A Case-Based Approach to Pacemakers, ICDs, and Cardiac by Paul A. Friedman, David L. Hayes, Samuel J. Asirvatham,

By Paul A. Friedman, David L. Hayes, Samuel J. Asirvatham, Melissa A. Rott, Anita Wokhlu

Complete on-line textual content unfastened with buy of a Print Book

Many caregivers operating within the box of drugs locate that the best way to profit is by means of operating via medical circumstances, and for lots of contributors it truly is much more invaluable to paintings in the course of the examples as "unknowns." this can be very true within the area of implantable cardiac devices.

for you to supply this adventure, specialists from the Mayo health center, Rochester, Minnesota, have produced volumes of case stories that surround diversifications of standard and irregular functionality of pacemakers, ICDs, and CRT units.

The texts were written collaboratively by means of 5 clinicians with differing backgrounds which will current the circumstances in one of these means that they're appropriate to a number of caregivers. instances for this booklet have been chosen in response to scientific relevance and their usefulness for illustrating common ideas, functional counsel, or attention-grabbing findings in gadget perform, with the target of advancing common options in equipment administration.

the 1st quantity comprises introductory and intermediate situations. the second one quantity contains extra intermediate circumstances in addition to advanced/multipart circumstances.

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Additional info for A Case-Based Approach to Pacemakers, ICDs, and Cardiac Resynchronization: Advanced Questions for Examination Review and Clinical Practice - Volume 2

Example text

Heart Rhythm 2005; 2:1371-1375. Used with permission. 4╇ Close-up image of seal plug damaged by wrench (see arrows). From Lee BP, Wood MA, Ellenbogen KA. Oversensing in a newly implanted dual-chamber implantable cardioverter defibrilator: what is the mechanism? Heart Rhythm Journal 2005: 782-783. Used with permission. 5╇ Noise due to a loose set screw (from a different patient). From top to bottom are shown surface ECG, markers, and RV tip to RV distal coil EGM. During provocative maneuvers, high-frequency, saturated EGMs that are typical of loose set screw (or lead fracture) are recorded on the RV tip-RV distal coil EGM.

Myopotential oversensing occurs more not disrupted, if there is air in the header, as the air escapes through the commonly with integrated bipolar leads in which sensing occurs be- damaged seal plug it displaces fluid, transiently alters the impedance, tween a tip electrode and distal coil (larger electrodes with greater sepa- and leads to nonphysiologic noise signals that can be sensed by the ICD. ration lead to a larger “antenna”) than with true bipolar sensing between This form of oversensing subsides after the entrapped air has escaped a distal helix and ring electrode.

Alignment errors lead to misclassi1. Obtain a representative ventricular EGM template during baseline rhythm. 2. Generate a quantitative representation of this template that is stored for future comparison. fication of similar EGMs as different due to improper alignment. St Jude ICDs use the onset of the EGM as the point of reference for alignment. 1 but with accents to facilitate discussion. A single far-field EGM is enlarged (center). Note how the top of the EGM is clipped (arrow). Clipping caused misclassification as VT.

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