OutlineOutline
Electrical System of HeartElectrical System of Heart Indications for a PacemakerIndications for a Pacemaker The ProcedureThe Procedure Post procedural Care and Follow-Post procedural Care and Follow-
upup History of the pacemakerHistory of the pacemaker
Electrical SystemElectrical System
Sinoatrial nodeSinoatrial node
-heart’s natural -heart’s natural pacemakerpacemaker
-located in the -located in the right atriumright atrium
-stimulates right -stimulates right and left atria to and left atria to contract & pump contract & pump blood into blood into ventriclesventricles
Electrical SystemElectrical System
Atrioventricular Atrioventricular NodeNode
-located between -located between the atria and the atria and ventriclesventricles
-transfers -transfers electrical signal electrical signal from SA node to from SA node to Bundle of HisBundle of His
Bundle of HisBundle of His
-located in the -located in the interventricular interventricular septumseptum
-splits into right -splits into right and left and left branchesbranches
-stimulates -stimulates ventricles to ventricles to contractcontract
Electrical SystemElectrical System
Electrical impulses are documented Electrical impulses are documented and monitored on an and monitored on an electrocardiogram (EKG)electrocardiogram (EKG)
Indications for a Indications for a PacemakerPacemaker
Symptomatic BradycardiaSymptomatic Bradycardia
Complete Heart Block Complete Heart Block
Patient PrepPatient Prep
NPO at midnight before examNPO at midnight before exam Arrive in Cath LabArrive in Cath Lab Vitals continuously monitoredVitals continuously monitored Skin scrubbed with betadineSkin scrubbed with betadine
Doctor’s RoleDoctor’s Role
Injects lidocaineInjects lidocaine Makes incision Makes incision
-inferior to clavicle-inferior to clavicle
-through skin and subcutaneous -through skin and subcutaneous layerslayers
Threads catheter through subclavian Threads catheter through subclavian vein and into the heartvein and into the heart
The lead connects to the pacemaker The lead connects to the pacemaker and allows it to pace the heart’s and allows it to pace the heart’s electrical activityelectrical activity
Technologist’s RoleTechnologist’s Role
Assists DoctorAssists Doctor Washes out pocket with Washes out pocket with
neomycin/polymicinneomycin/polymicin Sews incision back together after Sews incision back together after
pacemaker insertionpacemaker insertion
Post-procedural carePost-procedural care
Chest x-ray Chest x-ray -checks:-checks:
-placement of leads-placement of leads
-look for pneumothorax-look for pneumothorax
Post-procedural carePost-procedural care
Inpatient Care:Inpatient Care: 1-2 night stay in 1-2 night stay in
hospitalhospital Check site for Check site for
bleeding and bleeding and infectioninfection
Patients treated Patients treated with antibioticswith antibiotics
Outpatient Care:Outpatient Care: Pacemaker Pacemaker
checked every 2 checked every 2 weeks after 1weeks after 1stst month of month of insertioninsertion
Assessed every Assessed every other monthother month
Thorough testing Thorough testing every six months every six months
HistoryHistory
11stst pacemakers date back to the pacemakers date back to the early 1900s were external devicesearly 1900s were external devices
1959 11959 1stst implantable pacemaker implantable pacemaker 1970s 11970s 1stst programmable programmable
pacemakerpacemaker 1980s 11980s 1stst steroid-eluting lead used steroid-eluting lead used Pacemakers now more like a mini Pacemakers now more like a mini
computercomputer The sky is the limit! The sky is the limit!
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