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26 Cards in this Set
- Front
- Back
goal of pacing
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maintian CO
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-ability of pacing stim to depolaize chamber
-recognized when pacing spike is followed by appropriate waveform |
capture
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-ability of pacemaker to detect intrinsic cardiac activity to be able to respond appropriately
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sensing
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Absence of pacing stimulus where one should be
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Failure to discharge
-Ck battery, connections -r/o electrical interference -may need emergent temp pacer |
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Inability of pacer to sense pt's own intrinsic beats. pacer seen firing on ST segments and R waves, etc.
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Undersensing
-increase sensitivity i.e. reduce mV setting (set too high) -lead dislodgment |
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Strength of electrical impulse from pacer measured in
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mA
Output/Stim threshold |
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Strength of electrical impulse from heart measured in
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mV
Sensing/sensitivity |
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Occurs when pacer senses stray electrical signals. Pacer fires impulses at slower rate then programmed for.
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Oversensing
Decrease sensitivity i.e. increase mV setting (set too low) |
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Pacer spikes not followed by waveforms (ie P wave or QRS wave)
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Failure to capture
Ck pt for S&S dec CO -lead dislodgment/connections -increase output (mA)(set too low) -Check labs - |
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mA too low causes
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Failure to capture
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mV set too low causes
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Oversensing
Must increase setting (thus decreasing sensitivity) |
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mV set too high causes
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Undersensing
Must decrease setting (thus increasing sensitivity) |
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Impt teaching for pt in hosp with transvenous pacer
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Keep arm/leg straight
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Position-chambers paced
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1
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Position-chambers sensed
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2
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Position-response to sensing
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3
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Position-rate modulation
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4
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Pacer set to I in 3rd position (response to sensing). Pacer only fires if pt's own intrinsic rate drops below set rate (say 70)
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Demand pacing
I=pacer being inhibited |
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Mode used to test pacers fxn (ie approp firing/capture) on Dr visit
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asynchronous
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VVI
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Single lead pacer
In ventricle On demand -Often used for temp vent pacers |
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DDD
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Dual lead
Ventricle and atrium Paces and senses (works as on demand but also can trigger a qrs based on sensed p wave) -Often used for perm pacer |
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DDDR
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Dual lead
Ventricle and atrium Paces and senses Also speeds up or slows rate in response to sensor output |
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T/F
Nurses can change settings on pacers |
T for temp pacer
F for perm pacer |
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ICD must get checked how often
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q2-3 mo
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T/F
Pt with ICD can stop antiarrhythmic Rx |
F-Treated no differently. In emergent situations can still be shocked as well
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indicate in class 3/4 HF
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Bivent ICD
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