Pacemaker Components
the can
What are the two types of leads, in terms of polarity?
Unipolar and bipolar leads
What is the name of the pacemaker mode coding system?
NBG codes
What is always the first timing cycle you should evaluate?
Lower rate limit (LRL, LRi)
A patient presents with symptomatic CHB with significant pauses. What symptoms are they likely feeling?
Fatigue, cold, dizzy, lightheaded, syncope
The lead(s)
This type of lead may cause pectoral muscle stimulation.
Unipolar lead
What does the second letter in an NBG code represent?
The chamber(s)being sensed
Name of the timing cycle that occurs directly after an atrial pace is delivered in a single chamber device.
Atrial blanking (AB)
A patient presents with symptomatic CHB with significant pauses. What can you do immediately to improve their quality of life?
Temporary pacing!
Microprocessors inside the can are responsible for determining which features?
•sensing
•Output
•Telemetry
•diagnostic circuits.
This type of lead is usually less susceptible to oversensing of non-cardiac signals.
Bipolar leads
Define the "I" in the third column of NGB codes.
I = inhibit. A pace will not be delivered to that chamber if there are intrinsic beats sensed.
AVi + PVARP = ???
TARP
A patient presents with symptomatic CHB with significant pauses. What class indication for permanent pacing is this?
Class I - if not reversible, regardless of symptoms.
Class IIa - with ICD is recommended if they it is caused by cardiomyopathy
Explain how your own body tissue can be part of a pacemaker's conduction system.
Body tissue helps to transmit electrical impulses cell-by-cell back to the can.
A _____________ pacemaker consists of one lead in either the atrium or ventricle.
What does VVRI mode mean?
Paces: Ventricle
Senses: Ventricle
Inhibits if it senses an intrinsic ventricular beat
Rate response sensor is on
Where on the QRS complex would you see a PVAB?
In the qR wave - right after a VP or VS.
A patient presents with symptomatic CHB with significant pauses. What mode do you recommend?
VDD and/or DDD
(P-wave tracking)
This type of fixation allows for lead positioning anywhere in the heart’s chamber.
Active fixation.
A ___________ pacemaker provides AV synchrony and pacing support in both atrium and ventricle if needed
dual chamber
What mode is referred to as AV sequential pacing, dual‐chamber sensing with inhibition, and P‐synchronous pacing with rate modulation?
DDDR
What effect would shortening the AV internal accomplish?
Allows more frequent ventricular beats; mimicks a healthy heart's intrinsic rhythm when demand increases.
The patient is at their first check-up post-implant and feeling much better! What pacemaker feature can you turn on to evaluate their intrinsic rhythm?
Hysteresis