tailieunhanh - Essential Cardiac Electrophysiology Self Assessment - Part 10

Nguyên nhân vắng mặt bất thường của EKG máy điều hòa nhịp tim gai người tập dượt 1 pin cạn kiệt 2 cuộn dây dẫn gãy 3 Loose thiết lập vít 4 Oversensing không do tim tín hiệu 5 Thiếu liên hệ với anodal 6 mạch thất bại Thiếu chụp trên / dưới cảm biến | 264 Essential Cardiac Electrophysiology Table Causes of abnormal pacemaker EKG Absence of pacer spikes Lack of capture Over under sensing Altered pacing rate 1 Battery depletion 1 Inadequate output 1 Over sensing P and 1 Sensor rate 2 Conductor coil 2 High threshold T wave 2 Magnet rate fracture spontaneous or 2 Undersensing PVC 3 Hysteresis 3 Loose set screw drug and 3 Lead dislodgment 4 Cross talk 4 Oversensing metabolic induced 4 Insulation break 5 Oversensing noncardiac signal 3 Insulation defect 5 EMI 6 Circuit failure 5 Lack of anodal 4 Lead dislodgment 6 Asynchronous 7 Altered recording contact 5 Perforation mode magnet speed 6 Circuit failure 6 Functional application noncapture stim 7 Circuit failure on refractory 8 Functional period undersensing 7 Battery depletion event during 8 Poor connection refractory period Programming the pacemaker temporarily to the triggered mode may reveal the source of abnormal sensing. When a cardiac event has morphology between an intrinsic and a paced beat it is called a fusion beat. Pseudo fusion occurs when a pacer spike falls on an intrinsic event but does not contribute to or alter that event. This is due to insufficient cardiac voltage to inhibit the sensing circuit. Pseudo fusion may occur when there is intraventricular conduction delay. Class IC drugs may increase pacing thresholds and may also cause sensing abnormalities. Electrolyte and metabolic abnormalities such as hyperkalemia acidosis hypoxia hyperglycemia and myxedema may affect pacing and sensing thresholds. Ventricular pacing may result in pacemaker syndrome manifested by shortness of breath dizziness fatigue pulsations in the neck or abdomen cough and apprehension. Pacemaker-related complications Subclavian puncture may be associated with traumatic pneumothorax and hemopneumothorax inadvertent arterial puncture air embolism arteriovenous fistula thoracic duct injury subcutaneous emphysema and brachial plexus injury. Hematoma at the pulse generator site