Download The Nuts and bolts of Paced ECG Interpretation (Nuts and by Tom Kenny PDF

By Tom Kenny

Not anything is extra difficult to the clinician new to equipment treatment than having to accommodate cardiac electrocardiograms from a tool sufferer. Pacemakers and different implantable cardiac rhythm administration units go away their “imprint” on ECGs and will considerably switch what clinicians see - or anticipate to work out. comparing paced ECGs may be hard, but nowhere is it taught in any kind of finished manner.Designed in particular for clinicians new to equipment treatment, The Nuts and Bolts of analyzing Paced ECGs and EGMs deals functional, trustworthy and goal details on paced cardiac electrograms. Written in a full of life, clever and simple to navigate variety, emphasizing real-life scientific perform and useful suggestions, this e-book contains illustrated paced ECGs via expert artists to assist reduce “fuzzy” traces and emphasize key issues. every one bankruptcy concludes with a record of key issues from every one topic (“Nuts and Bolts”).

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Not anything is extra complicated to the clinician new to gadget remedy than having to accommodate cardiac electrocardiograms from a tool sufferer. Pacemakers and different implantable cardiac rhythm administration units go away their “imprint” on ECGs and will considerably switch what clinicians see - or count on to determine.

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2 Is there sensing? 3 Knowing the device is VVIR with a pacing rate of 70 ppm, is sensor drive active? 4 How would you troubleshoot this situation? There is no capture on this strip, although the pacemaker “thinks” that there is capture (VP). Notice that the small pacemaker spikes do not cause a ventricular depolarization. The only ventricular events on this strip are the four intrinsic ones marked VS on the annotation. Annotations can be great time savers, but you should always compare them against the ECG!

The two main problems that clinicians encounter with sensitivity will be: • Oversensing (the device senses signals that do not represent intrinsic cardiac events) • Undersensing (the device misses signals that do represent intrinsic cardiac events) When you look at the rhythm strips, you’ll see that: • Oversensing leads to under-pacing (look for pauses) • Undersensing leads to over-pacing (visible as “too many spikes”) In order to correct the problem, you need to adjust the sensitivity setting.

4 How would you troubleshoot this situation? There is no capture on this strip, although the pacemaker “thinks” that there is capture (VP). Notice that the small pacemaker spikes do not cause a ventricular depolarization. The only ventricular events on this strip are the four intrinsic ones marked VS on the annotation. Annotations can be great time savers, but you should always compare them against the ECG! The Nuts and Bolts of Paced ECG Interpretation Tom Kenny © 2009 St. Jude Medical. 2 The pacemaker appears to be sensing normally.

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