Rhythms Gone Wild! Tachycardia in a Patient with a Pacemaker.
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- Опубликовано: 2 июл 2024
- Assessing whether a pacemaker is functioning normally can be a challenge, since those devices can be pretty complicated. In this lesson I present a case of a critically ill patient with a pacemaker that was having periods of a rapid heart rate. We'll talk about the patient's history, what the monitor showed, and then how to evaluate pacemakers properly... which really depends on understanding how they work.
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Thank you! I did enjoy this discussion.
Great presentation. Working in EMS, I had a pt recently experience this PMT going from a rate of 78 to sustained 150 while we were driving her to the ER. Rate returned to normal as the speed of the vehicle decreased to a stop
This happened to a patient of mine who was admitted in Nephrology for CKD and had a TPM placed too.
You are the best doc! Keep up the great work! Amazing courses and content, top of the line!
Thanks to your ECG Academy I can read most ECG's with a little time and effort but, I don't have a physical feel for the augmented leads yet. I know their used to amplify the voltage in the ECG in conjunction with Leads I, II, III but, what part of the heart am I looking at if say if the aVL QRS is a very low amplitude; is it the left side looking down at a 30 degree angle or through the heart to the right side at say 150 degree? Where is the camera snap shot of the heart for the aVL lead? I can't wait to get to medical school. As far as the patients in the burn units etc... thanks to the organized groups that use those hypnotic drugs that help them. Those drugs are strong. I wonder if their similar to those antidepressant drugs that effect the heart?
I’m also a ecg academy student, and I think I can help you with that. The augmented vector leads aren’t necessarily used to “amplify” the voltage, rather they are used to view the heart in a frontal plane. The precordial leads views the heart in a transverse plane, where the augmented vector leads view the heart in a coronal plane. aVL is used to view the heart from +30• above lead I on the left. This means it views the heart from the “left arm” (aVL), just like the aVR lead views the heart from the perspective of the right arm, 30• above lead I on the right.
It is technically the view from the left side looking down at 30• form the left toward the heart. A positive deflection on this lead (lead aVL) indicates that the vector of conduction is heading towards +30• or towards aVL.
So would they work for IST? For my 18 year old daughter? Instead of meds
Great discussion, I'm a new Abbott CRM rep and enjoyed it.
Hi, Charles! Thanks for the compliment! Check out ECGAcademy.com for more terrific tutorials! NT
Doctor just told me my heart rate has dropped to zero and that it wont work again, so basically only the pacemaker is what's keeping me alive.
Do you have any reading material for people in my condition?
Thank you!
www.uptodate.com/contents/pacemakers-beyond-the-basics?search=pacemaker&source=search_result&selectedTitle=1~18&usage_type=default&display_rank=1
Sonia -- You will find useful articles about pacemakers that I wrote on heartrhythmcentral.com
Sensor indicated pacing is a nightmare when you have to deal with chronotropic incompetance
Yes, but most devices are programmable so that the sensor response to activity can be tailored to your body. You need to check with your EP/pacer physician and let him/her know you are not satisfied.
I don't agree PT would cause rapid pacing rate.
There is no other explanation.
I will do the patient after 12;30 12;30