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Devices: Difference between revisions
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===Non-capture:=== | ===Non-capture:=== | ||
[[Image:AtrialCap.jpg|right|thumb|300px|Failure of atrial capture in a patient with atrial standstill, no P-waves are seen after the atrial stimuli.]] | |||
The electrical impulse is not followed by the myocardium. | The electrical impulse is not followed by the myocardium. | ||
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The arrhythmia detection zone is the category in which a predefined therapy will be given: | The arrhythmia detection zone is the category in which a predefined therapy will be given: | ||
*'''Monitor zone (e.g. 160-180 bpm):''' All events in this zone will be recorded in the ICD and can be seen during follow up visits, however no therapy is given. | *'''Monitor zone (e.g. 160-180 bpm):''' All events in this zone will be recorded in the ICD and can be seen during follow up visits, however no therapy is given. | ||
[[Image:ICD.jpg|right|thumb|300px|ICD strook met intracardiale electrocardiogram (EGM): VF met shock. De rode pijl geeft het moment van de shock aan.]] | |||
*'''Fast VT zone (e.g. 180-240 bpm):''' All events in this zone will be recorded in the ICD and can be seen during follow up visits. Therapy is given or not if the arrhythmia satisfies several criteria, which are programmed as well, such as SVT/VT discriminators. | *'''Fast VT zone (e.g. 180-240 bpm):''' All events in this zone will be recorded in the ICD and can be seen during follow up visits. Therapy is given or not if the arrhythmia satisfies several criteria, which are programmed as well, such as SVT/VT discriminators. | ||
*'''VF zone (e.g. >240 bpm):''' All events in this zone will be recorded in the ICD and can be seen during follow up visits and therapy is given immediately. | *'''VF zone (e.g. >240 bpm):''' All events in this zone will be recorded in the ICD and can be seen during follow up visits and therapy is given immediately. | ||
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===Numbers of intervals to detect / Time to detect=== | ===Numbers of intervals to detect / Time to detect=== | ||
The ICD diagnoses an arrhythmia when a sufficient (and programmable) number of events in an event sequence are binned. This is usually stated in an “X out of Y” pattern, such as 12 out of 16 intervals. | The ICD diagnoses an arrhythmia when a sufficient (and programmable) number of events in an event sequence are binned. This is usually stated in an “X out of Y” pattern, such as 12 out of 16 intervals. | ||
===Therapy=== | ===Therapy=== | ||
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==Cardiac resynchronisation therapy (CRT)== | ==Cardiac resynchronisation therapy (CRT)== | ||
[[Image:Schematic.jpg|right|thumb|Schematic display of an CRT device]] | [[Image:Schematic.jpg|right|thumb|200px|Schematic display of an CRT device]] | ||
[[Image:ChestXray.jpg|right|thumb| | [[Image:ChestXray.jpg|right|thumb|250px|Chest X-ray of a patient with an CRT device (in posteroanterior and lateral view)<br/>The red arrow is the right atrial lead<br/>The blue arrow is the right ventricular lead<br/>The green arrow is the coronary sinus lead]] | ||
CRT-pacemaker (CRT-P) is a biventricular pacemaker with leads in both ventricles to ensure synchronized contraction. A CRT-defibrillator (CRT-D) is an ICD with biventricular pacing option. | CRT-pacemaker (CRT-P) is a biventricular pacemaker with leads in both ventricles to ensure synchronized contraction. A CRT-defibrillator (CRT-D) is an ICD with biventricular pacing option. | ||