Pacemakers (Exam #2) Flashcards
What are the three criteria for a permanent pacemaker?
- NON-reversible
- Symptomatic
- Bradycardia
How can you differentiate atrial pacing from ventricular pacing (2)?
Atrial pacing
- Pacing spike before each P wave
- Normal QRS
Ventricular pacing
- Pacing spike before each QRS complex
- Wide QRS
What are the four functions of a Pacemaker?
- Stimulate cardiac depolarization
- Sense intrinsic cardiac function
- Respond to increased metabolic demand by providing rate response pacing
- Provide diagnostic information
What do pacing spikes look like, and what do they represent?
Narrow pacing spikes represent depolarization of the paced chamber
What are the four types of Pacemaker failure?
- Failure to Capture
- Failure to Sense
- Failure to Pace (oversensing)
- Pacemaker-Mediated Tachycardia
What is Failure to Capture?
Pacing spikes NOT followed by P wave or QRS complex
What failure involves pacing spikes NOT followed by P wave or QRS complex?
Failure to Capture
What is Failure to Sense?
Pacing spikes that fall where they shouldn’t
What failure involves pacing spikes that fall where they shouldn’t?
Failure to Sense
What is Failure to Pace?
Absence of pacing spikes in presence of slower HR than the set rate
What failure involves absence of pacing spikes in presence of slower HR than the set rate?
Failure to Pace
What is Pacemaker-Mediated Tachycardia?
Fast HR with pacing spikes preceding each QRS complex (+/- P waves)
What failure involves fast HR with pacing spikes preceding each QRS complex (+/- P waves)?
Pacemaker-Mediated Tachycardia
How can you differentiate Pacemaker from ICD?
- Pacemaker: senses and paces
- ICD: senses and paces AND cardioverts and defibrillates
How can you differentiate unipolar leads from bipolar pacemaker systems on EKG?
- Unipolar = TALL pacing spikes
- Bipolar = SHORT pacing spikes
