Basic Cardiac Pacing

Claire Regan MSc

Chief Cardiac Physiologist

UHSM

2009

A Pacemaker!

What is a Pacemaker?

A pacemaker is an electronic device implanted in the body to regulate the heart beat.

It consists of a battery and electronic circuits enclosed in a hermetically sealed can.

The pacemaker delivers electrical stimuli over leads with electrodes in contact with the heart.

(‘Cardiac Pacemakers Step by Step’ – S.Serge Barold, Roland X. Stroobandt, Alfons F. Sinnaeve).

Atrial and Ventricular Leads

Lead Detail

RA and RV Leads

RA Septum/RVOT Leads

Pacemaker Code

Unipolar

Bipolar

Reasons for Implanting AAI

Sinus Node Dysfunction. Sick Sinus Syndrome in the absence of

known or anticipated AV block.

Contraindications for AAI

Heart Block known or anticipated. Atrial Tachyarrhythmias. Neurally Mediated Syncope.

AAI

AAIR

AAI Pacing

AAI Pacing

Reasons for Implanting VVI

Chronic Atrial Tachyarrhythmias.

Contraindications for VVI

Heart Failure. Left Ventricular Systolic or Diastolic

Dysfunction. Neurally Mediated Syncope.

VVI

VVIR

VVI Pacing

VVI Pacing (Bipolar – RVA)

Ventricular Pacing (Unipolar - RVOT)

Reasons for Implanting DDD

♥ AV block

♥ Chronic Bi/Trifascicular block

♥ Sinus Node Dysfunction

Contraindications for DDD

♥ Heart Failure

♥ Chronic Atrial Tachyarrhythmias

DDD

DDDR

AV (DDD) Pacing

AV (DDD) Pacing

References

• Barold, S. S., Stroobandt, R. X., Sinnaeve, A. F. (2004). Cardiac Pacemakers Step by Step. USA: Blackwell Futura.

• Bennett, D. H. (2007). Cardiac Arrhythmias. London: Hodder Arnold.

• Ellenbogen, K. A., Wood, M. A. (2002). Cardiac Pacing and ICD’s. USA: Blackwell Science.

• Hayes, D. L., Lloyd, M. A., Friedman, P. A. (2000). Cardiac Pacing and Defibrillation: A Clinical Approach. USA: Futura Publishing Company.

Any Questions?