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Devices: Difference between revisions
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{{DevelopmentPhase}} | |||
==Pacemakers== | ==Pacemakers== | ||
[[Image: |right]] | [[Image: |right]] | ||
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The degree that the pacing system “sees” or senses signals, controlled by the sensitivity setting which is graduated in mV. | The degree that the pacing system “sees” or senses signals, controlled by the sensitivity setting which is graduated in mV. | ||
====Impedance (in | ====Impedance (in Ω):==== | ||
The total pacing impedance is the sum of all resistance to the flow of the electrical impulses. | The total pacing impedance is the sum of all resistance to the flow of the electrical impulses. | ||
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==Complications== | ==Complications== | ||
===Undersensing:=== | ===Undersensing:=== | ||
[[Image:Ventricular undersensing.svg]] | [[Image:Ventricular undersensing.svg|right|thumb|300px]] | ||
An intrinsic depolarization that is present, is not sensed by the pacemaker. This can be due to: | An intrinsic depolarization that is present, is not sensed by the pacemaker. This can be due to: | ||
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===Oversensing:=== | ===Oversensing:=== | ||
[[Image:Ventricular oversensing.svg]] | [[Image:Ventricular oversensing.svg|right|thumb|300px]] | ||
The pacemakers senses signals on the marker | The pacemakers senses signals on the marker | ||
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Patients do not meet the evidence based ICD implantation criteria if they have (1) a myocardial infarction within 40 days before ICD implantation; (2) newly diagnosed heart failure at the time of ICD implantation without prior therapy; (3) NYHA class IV symptoms of congestive heart failure. | Patients do not meet the evidence based ICD implantation criteria if they have (1) a myocardial infarction within 40 days before ICD implantation; (2) newly diagnosed heart failure at the time of ICD implantation without prior therapy; (3) NYHA class IV symptoms of congestive heart failure. | ||
==Implantation== | |||
[[Image:ChestXray.jpg|right|thumb|Chest X-ray of a patient with an CRT device (in posteroanterior and lateral view) | |||
The red arrow is the right atrial lead | |||
The blue arrow is the right ventricular lead | |||
The green arrow is the coronary sinus lead]] | |||
ICDs are implanted under local anaesthesia in a sterile operating room or catheterization laboratory. Transvenous ICD implantation starts, like pacemaker implantation, with inserting the ICD leads in the left or right cephalic vein. Fluoroscopy is used to ensure the appropriate location in the atrium or ventricle. Leads are often positioned in the auricle of the right atrium and/or the right ventricular apex. | ICDs are implanted under local anaesthesia in a sterile operating room or catheterization laboratory. Transvenous ICD implantation starts, like pacemaker implantation, with inserting the ICD leads in the left or right cephalic vein. Fluoroscopy is used to ensure the appropriate location in the atrium or ventricle. Leads are often positioned in the auricle of the right atrium and/or the right ventricular apex. | ||