Pacemaker RhythmsDr. Michael-Joseph F. Agbayani

@HeartRhythmMD

Images used are mine or under a creative commons license or public domain. These slides are licensed under Creative Commons license: Attribution-NonCommercial-ShareAlike 4.0 International License. http://creativecommons.org/licenses/by-nc-sa/4.0/

Images from Steven Fruitsmaak: https://commons.wikimedia.org/wiki/File:St_Jude_Medical_pacemaker_with_ruler.jpg and https://commons.wikimedia.org/wiki/File:St_Jude_Medical_pacemaker_in_hand.jpgImage from Drj of ECGpedia: http://en.ecgpedia.org/wiki/File:Picture_pacemaker.jpg

Pacemaker

Blausen.com staff. "Blausen gallery 2014". Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762

Image from AJC ajcann.wordpress.com: https://www.flickr.com/photos/ajc1/8520716268Image from ECGPedia user Drj: http://en.ecgpedia.org/wiki/File:Ventricular_oversensing.svg

I II III IV V

Chamber(s) paced

Chamber(s) sensed

Response to sensing

Rate modulation Multisite pacing

O = None O = None O = None O = None O = None

A = Atrium A = Atrium T = Triggered R = Rate modulation A = Atrium

V = Ventricle V = Ventricle I = Inhibited V = Ventricle

D = Dual (A+V) D = Dual (A+V) D = Dual (T+I) D = Dual (A+V)

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Image from Lanzman RS, Winter J, Blondin D, Fürst G, Scherer A, Miese FR, Abbara S, Kröpil P - Korean J Radiol (2011). "Where does it lead? Imaging features of cardiovascular implantable electronic devices on chest radiograph and CT."URL: https://openi.nlm.nih.gov/detailedresult.php?img=3168803_kjr-12-611-g003&req=4

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker/

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker/

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker/

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker/

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker/

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker/

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Image from Lanzman RS, Winter J, Blondin D, Fürst G, Scherer A, Miese FR, Abbara S, Kröpil P - Korean J Radiol (2011). "Where does it lead? Imaging features of cardiovascular implantable electronic devices on chest radiograph and CT."URL: https://openi.nlm.nih.gov/detailedresult.php?img=3168803_kjr-12-611-g003&req=4

ECG from James Heilman MD: https://commons.wikimedia.org/wiki/File:AtrialPacemakerECG.JPG

ECG from W.G. de Voogt, MD, PhD, SLAZ, The Netherlands: http://en.ecgpedia.org/wiki/File:DVA0838.jpg

Image from Charles Gomersall: https://www.aic.cuhk.edu.hk/web8/ddd_pacing.htm

Image from Charles Gomersall: https://www.aic.cuhk.edu.hk/web8/ddd_pacing.htm

ual

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Image from Lanzman RS, Winter J, Blondin D, Fürst G, Scherer A, Miese FR, Abbara S, Kröpil P - Korean J Radiol (2011). "Where does it lead? Imaging features of cardiovascular implantable electronic devices on chest radiograph and CT."URL: https://openi.nlm.nih.gov/detailedresult.php?img=3168803_kjr-12-611-g003&req=4

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker/

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker/

A

V

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker/

ECG from James Heilman MD: https://commons.wikimedia.org/wiki/File:Duelchamber.JPG

ECG from ECGPedia: http://en.ecgpedia.org/wiki/File:Pacemaker2.jpg

ECG from ECGPedia: http://en.ecgpedia.org/wiki/File:Pacemaker2.jpg

A

V

ECG from James Heilman MD: https://commons.wikimedia.org/wiki/File:AtrialPacemakerECG.JPG

ECG from W.G. de Voogt, MD, PhD, SLAZ, The Netherlands: http://en.ecgpedia.org/wiki/File:DVA0838.jpg

ECG from W.G. de Voogt, MD, PhD, SLAZ, The Netherlands: http://en.ecgpedia.org/wiki/File:DVA0838.jpg

A

V

Image from Charles Gomersall: https://www.aic.cuhk.edu.hk/web8/ddd_pacing.htm

Image from AJC ajcann.wordpress.com: https://www.flickr.com/photos/ajc1/8520716268Image from ECGPedia user Drj: http://en.ecgpedia.org/wiki/File:Ventricular_oversensing.svg

OversensingUndersensing Loss of capture

Image from ECGPedia user Drj: http://en.ecgpedia.org/wiki/File:Ventricular_noncapture.svg

Image from ECGPedia user Drj: http://en.ecgpedia.org/wiki/File:Ventricular_noncapture.svg

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker-malfunction/

Image from ECGPedia user Drj: http://en.ecgpedia.org/wiki/File:Atrial_capture_loss.svg

Image from ECGPedia user Drj: http://en.ecgpedia.org/wiki/File:Atrial_capture_loss.svg

A

V

Image from ECGPedia user Drj: http://en.ecgpedia.org/wiki/File:Ventricular_undersensing.svg

Image from ECGPedia user Drj: http://en.ecgpedia.org/wiki/File:Ventricular_undersensing.svg

Image from ECGPedia user Drj: http://en.ecgpedia.org/wiki/File:Ventricular_oversensing.svg

Image from ECGPedia user Drj: http://en.ecgpedia.org/wiki/File:Ventricular_oversensing.svg

A

V

Image from Charles Gomersall: https://www.aic.cuhk.edu.hk/web8/pacemaker_failure.htm

Image from Charles Gomersall: https://www.aic.cuhk.edu.hk/web8/Pacing%20-%20reversed%20leads.htm

Image from Charles Gomersall: https://www.aic.cuhk.edu.hk/web8/Pacing%20-%20reversed%20leads.htm

Image from Flickr user Alberto G.: https://www.flickr.com/photos/albertogp123/5843577306

Image from WG de Voogt, MD, via ECGPedia: http://en.ecgpedia.org/wiki/File:DVA0968.jpg

Image from WG de Voogt, MD, via ECGPedia: http://en.ecgpedia.org/wiki/File:DVA0856.jpg

Image via ECGPedia, from J.S.S.G. de Jong, MD, and the CCU nurses of AMC , Amsterdam, The Netherlands: http://en.ecgpedia.org/wiki/File:ECG000020.jpg

Image from ECGPedia: http://en.ecgpedia.org/wiki/File:Atrial_malsensing.svg

Image from ECGPedia: http://en.ecgpedia.org/wiki/File:Atrial_malsensing.svg

A

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker/

Image from WG de Voogt, MD via ECGPedia: http://en.ecgpedia.org/wiki/File:DVA0968.jpg

Image from EKG World Encyclopedia http://cme.med.mcgill.ca/php/index.php , courtesy of Michael Rosengarten BEng, MD.McGill via wikimedia: https://commons.wikimedia.org/wiki/File:E00031141_(CardioNetworks_ECGpedia).jpg

Image from W.G. de Voogt, MD, PhD, SLAZ, The Netherlands via wikimedia and ECGpedia: https://commons.wikimedia.org/wiki/File:DVA0923_(CardioNetworks_ECGpedia).jpg

Image from EKG World Encyclopedia http://cme.med.mcgill.ca/php/index.php , courtesy of Michael Rosengarten BEng, MD.McGill via wikimedia: https://commons.wikimedia.org/wiki/File:132_(CardioNetworks_ECGpedia).jpg

Image from wikimedia user Jer5150: https://commons.wikimedia.org/wiki/File:AF_with_RVR-Ashmans_phenomenon-RBBB_aberrancy.png

Image from Dr. Michael-Joseph F. Agbayani