23. Cardiac Pacing
Published Online: 1 NOV 2012
Copyright © 2013 John Wiley & Sons, Ltd.
Bennett's Cardiac Arrhythmias: Practical Notes on Interpretation and Treatment, Eighth Edition
How to Cite
Bennett, D. H. (2013) Cardiac Pacing, in Bennett's Cardiac Arrhythmias: Practical Notes on Interpretation and Treatment, Eighth Edition, John Wiley & Sons, Ltd, Oxford. doi: 10.1002/9781118432389.ch23
- Published Online: 1 NOV 2012
- Published Print: 14 JAN 2013
Print ISBN: 9780470674932
Online ISBN: 9781118432389
- Cardiac pacing;
- Electromagnetic interference;
- Long-term cardiac pacing;
- Pacemaker clinic;
- Pacemaker hardware;
- Pacemaker implantation;
- Pacing modes;
- Temporary cardiac pacing
Long-term pacing is indicated in cases of symptomatic bradycardia whether due to atrioventricular (AV) block or sick sinus syndrome, and should be considered in asymptomatic patients with high-degree AV block or long pauses in sinus node activity.
Dual-chamber pacing (DDD) preserves the haemodynamic benefit of normal AV synchronisation and facilitates a chronotropic response to exercise provided sinus node function is normal. In patients with impaired sinus node function, rate-responsive systems (DDDR/VVIR) can increase the stimulation rate in response to a physiological parameter that alters with exercise.
The modern pacemaker is small, reliable and has a long battery life. It is usually implanted over the pectoral muscle. The pacing lead(s) are introduced via the subclavian or cephalic vein. Infection is the commonest complication.
Electromagnetic interference from household devices and from electronic surveillance equipment is unlikely to affect the modern pacemaker. Caution is required with cardioversion, diathermy, MRI scanning and radiotherapy.