Term
Let's try a few:
1) VOO
2) DOO
3) VVI
4) DDD
5) what does an AV sequential do? |
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Definition
1) Vetricular paced, no chamber sensed (asynchronous), no mode response
2) both chambers paced, no chamber sensed, no mode response
3) Ventricle paced, ventricle sensed, no response
4) dual chambers paced, dual sense, dual mode of response
5) AV sequential = DVI pacing; dual chamber paced, sensing in ventricle & inhibited mode of response. This is god for preserving AV synchrony during bradycardia. |
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Term
| Will placing a magnet over a generator always produce a change in pacing? |
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Definition
| NO. Not all pacemakers have a continuous, asynchronous mode. |
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Term
| What is the safest way to avoid intaoperative problems, esp. if monopolar Bovie will be used? |
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Definition
Asynchronous pacing at a rate > than pt's underlying rate. This ensures no over or undersensing from EMI.
(remember: competition w/ intrinsic rate is not good) |
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Term
| What are some "ideal" preoperative key points for pts w/ pacemakers? |
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Definition
- have the "can" interrogated by a competent authority before anesthetic
- look for copy of interrogation to ensure device has appropriate safety margins.
- replace if near elective replacement period.
- determine underlying rate/rhythm for backup pacing support
- identify magnet rate/rhythm
- program all rate enhancements off
- major cases should warrant increase pacing rates
- disable antitachycardia therapy if a defibrillator |
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Term
| Does a bipolar Bovie cut better than a monopolar Bovie? |
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Definition
| Hells NO. Bipolar Bovie use is better for pacemakers. Also, short bursts are better than long, sustained bursts. |
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Term
| T or F: "Coagulation" and "Blend" cutting is better than pure cutting. |
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Definition
False.
Maybe for the surgeon, but not for the pacemaker. |
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Term
| What are some things you can do if a pt with a pacemaker is undergoing electroconvulsive therapy (ECT)? |
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Definition
- ICD should be disabled
- Consider temp. pacing if ICD also paces
- consider asynchronous pacing
- be ready to pace or shock; there are many rhythm changes during ECT
- a rep should check the device after therapy
* ECT was not found to impact pacer* |
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Term
| T or F: MRI on pts with pacemakers is OK |
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Definition
| Big, fat FALSE. Majority agree that it is contraindicated |
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Term
| Is there a contraindication w/ radiation therapy and pacemakers? |
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Definition
| Not really. It's a case-by-case basis w/ EP or cardiologist consults in order. |
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Term
| What should be avoided if a pt w/ a pacemaker is having some vicious kidney boulders broken up (lithotripsy) |
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Definition
1) avoid beam towards generator
2) DC atrial pacing if the system triggers on the R wave |
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