Cardiac Pacemakers and Resynchronization Step by Step E-Book

S. Serge Barold

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 322

Veröffentlichungsjahr: 2010

Beschreibung

This new edition of the bestselling step-by-step introduction to cardiac pacemakers now includes additional material on CRT and an accompanying website. It retains the effective use of full-page illustrations and short explanations that gained the book such enormous popularity and now provides information on recent advances in cardiac pacing, including biventricular pacing for the treatment of heart failure.

Leseprobe

Contents

Cover

Half Title Page

Series

Title Page

Copyright

Preface to the First Edition

Preface to the Second Edition

Abbreviations

Color Plate Section

Cardiac Pacing

Implantation

Basic Function

Power Source

Rate or Interval?

Single Chamber Pacemakers

Basic Electricity

Chronic Pacing Threshold and Safety Margin

Sensing

Polarity: Unipolar Versus Bipolar Pacing and Sensing

Ventricular Fusion and Pseudofusion Beats

Operational Characteristics of a Simple DDD Pacemaker

Crosstalk and Crosstalk Intervals

Increasing Complexity: Our Simple DDD Pacemaker Grows to Nine Intervals

Upper Rate Response of DDD Pacemakers

Lower Rate Timing of Dual Chamber Pacemakers

Phantom Programming

Programmability of Lower Rate

Endless Loop Tachycardia

Repetitive Non-Reentrant VA Synchrony: The Cousin of Endless Loop Tachycardia

Types of Dual Chamber Pacemakers

Overdrive Suppression and the Underlying Rhythm

Pacemaker Hemodynamics

Rate-Adaptive Pacemakers

The Pacemaker Stimulus

Magnet Mode

Normal QRS Patterns During Right Ventricular Pacing

Left Ventricular Endocardial Pacing

Manifestations of Myocardial Infarction in the Paced Rhythm

Cardiac Memory

Pacemaker Alternans

Complications of Pacemakers

Non-Electrical Complications

Electrical Complications

Automatic Mode Switching

Minimizing Right Ventricular Pacing

Effect of Drugs and Electrolyte Imbalance

Magnet Application

Capture Verification Algorithms

Keeping Good Records

Factors Influencing Pacemaker Longevity

Pacemaker Follow-Up

The Pacemaker as an Implantable Holter System: Electrogram Storage

Special Functions of Pacemakers

Cardiac Resynchronization (CRT)

Cardiac Resynchronization Hemodynamics

CRT with Only Left Ventricular Pacing

NYHA Class I and II Patients with LBBB and Depressed LV Function

Right Bundle Branch Block

CRT in Patients with a Narrow QRS Complex

Impact of CRT

Alternative Routes to Left Ventricular Pacing

What is a CRT Responder?

Complications of CRT Implantation

Impact of Comorbidities

Programming of CRT Devices

Atrial Fibrillation and Atrial Tachyarrhythmia

Congestive Heart Failure After CRT

Arrhythmias after CRT

Appendix: Guidelines

American Guidelines for Pacemaker Implantation

European Guidelines for Pacemaker Implantation

Commentary

Further Reading

Index

Cardiac Pacemakers and ResynchronizationStep by Step

AN ILLUSTRATED GUIDE

Companion Website

With this book you are given free access to a companion resources site:

www.wiley.com/go/barold/cardiac.

The website includes more than 300 images taken from this book

You are free to download these images and use them for your own presentations to students1

How to access the website:

Look under the label below to see your access code.

Go to www.wiley.com/go/barold/cardiac and enter the code when prompted.

1. Please note that these images are for your own use for study and instruction. If you are using these images in a presentation, the reference to the book should always be displayed along with the image. See website for full copyright information.

This edition first published 2010, © 2010 by S. Serge Barold, Roland X. Stroobandt, and Alfons F. Sinnaeve

Blackwell Publishing was acquired by John Wiley & Sons in February 2007. Blackwell's publishing program has been merged with Wiley's global Scientific, Technical and Medical business to form Wiley-Blackwell.

Registered office:John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

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Library of Congress Cataloging-in-Publication Data

Barold, S. Serge. Cardiac pacemakers and resynchronization therapy step-by-step : an illustrated guide / S. Serge Barold, Roland X. Stroobandt, Alfons F. Sinnaeve. – 2nd ed. p. ; cm. Rev. ed. of: Cardiac pacemakers step-by-step. c2004. Includes bibliographical references and index. ISBN 978-1-4051-8636-0 1. Cardiac pacemakers–Pictorial works. I. Stroobandt, R. (Roland) II. Sinnaeve, Alfons F. III. Barold, S. Serge. Cardiac pacemakers step-by-step. IV. Title. [DNLM: 1. Cardiac Pacing, Artificial–methods–Handbooks. 2. Pacemaker, Artificial–Handbooks. 3. Electrocardiography–methods–Handbooks. WG 39 B264c 2010] RC684.P3B365 2010 617.4'120645–dc22 2010010756

ISBN: 9781405186360

A catalogue record for this book is available from the British Library.

Preface to the First Edition

The impetus for writing this book came from our observations that many healthcare professionals and young physicians working in emergency rooms, intensive and coronary care units were unable to interpret simple pacemaker electrocardiograms correctly. Over the years we also heard many complaints from beginners in the field of cardiac pacing that virtually all, if not all, the available books are too complicated and almost impossible to understand. Indeed, the ever-changing progress in electrical stimulation makes cardiac pacing a moving target. Therefore we decided to take up the challenge and write a book for beginners equipped with only a rudimentary knowledge of electrocardiography and no knowledge of cardiac pacing whatsoever. Because many individuals first see the pacemaker patient after implantation, the book contains little about indications for pacing and implantation techniques. The book starts with basic concepts and progressively covers more advanced aspects of cardiac pacing including troubleshooting and follow-up.

As one picture is worth a thousand words, this book tries to avoid unnecessary text and focuses on visual learning. We undertook this project with the premise that learning cardiac pacing should be enjoyable. Cardiac pacing is a logical discipline and should be fun and easy to learn with the carefully crafted illustrations in this book. The artwork is simple for easy comprehension. Many of the plates are self-explanatory and the text in the appendix only intends to provide further details and a comprehensive overview.

Many of the images used to create the illustrations in this book are taken from CorelDraw and Corel Mega Gallery clipart collections.

We are grateful to Charlie Hamlyn of Blackwell Publishing and Tom Fryer of Sparks for their superb work in the production of this book.

S. Serge Barold Roland X. Stroobandt Alfons F. Sinnaeve

Preface to the Second Edition

The first edition of the book has been well received all over the world and translated into Japanese, Chinese and Polish. The same format has been retained in the second edition because of its wide popularity and the frequent positive feedback that it facilitates learning and understanding. Many new plates were added. A few plates were upgraded and a few were deleted when the message was no longer relevant. We have reviewed the advances in cardiac pacing over the last seven years and introduced an important new presentation on cardiac resynchronization, which is a rapidly growing field. The incorporation of many suggestions from readers has also contributed to the increased size of the second edition. For example, the latter now includes an expanded text (including a large section on cardiac resynchronization), a discussion of indications, and a list of pertinent references. As before, we omitted the technical details of pacemaker implantation and lead extraction. We are grateful to Thomas V. Hartman, Kate Newell, and Cathryn Gates from Wiley-Blackwell Publishing for their outstanding work in the production of this book.

S. Serge Barold Roland X. Stroobandt Alfons F. Sinnaeve

Abbreviations

AampereACCAmerican College of CardiologyAEGMatrial electrogramAEIatrial escape intervalAFatrial fibrillationAFRatrial flutter responseAhamperehourAHatrial–HisAHAAmerican Heart AssociationAHRatrial high rateAMSautomatic mode switchingAPatrial paced eventAPCatrial premature complexARatrial event sensed in the refractory periodAsamperesecondASatrial sensed eventATatrial tachycardiaATPantitachycardia pacingATRatrial tachycardia responseAVatrioventricularAVEatrioventricular extensionAVIatrioventricular interval (also called AV delay)AVI-Uatrioventricular interval, unblankedBiVbiventricularBLRbasic lower rateBOLbeginning-of-lifeBPbiventricular paced eventBPblood pressurebpmbeats per minuteBVbiventricularCcoulombCADcoronary artery diseaseCHFcongestive heart failureCOcardiac ouputCRTcardiac resynchronization therapyCRT-Dcardiac resynchronization therapy device and defibrillatorCScoronary sinusCSNRTcorrected sinus node recovery timeCTcomputed tomographyECGelectrocardiogramEGMelectrogramELTendless loop tachycardiaEMIelectromagnetic interferenceEOLend-of-lifeEOSend-of-serviceERevoked responseERIelective replacement indicatorERTelective replacement timeESCIescape intervalESCRescape rateFARIfiltered atrial rate intervalFCCFederal Communications CommissionHCMhypertrophic cardiomyopathyHFheart failureHRheart rateHRSHeart Rhythm SocietyHRVheart-rate variabilityHVHis–ventricularHzhertzIcurrent (in amps, A)IACDintraatrial conduction delayICDimplantable cardioverter-defibrillatorIVinterventricularLAleft atriumLBBBleft bundle branch blockLBTlisten before talkLRIlower rate intervalLRLlower rate limitLVleft ventricleLVEFleft ventricular ejection fractionLVESVleft ventricular end-systolic volumeLVOTleft ventricular outflow tractμAmicroamperemAmilliamperemEqmilliequivalentMImyocardial infarctionMICSMedical Implant Communications SystemMRImagnetic resonance imagingmsmillisecondMSDRmaximum sensor-driven rateMTRmaximum tracking ratemVmillivoltMVminute volumeMVPmanaged ventricular pacingNYHANew York Heart AssociationOVIopen ventricular intervalPAVBpostatrial ventricular blanking periodpAVIAV interval after a paced eventPMpacemakerPMTpacemaker-mediated tachycardiappmpacing per minutePRperipheral resistancePVABpostventricular atrial blanking periodPVARPpostventricular atrial refractory periodPVARP-Upostventricular atrial refractory period, unblankedPVCpremature ventricular complex (= VPC)PVEpremature ventricular eventpVRPventricular refractory period after pacingRresistance (in ohms, Ω)RAright atriumRAMrandom-access memoryRBBBright bundle branch blockRFradiofrequencyRNRVASrepetitive non-reentrant VA synchronyROMread-only memoryRRrespiratory rateRRTrecommended replacement timeRVright ventricleRVAright ventricular apexRVOTright ventricular outflow tractSAIspontaneous atrial intervalSARspontaneous atrial rateSASsynchronous atrial stimulationsAVIAV interval after a sensed eventSDIsensor-driven intervalSDRsensor-driven rateSNDsinus node dysfunctionSVstroke volumesVRPventricular refractory period after sensingSVTsupraventricular tachycardiaTARPtotal atrial refractory periodTCLtachycardia cycle lengthTDItissue Doppler imagingTEEtransesophageal echocardiographyTVtidal volumeUvoltage (in volts, V)URIupper rate intervalURLupper rate limitVvoltVAventriculoatrialVBventricular blanking periodVEGMventricular electrogramVFventricular fibrillationVHRventricular high rateVPventricular paced eventVPCventricular premature complexVPIventricular paced intervalVPRventricular paced rateVRventricular event sensed in the refractory periodVRPventricular refractory periodVRP-Uventricular refractory period, unblankedVSventricular sensed eventVSPventricular safety pacingVTventricular tachycardiaWIWenckebach interval

Color Plate Section