Medtronic 5348 Technical Manual
RATE AOUTPUT VOUTPUT A SENSITIVITY V SENSITIVITY A TRACKING, UPPER RATE, PVARP A-V INTERVAL current setting, or 80 min -1 if device was off 20 ma 25 ma ASYNC i. Intra-cardial In 2013, multiple firms announced devices that could be inserted via a leg catheter rather than invasive surgery. When AOUTPUT is set to OFF, both the atrial output and the atrial sensitivity are turned off i.
The terminal connector at the other end of each cable is designed to mate with the output terminal on the Model 5348 pacemaker. Villafaña and founders of in St.
Medtronic 5348 Technical Manual - Note: Modes that are punctuated by!? Line-powered Equipment An implanted lead or lead with extension cable constitutes a direct, low-resistance current pathway to the myocardium.
Usually the pacemaker site is the , near the junction with the superior vena cava. The normal rhythm, 60 to 100 contractions per minute, increases during physical or emotional stress and decreases during rest. The pace varies from person to person and is affected by abnormal conditions such as heart injuries and generalized infections. If the normal pacemaker fails to function, its regulating task may be taken over by another small mass of special muscular tissue, the. When the fetus is ready to be born the pacemakers set off a series of rhythmic contractions in the uterine muscle that gradually force the infant out into the birth canal. It is worn by or implanted in the body of the patient, is battery-driven, is usually triggered or inhibited to modify output by sensing the intracardiac potential in one or more cardiac chambers, and may also have antitachycardia functions. Many are designated by a three to five letter code used to categorize them functionally. It initiates the contractions of the atria, which transmit the impulse onto the atrioventricular AV node, thereby initiating the contraction of the ventricles. An ectopic or idioventricular pacemaker, originating in the atria, AV node, or ventricle, may cause contractions in cases of abnormal heart functioning. Also called cardiac pacemaker. A device that can trigger mechanical contractions of the heart by emitting periodic electrical discharges. If the device delivers electricity through the chest wall, it is called a transcutaneous pacemaker; if it works via electrodes inserted inside the body, it is called an internal or implantable pacemaker. Pacemakers are used most often to treat patients with symptomatic slow heart rates or long pauses between heart beats such as patients with third-degree heart block, symptomatic second-degree heart block, bifascicular block with first-degree heart block, carotid sinus hypersensitivity, and tachybrady syndrome and slow ventricular response rates. Occasionally, though, they also are used for other purposes, such as to capture and override some tachyarrhythmias. See: illustration All artificial cardiac pacemakers have a pulse generator a device that gives off an electrical impulse at prescribed intervals , electrical leads which transmit the impulse to the myocardium , and a battery usually made of lithium iodide encased in titanium and implanted surgically in a subcutaneous pocket usually in the chest. The pacing leads are threaded through a subclavian vein into the right heart, with the primary lead placed in the ventricle, and the second lead if required in the atrium. For biventricular pacing, a third lead is placed in the left ventricle. A biventricular pacemaker also may have a built-in cardiovertor-defibrillator. Pacemakers typically have the ability to pace the ventricle, the atrium, or both; to sense electrical discharges coming from cardiac chambers; and to respond to sensed beats. Most pacemakers in the U. The five positions describe the pacer's functions as follows:1. Thus a pacemaker with the letter I in position 3 of its code will inhibit firing when it senses an intrinsic beat but will pace the cardiac chamber if no beat is sensed. The letter D in position 5 indicates that both atria and both ventricles are paced, with the left and right chambers stimulated simultaneously to maintain coordination and thus improve cardiac output. When the pacemaker has a rate modulation feature R in position 4 , also known as an adaptive rate mechanism, it works to copy the abilities of a normally functioning heart, such as detecting exercise and triggering pacer rate acceleration to meet the increased metabolic need. Other pacemaker features include hysteresis, which delays unnecessary pacing which can harm the right ventricle , and allows the patient's intrinsic impulse to provide an atrial kick, which stokes the ventricle and increases cardiac output by 15% to 30% over a beat without atrial kick. Patient care After pacemaker implantation, follow-up care is provided to ensure that the device is working optimally. A chest x-ray confirms correct placement of the leads and also can identify some complications, such as pneumothorax. Immobilizing the patient's shoulder and arm on the operative side with a sling or ace-wrap for 24 to 48 hr limits movement that could dislodge the tip of the pacing electrode s from the endocardial wall, preventing sensing of intrinsic beats or needed pacing. The incision is assessed for bleeding, infection, and incisional discomfort, which is controlled with prescribed analgesia. The patient also is assessed for chest pain, palpitations, dizziness, shortness of breath, hiccuping, and a sensation of pacing in the abdomen, and the cardiologist or surgeon notified if any of these occur. The chest x-ray usually is repeated the following day to document positioning and rule out pneumothorax. Pacer function is checked, and the patient discharged with instructions for activity restrictions and further care. Follow-up care typically includes monitoring the pacemaker's performance, either in the cardiologist's office or by telephonic link-up to ensure, for example, that the pulse generator is triggering a heart rate that is appropriate for the patient's needs, that the leads are working, and that the battery's strength is adequate. They should encourage the patient to wear or carry medical identification and information indicating the presence and type of pacemaker implanted, along with an electrocardiogram rhythm strip showing pacemaker activity and capture. Patients with artificial cardiac pacemakers should avoid MR imaging. It senses and paces both atrial and ventricular events, triggering the atrioventricular AV interval so that AV synchrony is maintained over a wide range of heart rates. This type of pacing has reduced the incidence of pacemaker syndrome. It is the most versatile pacing device used. See: ; DDI pacemaker An electronic device for permanent cardiac pacing. The leads are usually inserted transvenously through the subclavian or cephalic veins with leads positioned in the right atrium for atrial pacing or in the right ventricular apex for ventricular pacing. The leads are connected to the pulse generator, which is implanted in a subcutaneous pocket below the clavicle. The device alters cardiac rate by sensing body motion, changes in breathing, or slight changes in blood temperature, which improves the quality of life for active patients. It is also called a rate-adaptive pacemaker. An artificial pacemaker may be implanted when normal rhythm generation is affected by heart disease. A pacemaker that does not function properly may cause irregularities in the function of the heart. Also called cardiac pacemaker. Pacemakers can be permanent indwelling appliances. The use of electronic devices on patients with pacemakers is now considered permissible because of modern shields. The device may also have a defibrillator. Also called cardiac pacemaker. Want to thank TFD for its existence? This information should not be considered complete, up to date, and is not intended to be used in place of a visit, consultation, or advice of a legal, medical, or any other professional.
Coauthor s : Charles J. Any kind of an medico that involves intense magnetic fields should be avoided. The newer dual chamber devices can keep the amount of right ventricle pacing to a minimum and thus prevent worsening of the heart disease. The twenty counter-clockwise dial step changes from the 10 mV start-up position, or a lesser number of such sin changes from a lower value, are instantaneously detected, and the primary pacing mode switch is made to the AAI or VVI pacing mode. Progressively weaker pacing stimuli are administered, which results in in the second half of the tracing. Transvenous pacing temporary Main article: Transvenous pacing, when used for temporary pacing, is an alternative to transcutaneous pacing.