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45 Cards in this Set
- Front
- Back
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Name two types of pacemakers. |
1. Temporary 2. Permanent |
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Name three types of temporary pacing. |
1. transvenous pacing 2. trancutaneous pacing 3. epicardial pacing |
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Why would you use temporary pacing? |
1. 3rd degree AV Block 2. symptomatic bradycardia 3. cardiac arrest |
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Name the different locations that permanent pacing can be placed. |
1. Atrial (RA) 2. Ventricular (RV) 3. Dual chamber or Atrio-Ventricular (RA & RV) 4. Bi-Ventricular (RA, RV & Coronary Sinus) |
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Why would permanent pacing be necessary? |
1. sinus bradycardia 2. sinus arrest 3. heart blocks 4. sick sinus syndrome 5. tachyarrhythmias 6. atrial fib with slow ventricular response |
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Name the characteristics that show a pacer rhythm. |
1. pacer spikes or pacemaker artifact 2. larger P waves and wider QRS 3. rate of rhythm not lower than what is set on pacemaker |
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What kind of pacemaker only works when the heart rate falls below a set number? |
Demand Pacemaker
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What is another name for demand pacing and why? |
Synchronous pacing, works in coordination with the underlying rhythm. |
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What is another name for fixed pacing? |
Non-demand or asynchronous pacing, paces at a set rhythm regardless of the underlying rhythm |
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In AV sequential pacing, which chamber of the heart is paced first and which is paced second? |
the atria is first and then the ventricles |
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What is the advantage of AV sequential pacing? |
the atria empty completely and ventricular filling is improved (increased cardiac output) |
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In a paced rhythm, the PRI is called what? |
automatic interval |
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What are the two functions of the pacemaker? |
1. Sense the underlying rhythm 2. Pace the heart |
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What is the term used when a Pwave or QRS complex follows a pacer spike? |
capture |
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What is the term used when you see a pacer spike and no other activity? |
failure to capture |
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What is the term used when the pacemaker initiates a beat when it is not needed? |
failure to sense |
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What is a fusion beat? |
When the patient's intrinsic heartbeat and a pacemaker beat happen at the same time. |
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How many catagories of pacemaker NBG codes are there? |
five |
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What is another name for rapid pacing? |
overdrive suppression |
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What is overdrive suppression used to treat? |
rapid AFib or Ventricular arrhythmias |
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What is the difference between a unipolar and a bipolar pacemaker? |
Unipolar - one negative (-) electrode at the distole tip. Bipolar - one negative (-) and one positive (+) electrode at the distole tip |
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What is an external pulse generator? |
difibrillator |
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What kind of pacing has the wires inserted through the subclavian vein to the superior vena cava and into the right atria? |
Transvenous pacing |
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If the leads are placed on the chest wall, what is this called? |
transcutaneous |
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When in surgery, if pacing of the heart was needed, what kind of pacing would be used? |
epicardial pacing |
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What is known as the "brains" of the pacemaker? |
pulse generator |
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What are the three parts of the pulse generator? |
1. CPU 2. memory 3. battery |
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What are possible problems with using a fixed pacemaker? |
1. R on T Phenomena 2. could cause VT or VFib |
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What do the five letter of the NBG code stand for? |
1st letter - which chamber is paced 2nd letter - which chamber is sensed 3rd letter - response to what is sensed 4th letter - programmability 5th letter - antitachycardia functions |
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The first and second letters of the NGB code give choices of O, A, V, D. What do these stand for? |
O = No chamber paced A = Atrium (RA) V = Ventricles (RV) D = Dual (RA & RV) |
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The third letter of the NGB code gives choices of O, T, I, D. What do these stand for? |
O = None, fixed rate T = triggers pacing I = inhibits pacing D = dual, can trigger and/or inhibit |
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What could cause failure to capture? |
1. low sensitivity - need to increase voltage 2. low pacemaker battery 3. dislodged, loose, fibrotic or fractured electrode |
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What could you do when you see a failure to sense? |
1. increase pacemaker's sensitivity - lower the mV 2. check connections 3. reverse polarity 4. check electrodes |
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What is the term to describe when the pacer thinks it saw a beat when there actually was none? |
oversensing |
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What is a solution when oversensing occurs? |
1. decrease the pacemaker sensitivity - increase the mV decreases the amplitude |
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What is competition? |
When the patient's own heartbeat and the pacer beat are similar. |
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What can cause competition? |
1. asynchronous pacing 2. failure to sense 3. mechanical failure 4. loose connections |
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What does AICD stand for? |
automatic implantable cardioverter, defibrillator |
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What does ICD stand for? |
implantable cardioverter, defibrillator |
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What does the term intrinsic refer to? |
The patient's own rhythm. |
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Name the three refractory periods and the vulnerability of each one to be stimulated. |
1. beginning of the T wave - cannot be stimulated 2. midway of the T wave - will respond to a strong stimulus 3. end of the T wave - will respond to a weak stimulus |
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Which lead on the pacemaker causes a higher pacer spike, the bipolar or unipolar? |
the unipolar is larger than the bipolar |
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What does TTM mean and how is it used? |
transtelephonic monitoring, patients can use the telephone to send the readings of their pacemaker to their doctor. |
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How is a pacemaker programmed? |
using radio frequencies, the pacemaker can be programmed and reprogrammed to fit the patient's needs |
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What are some benefits to TTM? |
1. patients can schedule a followup with their doctor from their own home 2. in case of a problem, the patient can get their doctor's help immediately without leaving or calling for a squad that may not be needed |
