Cardiac Pacemakers and Defibrillators, 2nd Edition by Charles J. Love

By Charles J. Love

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Extra info for Cardiac Pacemakers and Defibrillators, 2nd Edition

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12. Pseudo-fusion. The arrows show 2 paced outputs that occurred after the intrin- 3 sic complex is formed. The pace output does not affect the depolarization or repolariza- tion of the heart (if it does then it is a fusion beat or a paced beat). This is often seen in normally functioning pacemakers, though in some situations it may also represent a malfunction. Fig. 13. Latency. This strip is recorded from a patient being paced in the atrium. Note the pause between the pace artifact (arrows) and the evoked P-wave.

19. Surface recording (top) of a patient left bundle branch block and a PVC with a right bundle branch block morphology (3rd beat from the left). Annotation (bottom) is provided by the pacemaker showing the point at which the pacemaker actually senses the QRS (VS = ventricular sensed event). As the depolarization begins in the left ventricle when there is a right bundle branch block, the right ventricle depolarizes last. Note that the sense marker of the PVC occurs near the end of the surface QRS complex.

The programming of this device was DDD with a lower rate limit of 45 and AVI of 230 ms. 4 Fig. 11. AR pacing. The atrium is paced, but the AV node conducts the impulse to the ventricle before the end of the programmed AVI, inhibiting the ventricular output. This device was programmed DDD with a lower rate of 80 and an AVI of 230 ms. Note that the PVC resets the entire timing cycle. Totally Inhibited (PR) This is seen when the intrinsic atrial rate is faster than the lower rate limit, and AV-nodal conduction is more rapid than the programmed A-V delay.

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