.
 
Aliases:
PPM
Pacemaker

Topic aliases are alternate phrasings for a particular topic.


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Pacemaker Code:
1st is chamber paced;
2nd is chamber sensed;
3rd is response to sensing;
4th is rate modulation. refl.in/1l

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V = Ventricular,
A=Atrial,
D=Dual,
O= nothing,
T=Triggered,
I=Inhibited,
R=Rate adaptive.
refl.in/1l

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Oct 07, 2012
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Determine where the generator box is located. This will determine where defibrillator pads are placed to minimise risk of damage to pacing box.

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If pacemaker type is unknown, and unable to contact the pacemaker technician, consider asking the cardiologist to examine the CXR to tell you what it is.

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Perform an ECG to help determine the nature of pacemaker, and whether the patient is pacemaker dependent.

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If an elective procedure is being undertaken, ensure the pacemaker has been checked within the last 6 months before proceeding.

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Oct 07, 2012
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If diathermy is to be used near leads ask the pacemaker tech to disable the inhibiting function (eg reprogram into a VOO or DOO mode) and ensure the pacemaker is reprogrammed postoperatively

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if not, watch for inhibition, and if present, use magnet cautiously.
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Magnet does NOT always reprogram into asynchronous mode, so if patient is pacemaker dependent this needs to be taken into account.

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Placement of the magnet may reprogram the pacemaker into asynchronous mode (VOO/DOO) in an emergency where insufficient time or resources aren't available to find a pacemaker technician. This asynchronous mode prevents misinterpration of diathermy signal interference as the patient's innate rhythm which would inhibit pacing.

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Consider an arterial line as a backup monitor for the pulse if the patient is pacemaker dependent, & diathermy is likely to obscure the ECG

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