Pacemaker Rhythms

artificial pacemaker

a medical device that substitutes for the normal pacemaker cells of the heart’s electrical conduction system by the use of electrical impulses

pacemaker spike

wave produced on EKG by artificial pacemaker

when the patient’s electrical conduction pathway fails

When may artificial pacemakers be necessitated?

generator

this part of the pacemaker controls rate/strength of electrical impulse

leadwires

this part of the pacemaker relays electrical impulses to the myocardium

temporary pacemakers

these are used to sustain a patient’s heart rate in emergency situations

permanent pacemakers

this is implanted inside the patient’s upper L chest and are left in place

transcutaneous pacing

this is commonly termed external cardiac pacing, it consists of two large electrode pads commonly placed on the anterior-posterior position to conduct impulses

transvenous pacing

this is used to deliver electrical impulses to myocardial tissue, lead wire is inserted through skin and threaded into a large vein leading to the R side of the heart

fixed-rate, demand

pacemakers are preset in what two modes?

fixed-rate

programmed to deliver electrical impulses at a constant and selected rate

demand

programmed to generate electrical impulses when patient’s heart rate falls below a predetermined rate

permanent pacemakers

surgically implanted generator and lead wire introduced into the heart through a central vein, treatment of patient’s w/ symptomatic bradycardia or complete heart block

atrial pacemaker

this is also known as a single-chamber pacemaker

lead wires inserted into RA, stimulates atrium and travels down normal pathway through ventricles

ventricular pacemaker

also known asa single chamber pacemaker

lead wire inserted into RV, impulse produces ventricular depolarization

AV sequential pacemaker

known as a duel-chamber pacemaker

two electrodes on lead wire, one in RA, one in RV

impulse first to atria then to ventricles

bradycardia

complete heart block

second-degree type II heart block

sick sinus syndrome

indications for pacing?

battery failure

runaway pacemakers

failure to capture

failure of sensing devices in demand pacemakers

Problems associated w/ pacemakers?

failure to capture

this occurs when pacemaker spike will be present on the EKG but not followed by a QRS