tailieunhanh - Ebook Practical cardiovascular medicine: Part 2

Part 2 book “Practical cardiovascular medicine” has contents: Permanent pacemaker and implantable cardioverter defibrillator, basic electr ophysiologic study, pericardial disorders, congenital heart disease, peripheral arterial disease, pulmonary embolism and deep vein thrombosis, and other contents. | 14  Permanent Pacemaker and Implantable Cardioverter Defibrillator I. Indications for permanent pacemaker implantation  320 II. Types of cardiac rhythm devices  320 III. Pacemaker intervals  324 IV. Leads 327 V. Systematic PM/ICD interrogation using the programmer  328 VI. Pacemaker troubleshooting  329 VII. Perioperative management of PM and ICD (during any surgery)  333 VIII. Differential diagnosis and management of the patient who presents with ICD shock(s)  333 IX. Evidence and guidelines supporting various pacing devices  334 Questions and answers: Cases of PM troubleshooting  338 I.  Indications for permanent pacemaker implantation1 1.  Any symptomatic sinus bradyarrhythmia or AV block (symptomatic means near‐syncope/syncope, severe fatigue, or active HF concomitant to bradycardia). 2.  AV block (see Chapter 13, Table ): a. Mobitz II AV block even if it is asymptomatic b. High‐grade or third‐degree AV block, even if it is asymptomatic c. Asymptomatic, severely prolonged HV interval (His‐ventricle) >100 ms or infra‐His block during incremental pacing on EP study d. Any AV block (including Mobitz I) with associated symptomatic bradycardia (., symptomatic rate 3 seconds or heart rate 40%), the implantation of a BiV PM rather than a right ventricular PM seems to be the best option regardless of NYHA symptoms (class IIa recommendation). The purpose of the BiV PM is to allow simultaneous contraction of the LV septal and posterolateral walls, as well as the RV and LV, to improve cardiac function. To be beneficial, it has to track the atrial rate and pace both ventricles ~100% of the time. It cannot be in a standby mode. The AV tracking interval needs to be programmed shorter than the intrinsic PR interval to ensure ventricular tracking. AV delay is also optimized to ensure appropriate diastolic filling (a long AV delay reduces diastolic filling and leads to fusion of E–A waves on echo; a very short AV delay leads to atrial contraction near systole and A .

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• Practical cardiovascular medicine
• Pulmonary embolism
• Deep vein thrombosis
• Pericardial disorders
• Congenital heart disease
• Peripheral arterial disease
• Manual of practical medicine
• Practical medicine
• Internal medicine
• Cardiovascular system
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• Non‐ST‐Segment elevation acute coronary syndrome
• ST‐segment elevation myocardial infarction
• Additional heart failure topics
• Heart failure
• Valvular disorders
• Preventive Cardiology
• Cardiovascular Disease
• Coronary Artery Disease
• Stable Angina
• Unstable Angina
• Myocardial Infarction
• Pocket protocols for ultrasound
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• Sudden cardiac death
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