Flashcards in Pacing & Anesthetic Management For CIEDs Deck (160)
What is the preferred pacing method in an emergency?
What energy does transcutaneous require to obtain capture?
transcutaneous pacing shows (atrial, ventricular, both) pacing
What are 2 options for transesophageal pacing?
1. Awake patients: swallow a pill electrode that is connected to a pacing wire
2. Sedated patients: flexible catheter connected to a pacing wire
transesophageal pacing paces the (atria, ventricle, both)
What current does transesophageal pacing require to obtain capture?
When is transvenous pacing used?
when a patient is stable or when transcutaneous pacing is not working
How is transvenous pacing placed?
through a central line
Transvenous pacing can pace (atria, ventricles, both)
both with atrial and ventricular leads
Which pacing method provides the most effective capture?
What current does transvenous pacing require?
When do you encounter epicardial pacing?
when the chest is open during cardiac surgery
-leads are sewn into the myocardium
Name 4 temporary pacing methods
A CIED is a (temporary/ permanent) pacemaker
A CIED has a ______ connected to pacing wires that are inserted into the heart via the ______
What are the 3 types of CIEDs?
2. AICD (automated implantable cardioverter defibrillator)
3. CRT (chronic resynchronization therapy) device
- biventricular pacemakers
What are the 2 primary reasons a patient would need a pacemaker?
1. to pace patients with slow heart rates
2. to improve the timing of atrial and ventricular beats in patients with complete heart block
What is a single chamber pacemaker?
When pacemaker leads are inserted into the right atrium OR the right ventricle
what is a dual chamber pacemaker?
When pacemaker leads are inserted in BOTH the right atrium AND the right ventricle
Where is the lead located in an ICD and what does it have?
has a built in shocking coil that can sense and shock tachyarrhythmias
What 3 things can intravascular ICDs do?
2. synchronized cardioversion
3. antitachycardia pacing (defibrillation)
What are subcutaneous ICDs used for?
Where are the leads in a biventricular pacemaker?
one lead in the right ventricle and a second lead guided into the left ventricle through the coronary sinus
How is the pulse generator for the ICD programmed?
by the pacemaker rep
How does the pacemaker rep test an ICD in surgery?
the rep purposely places the patient in Vfib and then will shock them back into sinus rhythm
When testing the ICD in surgery, what should the anesthetist be sure to do?
give a small propofol bolus prior to shock delivery
____ refers to cardiac cells responding to pacemaker stimulation
_____ refers to the minimum current level at which capture is observed
_____ is the current at which the pacemaker maintains capture