By Aaron B. Hesselson
Written as a significant other textual content to Dr Hesselson’s first booklet approximately pacing, Simplified Interpretation of ICD Electrograms specializes in instructing an figuring out of the electrogram (EGM) sign for troubleshooting ICD rhythms. The e-book comprises a detailed overview of the overall functionality of an ICD (defilbrillation electronics, arrthythmia detection/therapy), in addition to a longer precis of the widely encountered arrthythmia in an EGM and ECG structure. through the publication, Dr Hesselson emphasizes that the major for troubleshooting those units lies within the skill to make the transition from surfaceECG to EGM interpretation. additionally integrated is an in depth bankruptcy on biventricular pacing, quite because it pertains to its functionality in an ICD. The e-book ends with 50 scientific case reviews designed to demonstrate the text’s key principles.
No one has tried formerly to give an explanation for the EGM sign in any such pedagogical type, and no major volume of fabric has been officially released detailing equipment for troubleshooting biventricular ICD pacing systems.
- Expert tips on realizing the EGM sign for troubleshooting ICD rthythms.
- Includes 50 medical case experiences.
- Covers all facets of the final functionality of ICDs.
- Contains an in depth bankruptcy on biventricular pacing.
Chapter 1 what's An ICD? (pages 3–6):
Chapter 2 ICD approach and Cardiac Anatomy (pages 7–11):
Chapter three The (pages 13–30):
Chapter four ICD Electronics (pages 31–43):
Chapter five Sensing (pages 45–48):
Chapter 6 Detection (pages 49–58):
Chapter 7 The Tachycardias (pages 59–78):
Chapter eight The remedies (pages 79–82):
Chapter nine ICD Pacing (pages 83–108):
Chapter 10 strange ICD events and trade functions (pages 109–121):
Chapter eleven Case reports half A (pages 125–139):
Chapter 12 Case reports half B (pages 141–248):
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Additional info for Simplified Interpretation of ICD Electrograms
PR Logic” (Medtronic), “SMART Detection” (Biotronik)). Despite such strategies, an SVT may rarely cause an ICD to deliver therapy for what it thinks is a signiﬁcant ventricular tachyarrhythmia. This might also occur when such parameters as a “sustained duration timer” (Guidant), “sustained VT timer” (Biotronik), or “high rate timeout” (Medtronic) feature are programmed. These features will override any detection enhancement from withholding therapy should a tachycardia be of a prolonged nature.
Thus differences in heart rate allow multiple levels or “zones” of detection to be established in an ICD. ” The zones are deﬁned by programmable rate cutoffs that are determined by the implanting physician. All ICDs have at least a VF zone. Whether or not a VT zone is programmed may be guided by the presence of a clinical VT in the patient. Why even have multiple zones of detection? This allows for different levels of therapy based on the zone of tachycardia detection. 210 bpm VF Zone Ventricular Sensing Zone Single Zone 170 bpm VF VT Ventricular Sensing Zone Zone Zone 2-Zone 180 bpm 150 bpm VF Zone Fast Slow VT VT Zone Zone Ventricular Sensing Zone 0 Time 3-Zone Lower Rate Interval Detection 51 The methods for detection are not uniform amongst the ICD manufacturer’s devices.
1 Tachycardia detection in an ICD is founded on a beat-by-beat analysis of _____ _____. 2 A contemporary ICD may have as few as _____, and as many as _____ zones of tachycardia detection for ventricular tachyarrhythmias. 3 Multiple tachycardia detection zones in an ICD allows for different levels of _____. 4 Tachycardia detection methods _____ between the various manufacturer’s devices. 52 Simpliﬁed Interpretation of ICD Electrograms Heartbeat Classiﬁcation Each sensed ventricular heartbeat undergoes a classiﬁcation determined by its relationship in time to the previous sensed/paced ventricular beat, and the number of zones of detection that have been programmed.