pacemaker, aicds

Question 1

Where are pacemakers usually implanted?

Answer 1

In the subcutaneous tissues overlying the prepectoral fascia in the upper chest, usually on the left side. Can also be on the right chest if needed.

Question 2

What is the purpose of a pacemaker?

Answer 2

Uses electrical impulses to stimulate cardiac contraction, usually maintaining HR around 60 bpm.

Question 3

What are indications for pacemaker implantation?

Answer 3

Symptomatic sinus bradycardia, second-degree type II heart block, third-degree heart block.

Question 4

What are the primary components of a pacemaker generator?

Answer 4

Lithium-iodine battery (lasts ~10 years), hybrid circuit (microprocessor, resistors), and a small computer control device.

Question 5

How long does a pacemaker battery usually last?

Answer 5

About 10 years (replacement typically at 8–9 years).

Question 6

How are pacemaker settings checked/changed?

Answer 6

With a programmer (computer), using a wand or wireless connection (radiofrequency or Wi-Fi).

Question 7

How often should pacemaker checks be done?

Answer 7

Every 3–6 months.

Question 8

What can a pacemaker programmer do?

Answer 8

Change settings, download data, view rhythm, pacing, and spikes.

Question 9

Where are pacer spikes seen on ECG?

Answer 9

Right before the P wave.

Question 10

What is an Automatic Implantable Cardioverter-Defibrillator (AICD)?

Answer 10

A small electronic device implanted in the chest to monitor and correct dysrhythmias; capable of cardioversion and defibrillation.

Question 11

Where is an AICD usually implanted?

Answer 11

On the left side of the chest.

Question 12

Who are candidates for an AICD?

Answer 12

Patients with structural heart disease/defects, survivors of cardiac arrest (VF/VT), unexplained syncope, long QT syndrome, awaiting heart transplant, or autoimmune heart diseases.

Question 13

What does an AICD do besides treat arrhythmias?

Answer 13

Collects and stores data about the heart’s electrical activity for the cardiologist.

Question 14

How does an AICD treat arrhythmias?

Answer 14

First: burst of high-speed pacing (cardioversion). If that fails: delivers an electrical shock (defibrillation).

Question 15

What does a cardioversion shock from an AICD feel like?

Answer 15

Very low level (many don’t notice).

Question 16

What does a defibrillation shock from an AICD feel like?

Answer 16

Stronger shock — the patient will feel it.

Question 17

What dysrhythmias are AICDs used to treat?

Answer 17

Life-threatening dysrhythmias such as VF and VT.

Question 18

Post-pacemaker/AICD surgery: what complications should be monitored?

Answer 18

Infection (goes straight to the heart), rejection, rhythm monitoring.

Question 19

What education should be provided after pacemaker/AICD surgery?

Answer 19

Watch for signs of infection, follow-up for device checks, understand shocks may occur, importance of monitoring and battery changes.

Question 20

If a patient develops signs of infection post-pacemaker surgery, why is this critical?

Answer 20

Infection can spread directly to the heart.