Here, you will learn about Pacemakers and Automated implantable cardioverter defibrillators

Table Of Contents

Pacemakers

Types of Pacemakers

Biventricular Pacing (Cardiac Resynchronization Therapy [CRT])

<aside> ๐Ÿ’ก

Indication

Permanent Pacemaker

<aside> ๐Ÿ’ก

Indications for Permanent Pacemaker Implantation

  1. Irreversible Mobitz Type II Heart Block or Complete Heart Block.
  2. Persistent Symptomatic Bradycardia.
  3. Heart Rate < 40 bpm and Asymptomatic. </aside>

Permanent pacemakers (PPMs)

Permanent pacemakers (PPMs)

Automated implantable cardioverter defibrillators (AICD)

Description

Indications for AICDs

The primary goal of AICDs is to prevent sudden cardiac death from ventricular tachyarrhythmias.

Cardiac Event Monitors

Types of Cardiac Event Monitors

  1. Holter Monitor
  2. Loop Event Monitor
  3. Implantable Loop Recorder

<aside> ๐Ÿ’ก Indications for Cardiac Event Monitors:

  1. Unexplained syncope or near-syncope.
  2. Recurrent unexplained palpitations.
  3. Monitoring for atrial fibrillation.
  4. Screening for ventricular arrhythmias in patients with structural heart disease. </aside>

Comparison of PPMs, AICDs, and CRTs Indications

Device Common indications
PPMs ๐Ÿ”ท Symptomatic Sinus node dysfunction
๐Ÿ”ท Symptomatic AV block
๐Ÿ”ท High-risk AV block
AICDs ๐Ÿ”ท Primary prevention
 ๐Ÿ”ธ Cardiac Channelopathies (e.g., congenital long QT syndrome, Brugada syndrome)
 ๐Ÿ”ธ Severe congestive heart failure (EF < 35%)  in NYHA Class II/III HF
 ๐Ÿ”ธ Hypertrophic obstructive cardiomyopathy
 ๐Ÿ”ธ Arrhythmogenic right ventricular cardiomyopathy

๐Ÿ”ท Secondary prevention (In case the patient has a history of the following)

 ๐Ÿ”ธ Sudden cardiac arrest (e.g., due to Vfib or Unstable VT)
 ๐Ÿ”ธ Stable sustained VT

| | CRTs | ๐Ÿ”ท Patients with CHF with LVEF โ‰ค 35% & a wide QRS |