUTPUT dial counterclockwise until ECG shows loss of capture. 3. Increase OUTPUT: Slowly turn OUTPUT dial clockwise until ECG shows consistent capture. This value is the stimulation threshold. 4. Set OUTPUT to a value 2 to 3 times greater than the stimulation threshold value. This provides at least a 2:1 safety margin. 5. Restore RATE and OUTPUT to previous values.
18 Sensitivity Adjustments
19 Sensitivity (mv) 5 (mv) 2.5 (mv) 1.25 (mv) Sensitivity settings : at least a 2:1 safety margin
20 1. Set rate at least 10 ppm below patient s intrinsic rate. 2. Adjust output: Set OUTPUT to 0.1 ma (A OUTPUT for atrial threshold; V OUTPUT for ventricular threshold). 3. Highlight SENSITIVITY (atrial or ventricular) (Menu 1). 4. Decrease SENSITIVITY: Slowly turn MENU PARAMETER dial counterclockwise until pace indicator flashes continuously. 5. Increase SENSITIVITY: Slowly turn MENU PARAMETER dial clockwise until sense indicator flashes and pace indicator stops flashing. This value is the sensing threshold. 6. Set SENSITIVITY to half (or less) the threshold value. This provides at least a 2:1 safety margin. 7. Restore RATE and OUTPUT to previous values.
21 Rate-Dependent Parameters
22 Rapid Atrial Pacing
23 Basic Device Operation Turning device off Battery Replacement Push Buttons at the same time Push both buttons at the same time to turn OFF
24 Locking Feature Slide plastic cover over dials to protect against changes in settings Emergency Pacing Rate Check Rate Output Turn to MAX Sensitivity Turn to ASYNC MAX output Use caution when setting the sensitivity to asynchronous Asynch.
25 Normal capture
26 Loss of Ventricular Capture
27 Threshold test
28 Atrial/Ventricular Sensing Sensing Atrial Undersensing
29 Ventricle undersensing oversensing
30 arrhythmia in Temporary pacemaker VT : myocardial ischemia, acute infarction, hypoxia, general anesthesia, vagal stimulation, drug toxicity and catechoramine administration and coronary artery catheterization) VF : inf. Infarction inner 24 hours
31 Nursiug care Paced QRS complex : LBBB (if RBBB complex is coronary pacing, lead perforation into Lt ventricule or pericardial space) -> f/u EKG Protective dressing, examined daily for infection After insertion, pacing or sensing malfunction : 14~34% 발생 -> reposioning or catheter replace 24HR-inflammatory response : thresthold 증가 thromboembolism 예방 : anticoagulationg After pass 3 day, 50% infection risk.
32 References Ellenbogen KA, Wood MA. Cardiac Pacing & ICDS. 4th ed. Malden : Blackwell Science, Inc; Hayes DL, Lloyd MA, Friedman PA. Cardiac Pacing and Defibrillation : A Clinical Approach. Armonk: Futura ; Moses HW, Moulton KP, Miller BD, et al. A Practical Guide to Cardiac Pacing. 5 th ed. Boston : Little, Brown; Medtronic. inc
Figure 2. Normal ECG tracing. Table 1.
Figure 2. Normal ECG tracing that navigates through the left ventricle. Following these bundle branches the impulse finally passes to the terminal points called Purkinje fibers. These Purkinje fibers are
More informationPuzzling Pacemakers Cheryl Herrmann, APN, CCRN, CCNS-CSC-CMC
Puzzling Pacemakers Cheryl Herrmann, APN, CCRN, CCNS-CSC-CMC Pacemaker: An electric device implanted in the body to regulate the heart beat. Delivers electrical stimuli over leads with electrodes in contact
More informationPACEMAKER INTERPRETATION AND DEVICE MANAGEMENT PART I
1 PACEMAKER INTERPRETATION AND DEVICE MANAGEMENT PART I Cynthia Webner DNP, RN, CCNS, CCRN-CMC Karen Marzlin DNP, RN, CCNS, CCRN-CMC 2 PROFESSIONAL NURSING PRACTICE CAN ONLY ADVANCE AS MUCH AS INDIVIDUAL
More informationTemporary pacemaker : Programming &Trouble shooting
2015 춘계심장학회 Temporary pacemaker : Programming &Trouble shooting 서울아산병원 한두영 Temporary Pacemaker Overview Indication of Temporary Pacemaker Programming ; NBG Code, Pacing/Sensing Device Trouble shooting
More informationRN-BC, MS, CCRN, FAHA
Presented By: Barbara Furry, RN-BC, MS, CCRN, FAHA Director The Center of Excellence in Education Director of HERO Follow me on Twitter! CEE Med Updates@BarbaraFurryRN Like me on Facebook! 1 A. Atropine
More informationTIP CARD. Model Temporary External Pacemaker
TIP CARD Model 5392 Temporary External Pacemaker PRE-USE What to do... What NOT to do... Battery Replace the battery for each new patient. Do NOT reuse battery. Physical Check case for cracks/damage.**
More informationPresented By: Barbara Furry, RN-BC, MS, CCRN, FAHA Director The Center of Excellence in Education Director of HERO
Presented By: Barbara Furry, RN-BC, MS, CCRN, FAHA Director The Center of Excellence in Education Director of HERO Follow me on Twitter! CEE Med Updates@BarbaraFurryRN Like me on Facebook! What is a
More informationReview of Pacemakers and ICD Therapy: Overview and Patient Management
Review of Pacemakers and ICD Therapy: Overview and Patient Management Pacing Systems Charles J. Love, MD FACC FAHA FHRS CCDS Professor of Medicine Director, Cardiac Rhythm Device Services OSU Division
More informationMODEL EPG SINGLE CHAMBER TEMPORARY EXTERNAL PACEMAKER
MODEL 53401 EPG SINGLE CHAMBER TEMPORARY EXTERNAL PACEMAKER In-service Guide 53401 TRAINING LEARNING OBJECTIVES Identify the control knobs and be able to explain how to use them to program device. Distinguish
More informationPediatric pacemakers & ICDs:
Pediatric pacemakers & ICDs: perioperative management Manchula Navaratnam Clinical Assistant Professor LPCH, Stanford SPA 2016 Conflict of interest: none Objectives Indications in pediatrics Components
More informationTitle and contents page 1 Who should read this document 2 Scope of the Guideline 2 Background 2 What is new in this version 2
Temporary Transvenous Pacing Guideline Classification: Clinical Guideline Lead Author: Dr Peter Woolfson Additional author(s): Dr Alan Fitchet Sister Joanne Hughes, Matron Julie Winstanley Authors Division:
More informationSARASOTA MEMORIAL HOSPITAL
SARASOTA MEMORIAL HOSPITAL TITLE: NURSING PROCEDURE PACEMAKERS AND DETERMINING PACEMAKER DATE: REVIEWED: PAGES: 10/99 11/18 1 of 7 PS1094 ISSUED FOR: Nursing RESPONSIBILITY: *Qualified RN PURPOSE: To establish
More informationTEMPORARY PACEMAKERS HINTS ( DUAL CHAMBER 5392 PACER)
TEMPORARY PACEMAKERS HINTS ( DUAL CHAMBER 5392 PACER) TYPES OF PACERS 2018 1 TRANSCUTANEOUS: ( VENTRICULAR pacing only) Through the skin via gel electrode pads placed on the chest and back. Disadvantage:
More informationEssentials of Pacemakers and ICD s. Rajesh Banker, MD, MPH
Essentials of Pacemakers and ICD s Rajesh Banker, MD, MPH Pacemakers have 4 basic functions: Stimulate cardiac depolarization Sense intrinsic cardiac function Respond to increased metabolic demand by providing
More informationArrhythmic Complications of MI. Teferi Mitiku, MD Assistant Clinical Professor of Medicine University of California Irvine
Arrhythmic Complications of MI Teferi Mitiku, MD Assistant Clinical Professor of Medicine University of California Irvine Objectives Brief overview -Pathophysiology of Arrhythmia ECG review of typical
More informationEHRA Accreditation Exam - Sample MCQs Cardiac Pacing and ICDs
EHRA Accreditation Exam - Sample MCQs Cardiac Pacing and ICDs Dear EHRA Member, Dear Colleague, As you know, the EHRA Accreditation Process is becoming increasingly recognised as an important step for
More informationCardiac Implanted Electronic Devices Pacemakers, Defibrillators, Cardiac Resynchronization Devices, Loop Recorders, etc.
Cardiac Implanted Electronic Devices Pacemakers, Defibrillators, Cardiac Resynchronization Devices, Loop Recorders, etc. The Miracle of Living February 21, 2018 Matthew Ostrom MD,FACC,FHRS Division of
More informationEKG Competency for Agency
EKG Competency for Agency Name: Date: Agency: 1. The upper chambers of the heart are known as the: a. Atria b. Ventricles c. Mitral Valve d. Aortic Valve 2. The lower chambers of the heart are known as
More informationIntermittent episodes of paced tachycardia: what is the cause?
Intermittent episodes of paced tachycardia: what is the cause? Lindsey Parkinson and Lucy Broadhurst, Rotherham NHS Foundation Trust Contact: Lindsey.Parkinson@rothgen.nhs.uk Introduction A hospital in-patient
More informationCORONARY ARTERIES. LAD Anterior wall of the left vent Lateral wall of left vent Anterior 2/3 of interventricluar septum R & L bundle branches
CORONARY ARTERIES RCA Right atrium Right ventricle SA node 55% AV node 90% Posterior wall of left ventricle in 90% Posterior third of interventricular septum 90% LAD Anterior wall of the left vent Lateral
More informationCardiac Pacing. Learning outcomes. Introduction. The cardiac impulse - its formation and its failure CHAPTER. To understand:
Cardiac Pacing CHAPTER 10 Learning outcomes To understand: The indications for cardiac pacing in the peri-arrest setting How to perform percussion pacing How to apply non-invasive, transcutaneous electrical
More informationPacing Codes and Modes Concepts
Pacing Codes and Modes Concepts Pacing codes and modes concepts Objectives Upon completion of this program the participant will be able to: State what the first four positions of the NBG code represent.
More informationTranscutaneous Pacing on Zoll Defibrillator Version 4 Related Documents SOP-Zoll defibrillator ; Phillips MRX SOP Dr Randal McRoberts
Emergency Medical Retrieval Service (EMRS) www.emrs.scot.nhs.uk Standard Operating Procedure Public Distribution Title Transcutaneous Pacing on Zoll Defibrillator Version 4 Related Documents SOP-Zoll defibrillator
More information1 Cardiology Acute Care Day 22 April 2013 Arrhythmia Tutorial Course Material
1 Cardiology Acute Care Day 22 April 2013 Arrhythmia Tutorial Course Material Arrhythmia recognition This tutorial builds on the ECG lecture and provides a framework for approaching any ECG to allow the
More informationAss. Prof. Tomon Thongsri, MD Buddhachinaraj Phitsanuloke Hospital
Treatment Bradyarrhythmia Ass. Prof. Tomon Thongsri, MD Buddhachinaraj Phitsanuloke Hospital 1 What is the rhythm? Sinus Bradycardia What s rhythm Sinus Bradycardia Treatment Asymptomatic No treatment
More informationTemporary Pacemakers
07 Part I Anaesthesia Refresher Course 2018 University of Cape Town Dr Owen Porrill Private Practice Honorary lecturer- University of Cape Town Temporary pacemakers are usually inserted as part of the
More informationChapter 80 Implantable Cardiac Devices
Chapter 80 Implantable Cardiac Devices Episode Overview: 1. List 5 Indications for permanent pacing 2. Pacemaker nomenclature - what do the 5 letters mean a. What are common Pacemaker types? 3. List the
More informationReiterative ventricular fibrillation caused by R-on-T during temporary epicardial pacing: a case report
Nakamori et al. JA Clinical Reports (2016) 2:3 DOI 10.1186/s40981-016-0029-6 CASE REPORT Reiterative ventricular fibrillation caused by R-on-T during temporary epicardial pacing: a case report Yuki Nakamori
More informationΤΟ ΗΚΓ ΣΤΟΝ ΒΗΜΑΤΟΔΟΤΟΥΜΕΝΟ ΑΣΘΕΝΗ
ΤΟ ΗΚΓ ΣΤΟΝ ΒΗΜΑΤΟΔΟΤΟΥΜΕΝΟ ΑΣΘΕΝΗ ΤΖΩΡΤΖ ΔΑΔΟΥΣ ΕΠΙΚΟΥΡΟΣ ΚΑΘΗΓΗΤΗΣ Α.Π.Θ. ΜΑΡΙΑ ΚΑΡΑΛΙΟΛΙΟΥ ΕΙΔΙΚΕΥΟΜΕΝΗ ΙΑΤΡΟΣ ΚΑΡΔΙΟΛΟΓΟΣ Β ΚΑΡΔΙΟΛΟΓΙΚΗ ΚΛΙΝΙΚΗ Α.Π.Θ. ΙΠΠΟΚΡΑΤΕΙΟ Γ.Ν.Θ. 5 Why a Pacemaker is Implanted
More informationPacing Lead Implant Testing. Document Identifier
Pacing Lead Implant Testing 1 Objectives Upon completion of this presentation, the participant should be able to: Name the two primary surgical options for implanting pacing leads Describe three significant
More informationAortic Dissection Causes of Death
Aortic Dissection Causes of Death Rupture aorta 33.3% Unspecified 33.3% Neurological l deficit it 13.9% Visceral ischemia/kidney failure 11.5% Cardiac tamponade 7.9% (Circulation 2002;105:200-6) Medical
More informationReview Packet EKG Competency This packet is a review of the information you will need to know for the proctored EKG competency test.
Review Packet EKG Competency 2015 This packet is a review of the information you will need to know for the proctored EKG competency test. Normal Sinus Rhythm Rhythm: Regular Ventricular Rate: 60-100 bpm
More informationDual Chamber Temporary External Pacemaker
5392 Dual Chamber Temporary External Pacemaker Technical Manual Caution: Federal law (USA) restricts this device to sale by or on the order of a physician. The following list includes trademarks or registered
More informationNational Coverage Determination (NCD) for Cardiac Pacemakers (20.8)
Page 1 of 12 Centers for Medicare & Medicaid Services National Coverage Determination (NCD) for Cardiac Pacemakers (20.8) Tracking Information Publication Number 100-3 Manual Section Number 20.8 Manual
More informationPATIENT WITH ARRHYTHMIA IN DENTIST S OFFICE. Małgorzata Kurpesa, MD., PhD. Chair&Department of Cardiology
PATIENT WITH ARRHYTHMIA IN DENTIST S OFFICE Małgorzata Kurpesa, MD., PhD. Chair&Department of Cardiology Medical University of Łódź The heart is made up of four chambers Left Atrium Right Atrium Left Ventricle
More informationElectrocardiography for Healthcare Professionals
Electrocardiography for Healthcare Professionals Kathryn A. Booth Thomas O Brien Chapter 10: Pacemaker Rhythms and Bundle Branch Block Learning Outcomes 10.1 Describe the various pacemaker rhythms. 10.2
More informationYou have a what, inside you?
Costal Emergency Medicine Conference You have a what, inside you? Less than mainstream medical devices encountered in the ED. Eric Ossmann, MD, FACEP Associate Professor Duke University Medical Center
More informationYou have a what, inside you?
Costal Emergency Medicine Conference You have a what, inside you? Less than mainstream medical devices encountered in the ED. Eric Ossmann, MD, FACEP Associate Professor Duke University Medical Center
More informationPediatric Pacemaker Implantation Endocardial or Epicardial
Pediatric Pacemaker Implantation Endocardial or Epicardial HAITHAM BADRAN, MD, FEHRA CONSULTANT OF INTERVENTIONAL CARDIOLOGY CONSULTANT OF CARDIAC PACING AND ELECTROPHYSIOLOGY LECTURER OF CARDIOLOGY AIN
More informationTiming cycles. Objectives Upon completion of this program the participant will be able to:
Timing Cycles Timing cycles Objectives Upon completion of this program the participant will be able to: Identify the basic timing cycles of a single and dual chamber pacemaker. Describe the characteristics
More informationEXTERNAL TEMPORARY PACEMAKERS
Czech Republic EXTERNAL TEMPORARY PACEMAKERS Lukas Peter Engineering and Business Coordinator Pavel Taborsky Chief Executive Officer MEDIATRADE s.r.o. PRAGUE Valasske Mezirici MEDIATRADE s.r.o. More than
More informationImplantable Cardioverter-Defibril. Defibrillators. Ratko Magjarević
Implantable Cardioverter-Defibril Defibrillators Ratko Magjarević University of Zagreb Faculty of Electrical Engineering and Computing Croatia ratko.magjarevic@fer.hr Ventricular Fibrillation Ventricular
More informationCardiac implantable electronic devices (CIEDs) in children include pacemakers and implantable cardioverter defibrillators (ICDs).
Management of Children with Cardiac Devices Guideline originally developed by Leann Miles, APRN; Lindsey Pumphrey, RN; Srikant Das, MD, and the ANGELS Team. Last reviewed by Lindsey Pumphrey, RN, Srikant
More informationIs This Thing Working?
Is This *#@!* Thing Working? Pacemaker (and ICD) ECG and Telemetry Pitfalls Wayne O. Adkisson, MD adki0004@umn.edu Disclosures I currently receive research support from Medtronic, Inc. I have been compensated
More informationPermanent Pacemaker Implantation Post Cardiac Surgery: A Cautionary Tale
Permanent Pacemaker Implantation Post Cardiac Surgery: A Cautionary Tale Jason Collinson & Stuart Tan Essex Cardiothoracic Centre, Basildon and Thurrock University Hospital. Contact: jason.collinson@nhs.net
More informationNewer pacemakers also can monitor your blood temperature, breathing, and other factors and adjust your heart rate to changes in your activity.
Pacemakers & Defibrillators A pacemaker system consists of a battery, a computerized generator and wires with sensors called electrodes on one end. The battery powers the generator, and both are surrounded
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Implantable cardioverter defibrillators for the treatment of arrhythmias and cardiac resynchronisation therapy for the treatment of heart failure (review
More informationPacemakers 12/04. Pacemakers. 1. What is a pacemaker?
Pacemakers 12/04 1-What is a pacemaker? 2- What does intrinsic mean? 3- How exactly do pacemakers work on the heart? 4- What are the parts of a pacemaker? 5- Are there different kinds of pacemakers? 6-
More informationPaul Zoll first applied clinically evective
Heart 2000;83:715 720 ELECTROPHYSIOLOGY Temporary cardiac pacing Michael D Gammage Department of Cardiovascular Medicine, Queen Elizabeth Hospital, University Hospital Birmingham NHS Trust, Birmingham,
More informationCardiac rhythm detailed monitoring by an implanted pacemaker: The iecg solution
Cardiac rhythm detailed monitoring by an implanted pacemaker: The iecg solution Francesco Zanon, MD, FESC, FHRS Arrhythmia and Electrophysiology Unit, Cardiology Dept. Santa Maria della Misericordia General
More informationLa strategia diagnostica: il monitoraggio ecg prolungato. Michele Brignole
La strategia diagnostica: il monitoraggio ecg prolungato Michele Brignole ECG monitoring and syncope In-hospital monitoring Holter Monitoring External loop recorder Remote (at home) telemetry Implantable
More informationConduction disorders
Conduction disorders L.V. Bogun, N.I. Yabluchansky, F.M. Abdueva, O.Y. Bichkova, A.N. Fomich, P.A. Garkavyi, A.L. Kulik, N.V. Lysenko, N.V. Makienko, L.A. Martimyanova, I.V. Soldatenko, E.E. Tomina Department
More informationICD-9-CM Expert. for Payers Volumes 1, 2 & 3. International Classification of Diseases 9th Revision Clinical Modification.
ICD-9-CM Expert for Payers Volumes 1, 2 & 3 International Classification of Diseases 9th Revision Clinical Modification Sixth Edition Edited by: Anita C. Hart, RHIA, S, S-P Catherine A. Hopkins Beth Ford,
More informationNEIL CISPER TECHNICAL FIELD ENGINEER ICD/CRTD BASICS
NEIL CISPER TECHNICAL FIELD ENGINEER ICD/CRTD BASICS OBJECTIVES Discuss history of ICDs Review the indications for ICD and CRT therapy Describe basic lead and device technology Discuss different therapies
More informationProgramming of Bradycardic Parameters. C. W. Israel, M.D. Dept. of Cardiology Evangelical Hospital Bielefeld Germany
Programming of Bradycardic Parameters C. W. Israel, M.D. Dept. of Cardiology Evangelical Hospital Bielefeld Germany Carsten.Israel@evkb.de Programming of ICD Brady Parameters Conflict of Interest Biotronik
More information1. What additional information needs to be collected to properly treat this client?
CASE 1 A 45-year-old male presents to the emergency department with a complaint of chest pain for the past two hours. 1. What additional information needs to be collected to properly treat this client?
More informationPERMANENT PACEMAKERS AND IMPLANTABLE DEFIBRILLATORS Considerations for intensivists
PERMANENT PACEMAKERS AND IMPLANTABLE DEFIBRILLATORS Considerations for intensivists Craig A. McPherson, MD, FACC Associate Professor of Medicine Constantine Manthous, MD, FACP, FCCP Associate Clinical
More informationECG Interpretation Cat Williams, DVM DACVIM (Cardiology)
ECG Interpretation Cat Williams, DVM DACVIM (Cardiology) Providing the best quality care and service for the patient, the client, and the referring veterinarian. GOAL: Reduce Anxiety about ECGs Back to
More informationMEDTRONIC CARELINK NETWORK FOR PACEMAKERS. Comparison between the Medtronic CareLink Network for Pacemakers and Transtelephonic Monitoring
MEDTRONIC CARELINK NETWORK FOR PACEMAKERS Comparison between the Medtronic CareLink Network for Pacemakers and Transtelephonic Monitoring Transtelephonic Monitoring Transmission What can you determine
More informationINTERPRETING THE ECG IN PATIENTS WITH PACEMAKERS
INTERPRETING THE ECG IN PATIENTS WITH PACEMAKERS BEFORE INTERPRETING THE ECG: Nora Goldschlager, M.D. MACP, FACC, FAHA, FHRS. Cardiology San Francisco General Hospital UCSF Disclosures: None 1 2 QUESTIONS
More informationPacing and Device Jargon Made Simple. Dr Jonathan Timperley MB ChB MD FRCP Consultant Cardiologist Northampton General Hospital
Pacing and Device Jargon Made Simple Dr Jonathan Timperley MB ChB MD FRCP Consultant Cardiologist Northampton General Hospital Disclosure Dr Jonathan Timperley Honorarium from Bayer Arne Larson (1915
More informationBHRS Prep course Pub style Quiz NOT A
BHRS Prep course Pub style Quiz NOT A Round 1 Quiz questions Common ECG s in CRM Colin Cunnington Over the past 3 months, a 24-yearold man who works as a truck driver has had frequent episodes of pre-syncope
More informationUnitedHealthcare Medicare Advantage Cardiology Prior Authorization Program
Electrophysiology Implant Classification Table The table below contains the codes that apply to our UnitedHealthcare Medicare Advantage cardiology prior Description Includes Generator Placement Includes
More informationINTERNAL CARDIOVERSION. Lancashire & South Cumbria Cardiac Network
INTERNAL CARDIOVERSION Lancashire & South Cumbria Cardiac Network DC Cardioversion AF & AFL safe 1,2 efficacious 3,4 (60-94%) 5 SR - Increases exercise tolerance 6 Maintainence SR unlikely in patients
More informationICD: Basics, Programming and Trouble-shooting
ICD: Basics, Programming and Trouble-shooting Amir AbdelWahab, MD Electrophysiology and Pacing Service Cardiology Department Cairo University Feb 2013 Evolution of ICD Technology ICD Evolution Indications
More informationModel 5392 EPG Temporary Pacer
Model 5392 EPG Temporary Pacer Compatible Components Reference Card 5392 Surgical Cables 5487 Disposable, short 5487L Disposable, long 5832S Reusable, small clip 5833S 5833SL Disposable, small clip, short
More informationCRC 431 ECG Basics. Bill Pruitt, MBA, RRT, CPFT, AE-C
CRC 431 ECG Basics Bill Pruitt, MBA, RRT, CPFT, AE-C Resources White s 5 th ed. Ch 6 Electrocardiography Einthoven s Triangle Chest leads and limb leads Egan s 10 th ed. Ch 17 Interpreting the Electrocardiogram
More informationNon-Invasive Transcutaneous Pacing
Non-Invasive Transcutaneous Pacing Application Note Introduction This Application Note provides an overview of non-invasive transcutaneous pacing. It includes a brief history of pacing, describes the electrical
More informationUNDERSTANDING YOUR ECG: A REVIEW
UNDERSTANDING YOUR ECG: A REVIEW Health professionals use the electrocardiograph (ECG) rhythm strip to systematically analyse the cardiac rhythm. Before the systematic process of ECG analysis is described
More informationChapter 9. Learning Objectives. Learning Objectives 9/11/2012. Cardiac Arrhythmias. Define electrical therapy
Chapter 9 Cardiac Arrhythmias Learning Objectives Define electrical therapy Explain why electrical therapy is preferred initial therapy over drug administration for cardiac arrest and some arrhythmias
More informationArrhythmia Management Joshua M. Cooper, MD, FHRS, FACC
Arrhythmia Management Joshua M. Cooper, MD, FHRS, FACC Professor of Medicine Director of Cardiac Electrophysiology Temple University Health System Plumbing Electrical System Bradyarrhythmias Sinus Node
More informationAdvanced ICD Concepts
1 4 2 5 7 3 6 8 Advanced ICD Concepts This presentation is provided with the understanding that the slide content must not be altered in any manner as the content is subject to FDA regulations. This presentation
More informationECG Interpretation. Introduction to Cardiac Telemetry. Michael Peters, RN, CCRN, CFRN CALSTAR Air Medical Services
ECG Interpretation Introduction to Cardiac Telemetry Michael Peters, RN, CCRN, CFRN CALSTAR Air Medical Services Disclosures Nothing to disclose Objectives Describe the electrical conduction pathway in
More informationCardiac Pacemakers» 2013 HOSPITAL REIMBURSEMENT GUIDE
Cardiac Pacemakers» 2013 HOSPITAL REIMBURSEMENT GUIDE 2 Contents Page Introduction Medicare Coding and Payment Overview Hospital Inpatient Hospital Outpatient HCPCS Device Category C-Codes Coverage for
More informationCARDIAC DEVICE MR-CONDITIONAL PRODUCT SUMMARY CHART
CARDIAC DEVICE MR-CONDITIONAL PRODUCT SUMMARY CHART December 2015 This chart encompasses all Medtronic cardiac devices FDA-Approved as MR Conditional and included in the MRI SureScan portfolio. If a device
More informationDifferent indications for pacemaker implantation are the following:
Patient Resources: ICD/Pacemaker Overview ICD/Pacemaker Overview What is a pacemaker? A pacemaker is a device that uses low energy electrical pulses to prompt the heart to beat whenever a pause in the
More informationSpecified Tolerance (ms)
SigmaPace TM 1000: Medtronic Temporary External Pacemaker Model 5388 Checkout Procedure 1. PRELIMINARY SET UP a. Connect the pacemaker output to the analyzer s ATRIAL and VENTRICULAR 4 mm interface jacks
More informationCardiac arrhythmias. Janusz Witowski. Department of Pathophysiology Poznan University of Medical Sciences. J. Witowski
Cardiac arrhythmias Janusz Witowski Department of Pathophysiology Poznan University of Medical Sciences A 68-year old man presents to the emergency department late one evening complaining of increasing
More information-RHYTHM PRACTICE- By Dr.moanes Msc.cardiology Assistant Lecturer of Cardiology Al Azhar University. OBHG Education Subcommittee
-RHYTHM PRACTICE- By Dr.moanes Msc.cardiology Assistant Lecturer of Cardiology Al Azhar University The Normal Conduction System Sinus Node Normal Sinus Rhythm (NSR) Sinus Bradycardia Sinus Tachycardia
More informationPACEMAKER INTERPRETATION AND DEVICE MANAGEMENT PART II
1 PACEMAKER INTERPRETATION AND DEVICE MANAGEMENT PART II 2012 Cynthia Webner DNP, RN, CCNS, CCRN-CMC Karen Marzlin DNP, RN, CCNS, CCRN-CMC 2 ADDITIVES IN DEVICE THERAPY Key Choice / CNEA 1 Adaptive Rate
More informationTransvenous Pacemaker Procedures
Cardiology: Pacemaker and Defibrillator Coding Presented By: Moderate Sedation 2017 99151 : under age 5, initial 15 minutes by MD performing intervention 99152: age 5 or older, initial 15 minutes by MD
More informationPractice Questions.
IBHRE Prep Practice Questions Question 1 The relative refractory yperiod of the ventricular myocardium corresponds to which of the following phases of the action potential? A. (0) B. (1) C. (2) D. (3)
More informationDanish Pacemaker and ICD Register Annual report 2015
Danish Pacemaker and ICD Register Annual report 2015 Preface The Danish Pacemaker Register was founded in 1982 by physicians from all Danish hospitals where pacemakers were implanted. When the first implantable
More informationStep by step approach to EKG rhythm interpretation:
Sinus Rhythms Normal sinus arrhythmia Small, slow variation of the R-R interval i.e. variation of the normal sinus heart rate with respiration, etc. Sinus Tachycardia Defined as sinus rhythm with a rate
More informationECG Interactive Session
SA HEART 2018 PRE-CONGRESS WORKSHOP 4 OCTOBER 2018 ECG Interactive Session Ashley Chin Cardiologist/Electrophysiologist University of Cape Town Groote Schuur Hospital ECG 1 Which ONE of the following is
More information11/21/18. EKG Pop Quiz. Michael Giocondo, MD Cardiac Electrophysiology Saint Luke s Cardiovascular Consultants
EKG Pop Quiz Michael Giocondo, MD Cardiac Electrophysiology Saint Luke s Cardiovascular Consultants 1 Disclosures No financial relationships to disclose. EKG #1 75 y/o woman with a dual-chamber pacemaker
More informationDanish Pacemaker and ICD Register Annual Report 2016
Danish Pacemaker and ICD Register Annual Report 2016 Preface The Danish Pacemaker Register was founded in 1982 by physicians from all Danish hospitals where pacemakers were implanted. When the first implantable
More informationReviewed Date: Supersedes (Policy #/description & date): Prepared by: Jacque Callis, RN Approved by: D.R. Johnson, MD
External Pacemaker Set-up and Revised Date: 11/13/2014 Page 1 of 5 POLICY: The transcutaneous external pacemaker will be used as a noninvasive method of delivering electrical stimuli to the myocardium
More informationSupplementary Online Content
Supplementary Online Content Tseng ZH, Hayward RM, Clark NM, et al. Sudden death in patients with cardiac implantable electronic devices. JAMA Intern Med. Published online June 22, 2015. doi:10.1001/jamainternmed.2015.2641.
More informationCardiovascular Nursing Practice: A Comprehensive Resource Manual and Study Guide for Clinical Nurses 2 nd Edition
Cardiovascular Nursing Practice: A Comprehensive Resource Manual and Study Guide for Clinical Nurses 2 nd Edition Table of Contents Volume 1 Chapter 1: Cardiovascular Anatomy and Physiology Basic Cardiac
More informationSinus rhythm with premature atrial beats 2 and 6 (see Lead II).
Cardiac Pacemaker Premature Beats When one of ectopic foci becomes irritable, it may spontaneously fire, leading to one or more premature beats. Atrial and junctional foci may become irritable from excess
More informationQ & A: How to Safely Scan Patients with a SureScan MRI Pacemaker
Q & A: How to Safely Scan Patients with a SureScan MRI Pacemaker Patient Scheduling and Screening Q: Is there any special (other than regular MRI consent) consent form that should be signed by the patient?
More informationSIMPLY ECGs. Dr William Dooley
SIMPLY ECGs Dr William Dooley Content Basic ECG interpretation pattern Some common (examined) abnormalities Presenting ECGs in context Setting up an ECG Setting up an ECG 1 V1-4 th Right intercostal space
More informationNorthwest Community Healthcare Paramedic Education Program AV Conduction Defects/AV Blocks Connie J. Mattera, M.S., R.N., EMT-P
Northwest Community Healthcare Paramedic Education Program AV Conduction Defects/ Connie J. Mattera, M.S., R.N., EMT-P Reading assignments: Bledsoe Vol. 3: pp. 88-93; 120-121 (atropine, norepinephrine,
More informationHTEC 91. Performing ECGs: Procedure. Normal Sinus Rhythm (NSR) Topic for Today: Sinus Rhythms. Characteristics of NSR. Conduction Pathway
HTEC 91 Medical Office Diagnostic Tests Week 3 Performing ECGs: Procedure o ECG protocol: you may NOT do ECG if you have not signed up! If you are signed up and the room is occupied with people who did
More informationCardiac Telemetry Self Study: Part One Cardiovascular Review 2017 THINGS TO REMEMBER
Please review the above anatomy of the heart. THINGS TO REMEMBER There are 3 electrolytes that affect cardiac function o Sodium, Potassium, and Calcium When any of these electrolytes are out of the normal
More informationUNDERSTANDING ELECTROPHYSIOLOGY STUDIES
UNDERSTANDING ELECTROPHYSIOLOGY STUDIES Testing and Treating Your Heart s Electrical System A Problem with Your Heart Rhythm The speed and pattern of a heartbeat is called the heart rhythm. The rhythm
More informationREtrive. REpeat. RElearn Design by. Test-Enhanced Learning based ECG practice E-book
Test-Enhanced Learning Test-Enhanced Learning Test-Enhanced Learning Test-Enhanced Learning based ECG practice E-book REtrive REpeat RElearn Design by S I T T I N U N T H A N G J U I P E E R I Y A W A
More informationChapter 16: Arrhythmias and Conduction Disturbances
Complete the following. Chapter 16: Arrhythmias and Conduction Disturbances 1. Cardiac arrhythmias result from abnormal impulse, abnormal impulse, or both mechanisms together. 2. is the ability of certain
More informationMatters of the Heart: Comprehensive Cardiology SARAH BEANLANDS RN BSCN MSC
Matters of the Heart: Comprehensive Cardiology SARAH BEANLANDS RN BSCN MSC Who am I? Class Outline Gross anatomy of the heart Trip around the heart Micro anatomy: cellular and tissue level Introduction
More information