Workbook of Diagnostics for Cardiac Implantable Devices

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To understand cardiac implantable electronic device (CIED) management, the clinician requires a foundation of information regarding CIED purpose, design and function, as well as experience in interpreting CIED output, i.e., electrical assessment of the system, programmed parameters, electrograms, and markers.

In addition, one must be able to correlate and interpret the accompanying electrocardiographic tracing with the patient s clinical presentation.

For students of CIED management, be they beginners in the field or more advanced, there is always an appreciation for case studies, i.e., real-world examples of managing a specific device-related issue.

To this end, this workbook of 61 device management case studies has been prepared by six talented RN Device Specialists and three physicians involved in the Heart Rhythm Service practice at the Mayo Clinic in Rochester, Minnesota. Included in the case studies are examples from pacemakers, ICDs and CRT devices, illustrating interpretation and management of a variety of device behaviors, some with abnormal function that requires diagnosis and management approach, and others that display appropriate behavior of a specific device algorithm that may be confusing for the CIED student. ~David L. Hayes, MD, and the contributors - adapted from the Preface.
  • Perfect for exam prep, training across CIED devices, and as a reference to keep on hand in the lab.
  • Real-world examples of managing a specific device-related issue.
  • Includes straightforward clinical management issues to more complex issues that may be related to a specific device algorithm.

Author(s): David L. Hayes, James D. Ryan, Siva K. Mulpuru, Nora E. Olson, Tracy L. Webster, Yong-Mei Cha, Mark J. Henrich, Jon M. Meyer, Michael J. Hillestad
Publisher: Cardiotext Publishing
Year: 2020

Language: English
Pages: 204
City: Minneapolis

Online Access
Title Page
Copyright
Contents
Contributors
Preface
Abbreviations
Case 1 Variation in Paced QRS Morphology
Case 2 Ventricular Undersensing in a Dual-Chamber Pacemaker
Case 3 Atrial Pacing with a Competing Junctional Rhythm
Case 4 Loss of AV Synchrony
Case 5 Postventricular Atrial Refractory Period (PVARP) Function
Case 6 Atrial Loss of Capture
Case 7 Loss of Capture and Pseudofusion
Case 8 Loss of RV and LV Capture
Case 9 Atrial Undersensing
Case 10 Functional Atrial Undersensing
Case 11 Undersensing of Atrial Arrhythmia
Case 12 Ventricular Safety Pacing
Case 13 DDI Pacing Mode
Case 14 Functional Ventricular Undersensing
Case 15 Atrial Sensed Events in Refractory Period
Case 16 Pseudo-Wenckebach Upper Rate Behavior
Case 17 Pseudo-Wenckebach Upper Rate Behavior
Case 18 Pseudo-Wenckebach Upper Rate Behavior
Case 19 His Pacing Threshold at Implant
Case 20 Crosstalk Oversensing on Ventricular Channelwith His Pace/Sense Lead in RV Port
Case 21 Pseudo Undersensing in Leadless Pacemaker
Case 22 Remote Alert Follow-Up
Case 23 Promoting Intrinsic Ventricular Conduction
Case 24 Atrial Preference Pacing
Case 25 Rate Drop Response
Case 26 Rate Smoothing
Case 27 Atrial Flutter Response
Chapter 28 Atrial Tachyarrhythmia with Atrial Intervention Pacing
Chapter 29 Mode Switch Termination with Failure to Establish AV Synchrony
Chapter 30 Inappropriate Mode Switch
Chapter 31 Loss of AV Synchrony Due to Inappropriate Mode Switch
Chapter 32 Auto-PVARP and Inappropriate Mode Switch
Chapter 33 Pacemaker-Mediated Tachycardia
Chapter 34 Pacemaker-Mediated Tachycardia Intervention
Chapter 35 Pacemaker-Mediated Tachycardia in CRT-P
Chapter 36 Respiratory Trends and Atrial Oversensing
Chapter 37 Signal Artifact Monitor
Chapter 38 Ventricular Noise Reversion
Chapter 39 Ventricular Oversensing with RV Lead Failure
Chapter 40 Atrial Oversensing
Chapter 41 Noise Oversensing
Chapter 42 Electromagnetic Interference in ICD
Chapter 43 RV Lead Failure
Chapter 44 RV Lead Fracture
Chapter 45 Atrial Oversensing with Inappropriate Mode Switchand Arrhythmia Induction
Chapter 46 Short-Long-Short-Induced Ventricular Tachycardia
Chapter 47 Managed Ventricular Pacing Modeand Ventricular Arrhythmias
Chapter 48 Ventricular Pacing in the Vulnerable Period Due to Blanking and Associated Arrhythmia
Chapter 49 Ventricular Pacing in the Vulnerable Period During Atrial Flutter
Chapter 50 T-Wave Oversensing
Chapter 51 RV Lead Integrity Warning and T-Wave Oversensing Discrimination
Chapter 52 Subcutaneous ICD Oversensing
Chapter 53 Mode Switch During VT Detection
Chapter 54 Single-Chamber ICD with Atrial Sensing
Chapter 55 Medtronic Detection Zones with Fast VT via VT versus Fast VT via VF
Chapter 56 Ventricular Tachycardia Detection and Therapy
Chapter 57 Ventricular Tachycardia Accelerating to Ventricular Fibrillation with Undersensing
Chapter 58 Defibrillator Therapy Following Episode Termination
Chapter 59 Effective CRT
Chapter 60 CRT Pacing Diagnostics
Chapter 61 CRT Pacing Diagnostics
Appendix A: Cases by Title
Appendix B: Cases by Manufacturer
Notes