Cardiac Pacing, Defibrillation and Resynchronization E-Book

David L. Hayes

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

Seitenzahl: 1257

Veröffentlichungsjahr: 2011

Beschreibung

Consisting of 13 chapters, this book is uniformly written to provide sensible, matter-of-fact methods for understanding and caring for patients with permanent pacemakers, ICDs and CRT systems.

Now improved and updated, including a new chapter on programming and optimization of CRT devices, this second edition presents a large amount of information in an easily digestible form. Cardiac Pacing and Defibrillation offers sensible, matter-of-fact methods for understanding and caring for patients, making everyday clinical encounters easier and more productive.

Readers will appreciate the knowledge and experience shared by the authors of this book.

Leseprobe

Contents

Contributors

Preface

CHAPTER 1: Clinically Relevant Basics of Pacing and Defibrillation

Anatomy and physiology of the cardiac conduction system

Electrophysiology of myocardial stimulation

Pacing basics

Lead design

Left ventricular leads

Pulse generators

Pacemaker nomenclature

Defibrillation basics

Measuring the efficacy of defibrillation

The importance of waveform

Use of waveform theory in clinical practice

Drugs and defibrillators

CHAPTER 2: Hemodynamics of Device Therapy

Cardiovascular physiology

Basics of hemodynamic pacing

Effect of pacing mode on morbidity and mortality

Pacing in congestive heart failure

Ventricular timing optimization (V-V optimization)

Less common indications for pacing for hemodynamic improvement

Conclusions

CHAPTER 3: Indications for Pacemakers, ICDs and CRT

Indications for permanent pacing

Indications for the implantable cardioverter-defibrillator

Secondary prevention

Contraindications to implantable cardioverter-defibrillator therapy

Acknowledgement

CHAPTER 4: Generator and Lead Selection

Pacemaker selection

Choosing specific programmable options

Choosing the rate-adaptive sensor

Choosing the lead or leads

Generator and lead selection in defibrillators

Dual-chamber or single-chamber ICD?

Conclusion

CHAPTER 5: Implantation and Extraction Techniques

Implantation facility

Anesthesia

The pulse generator pocket

Venous approaches

Axillary (extrathoracic subclavian) approach

Ventricular lead placement

Coronary sinus lead placement

Dual-chamber pulse generator implantation

Measurement of pacing and sensing thresholds

Epicardial systems

Hardware adaptations

Special considerations in pediatric patients

Device implantation after cardiac transplantation

Hospital stay after implantation

Pulse generator replacement

Postimplant order set

Homegoing instructions

Lead extraction

CHAPTER 6: Implantation-related Complications

Complications related directly to the implant procedure

Inadvertent left ventricular lead placement

Loose connector block connection

Abandoned, nonfunctioning and noninfected leads

New symptoms secondary to pacemaker placement

Implant or hardware-related complications that may result in recurrence of preimplantation symptoms (see also Chapter 10, Troubleshooting)

CHAPTER 7: Pacemaker and Cardiac Resynchronization Timing Cycles and Electrocardiography

Pacing modes

Timing cycles in implantable cardioverter-defibrillators

Approach to the biventricular paced electrocardiogram*

Conclusion

CHAPTER 8: Programming

Programmers

Pacemaker programming

Diagnostics—set-up and assessment

Programming during routine follow-up

Defibrillator programming and algorithms

Ventricular therapies

Atrial defibrillators: detection and therapies

Optimizing programming

Conclusion

CHAPTER 9: Rate-adaptive Pacing

Indications for rate-adaptive pacing

Sensor applications for hemodynamic management

Rate-adaptive pacing with cardiac resynchronization devices

CHAPTER 10: Troubleshooting

Pacemaker troubleshooting

Diagnostic features

Focused troubleshooting

Conclusion

Implantable defibrillator troubleshooting

Stored episode data

Surface electrocardiography

Differential diagnosis and management in patients with frequent or recurrent shocks

Delayed, absent, or ineffective therapy

Troubleshooting cardiac resynchronization devices

Conclusion

CHAPTER 11: Pacemaker, ICD and CRT Radiography

Introduction

Pulse generators

Leads

Miscellaneous considerations

Summary

CHAPTER 12: Electromagnetic Interference and Implantable Devices

Pacemaker responses to noise

CHAPTER 13: Follow-up

Requirements for a device follow-up clinic

Pacemaker follow-up

Pacemaker clinic follow-up visit

Implantable cardioverter-defibrillator follow-up

Patient-specific programming and therapy

Conclusion

Index

Dedication

For Sharonne, Sarah, Drew, and my parents, Audrey and Henry Hayes.

DLH

To my wife, Vicki, my daughters, Lindsay, Hannah, and Maddy, and my parents, Charles and Ety Friedman, for your love, support, patience, and encouragement.

PAF

This edition first published © 2000, 2008 by Mayo Foundation for Medical Education and Research

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Library of Congress Cataloging-in-Publication Data Hayes, David L.

Cardiac Pacing, defibrillation and resynchronization : a clinical approach / by David L. Hayes, Paul A. Friedman. – 2nd ed.

p.; cm.

Includes bibliographical references and index.

ISBN-13: 978-1-4051-6748-2

ISBN-10: 1-4051-6748-3

1. Cardiac pacing. 2. Electric countershock. I. Friedman, Paul A. II. Title.

[DNLM: 1. Cardiac Pacing, Artificial. 2. Defibrillators, Implantable. 3. Pacemaker, Artificial. WG 168 H417c 2008]

RC684.P3H387 2008

617.4’120645--dc22

2008016865

ISBN: 9781405167482

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

1 2008

Contributors

Samuel J. As ir vat ham, MD

Consultant, Cardiac Electrophysiology, Mayo Clinic,

Rochester, Minnesota, USA

Associate Professor of Medicine, College of Medicine, Mayo

Clinic

T. Jared Bunch, MD.

Fellow in Electrophysiology, Mayo School of Graduate Medical Education, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA

Paul A. Friedman, MD

Consultant, Division of Cardiovascular Diseases, Mayo

Clinic, Rochester, Minnesota, USA

Professor of Medicine, College of Medicine, Mayo Clinic

Apoor S. Gami, MD

Fellow in Electrophysiology, Mayo School of Graduate

Medical Education, Mayo Clinic, Rochester, Minnesota,

USA Assistant Professor of Medicine, College of Medicine, Mayo

Clinic

Michael Glikson, MD

Associate Clinical Professor of Cardiology

Director - Electrophysiology and Pacing Unit

Heart Institute, Sheba Medical Center and Tel Aviv University,

Tel--Hashomer, Israel

David L. Hayes, MD

Chair, Division of Cardiovascular Diseases, Mayo Clinic,

Rochester, Minnesota, USA

Professor of Medicine, College of Medicine, Mayo Clinic

Charles D. Swerdlow, MD

Cedars Sinai Medical Center, Los Angeles Clinical Professor of Medicine David Geffen School of Medicine at UCLA Los Angeles, California, USA

Niloufar Tabatabaei, MD

Fellow in Cardiovascular Diseases, Mayo School of Graduate Medical Education, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA

Paul J. Wang, MD

Professor of Medicine

Director of Cardiac Arrhythmia Service and Cardiac

Electrophysiology

Stanford University School of Medicine, Stanford,

California, USA

Preface

In preparing this edition of Cardiac Pacing, Defibrilla-tion and Resynchronization: A Clinical Approach, our intention remained the same as for the previous edition, that is, to be a text that is uniformly written with sensible, matter-of-fact methods for understanding and caring for patients with permanent pacemakers, implantable cardioverter-defibrillators (ICDs), and, to a much greater extent in this edition, cardiac resynchronization therapy (CRT) devices. Once again, our intent was not to create an encyclopedic text. Instead, we want to provide practical clinical information for those involved in cardiac pacing, defibrillation and CRT. Several excellent multi- authored texts provide encyclopedic information.

Cardiac pacing, cardiac defibrillation, and, more recently CRT, have become fields unto themselves as the technology has proliferated and the devices have rapidly become increasingly more sophisticated. We have witnessed unbelievably rapid advances in the technology of implantable cardiac devices. With the first pacemaker implant in 1958, the first ICD implantation in 1980, and the first biventricular pacing report in 1994, few would have imagined the progress and improvements made in such a relatively short period of time. Having witnessed the continued improvements in pacemakers, ICDs and CRT in recent years, we would not underestimate the potential for future improvements of these devices and can see many opportunities for expansion of these therapies.

This text is meant to help the reader understand the technical capabilities of pacemakers, ICDs and CRT and how to apply this knowledge clinically. Whether the reader is new to these disciplines or sees patients with implantable devices every day, we hope that the information we have included will make clinical encounters easier.

We feel strongly that there is merit in a text written by a small number of contributors. Not to detract from the expertise of the contributors or editors of the excellent multiauthored texts available, limiting the number of authors allows a connection from chapter to chapter and a consistent writing style. Our hope is that this choice will make reading and comprehension easier.We (DLH and PAF) are involvedin all ofthe chapters. However, we need to thank a number of colleagues who have contributed to the preparation of this edition of the text. First, we acknowledge our colleague Dr Margaret (Peg) Lloyd, MD, an author on the first edition of this text. We have built upon her prior contributions in specific chapters and greatly appreciate the foundations she helped lay. Our special thanks to our colleague Samuel J. Asirvatham, MD, who became progressively more involved as this edition moved forward. We genuinely appreciate his expertise, tireless efforts, and counsel. Our friend Dr Charles (Chuck) D. Swerdlow, MD, is an innovator in the field who enriched the chapters on Troubleshooting and Programming with significant contributions. Others who have contributed include Apoor Gami, MD, Jared Bunch, MD, and Niloufar Ta-batabaei, MD - many thanks for your energy and contributions. We have enj oyed long and fruitful collaborations with Michael Glikson, MD, and Paul J. Wang, MD,, and appreciate their contribution to this effort.

The text has also been influenced by and we have been given incredible assistance from friends and colleagues in industry. A special thanks to Paul Levine, MD, who has graciously allowed us to use a number of examples from his personal collection and who remains one ofthe “giants” in the field. Others who have responded to many questions, and have reviewed sections of text to ensure its technical accuracy; we are grateful for their efforts. They include: Doug Welter and Mario Bradley (Biotronik, Inc.); Jodie Alwin, Dan Heffron, Tom Ermis, and Jim Gilkerson (Boston Scientific Company); Nancy Magnotto, Gregg Deutsch, Jay Wilcox, Jim Glover, Jeff Gilberg, Nancy Magnotto, Preface and Dave Furland (Medtronic, Inc.); Jim Gerrity and Marcel Limousin (Sorin Group); Leslie Meyer, Daryel Davis, Dan Hecker, and Steve Heinrich (St Jude Medical).

Many others have influenced this project. All our physician and nursing colleagues in the Heart Rhythm Services group at Mayo Clinic Rochester have had either a direct or an indirect influence on portions of this text. Our intention is not to officially represent our entire practice of pacing and electrophysiology with this text. However, given a significant consistency in the way we practice and how we approach patients, we would expect general agreement with the clinical management strategies put forward in this text.

Although the content of this text is patterned after the first edition, we have reorganized some sections, expanded ICD information and added CRT discussions to almost all chapters, to reflect the evolution of device practice. Internet-based remote monitoring has become a reality, “recalls” must be addressed, and new insights have revised how device therapy can prolong life and improve its quality; these important topics are extensively addressed. We have attempted to provide a logical progression from a description of device indications to selection of hardware, implantation, complications, programming, troubleshooting, and follow-up. It is our deepest hope that this effort will enhance the care of patients with arrhythmias.

David L. Hayes, MD & Paul A. Friedman, MD