Cardiac Pacing (Landes Bioscience Medical Handbook by Charles J. Love

By Charles J. Love

Ohio country Univ., Columbus. Pocket-sized instruction manual for physicians or citizens who are available touch with sufferers who've implanted center rhythm regulate units. Covers simple and complex pacemaker features, malfunctions, and symptoms for using pacemakers and defibrillators. Trim dimension: eight x five inches. Wire-spiral binding. DNLM: Pacemaker, man made.

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Additional resources for Cardiac Pacing (Landes Bioscience Medical Handbook (Vademecum))

Example text

2:1 Block (Multiblock) .......................................................................................... Pseudo-Wenckebach ............................................................................................. Rate Smoothing .................................................................................................... Fallback Response ................................................................................................. Sensor-driven Rate Smoothing .............................................................................

43 43 44 45 45 46 INTRODUCTION “Upper rate” behavior is intrinsic to the DDD and VDD pacing modes. It may be seen any time a mode is used that allows the ventricle to be paced as the result of an atrial-sensed event. Upper rate behavior occurs when the patient’s atrial rate is faster than the programmed upper rate limit (URL) and/or exceeds the atrial sensing limits imposed by the programmed total atrial refractory period (TARP). Since a dual chamber pacemaker acts as an artificial AV-node, it is not surprising that the upper rate response is similar to AV-node behavior.

With intrinsic AV-node function as in example (b), the QRS again occurs before the end of the AVI. The shortening of the AV interval of 50 ms is compensated for by adding back the “lost” 50 ms. The correct cycle length continues to be maintained, resulting in pacing at 150 bpm without violating the upper rate limit. A pacemaker programmed to the DDD mode may appear on the ECG in any of four ways. The function may change from beat to beat as the patient’s sinus rate and AV conduction vary. The description of the cardiac events are often expressed as AS, AP, VS, VP to represent atrial-sensed, atrial-paced, ventricular-sensed and ventricular-paced events respectively.

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