Pacemakers

toc =Pacemaker Design =

Battery, Circuit and lead wires
Battery- Lithium diode battery- life of 5-12 Y, provides energy to the Circuit and generates enough voltage to stimulate the heart Lead wires- carry electricity between the battery and heart, Unipolar or bipolar, bipolar are suitable for dual chamber stimulation, reduce unwanted excessive stimulation or pacemaker inhibition Circuit- microchip with heart monitoring sensors, voltage regulators, timing circuits and externally programmable controls.

The revised NASPE/BPEG generic code for antibradycardia pacing[|[18]]
 * ~ I ||~ II ||~ III ||~ IV ||~ V ||
 * Chamber(s) paced || Chamber(s) sensed || Response to sensing || Rate modulation || <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">Multisite pacing ||
 * <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">O = None || <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">O = None || <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">O = None || <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">O = None || <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">O = None ||
 * <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">A = Atrium || <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">A = Atrium || <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">T = Triggered || <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">R = Rate modulation || <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">A = Atrium ||
 * <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">V = Ventricle || <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">V = Ventricle || <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">I = Inhibited ||  || <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">V = Ventricle ||
 * <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">D = Dual (A+V) || <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">D = Dual (A+V) || <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">D = Dual (T+I) ||  || <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">D = Dual (A+V) ||

<span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">R- Adaptive rate pacing, compensates for chronotropic incompetence, improves excercise performance <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">Sensors have piezoelectric crystals or accelometers that detect motion, vibration, acceleration or pressure

<span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;"> <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">Single Chamber Pacing- AAI <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;"> <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">Dual Chamber Pacing- <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">

<span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">Terms
<span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">Sensitivity- Minimum current that the pacemaker is able to sense <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">Capture Threshold- minimum pacemaker output required to generate an action potential in the myocardium <span style="display: block; font-family: Arial,Helvetica,sans-serif; text-align: left;">Heart rate- optimal- 80-90/minTypical Settings:Atrial/ Ventricular output - 10- 20 mAPR interval- 150ms ( 20- 300ms)Atrial sensitivity- 5mV ( 0.4 - 10mV)Ventricle sensitivity- 5mV( 0.8 - 10mV)PVARP- 250 mS

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