The Nuts and bolts of Paced ECG Interpretation / Edition 1

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Overview

Nothing is more perplexing to the clinician new to device therapy than having to deal with cardiac electrocardiograms from a device patient. Pacemakers and other implantable cardiac rhythm management devices leave their "imprint" on ECGs and can significantly change what clinicians see - or expect to see. Evaluating paced ECGs can be challenging, yet nowhere is it taught in any sort of comprehensive manner. Designed specifically for clinicians new to device therapy, The Nuts and Bolts of Interpreting Paced ECGs and EGMs offers practical, reliable and objective information on paced cardiac electrograms. Written in a lively, intelligent and easy to navigate style, emphasizing real-life clinical practice and practical tips, this book includes illustrated paced ECGs by skilled artists to help minimize "fuzzy" lines and emphasize key points. Each chapter concludes with a checklist of key points from each subject ("Nuts and Bolts").

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Editorial Reviews

From the Publisher
'This is a concise, well-written introduction to the interpretation of paced rhythms with many well-done recreated practice ECGs that both educate and challenge readers.' (Doody's Reviews , October 2009)
Doody's Review Service
Reviewer: John Lee, MD (Ochsner Clinic Foundation)
Description: This standalone supplement to the author's Nuts and Bolts of Cardiac Pacing, 2nd edition (Wiley-Blackwell, 2008) specifically covers the topic of interpreting paced ECGs.
Purpose: It is intended to familiarize readers with the ECGs of patients with ICDs with pacing functions or pacemakers.
Audience: This book is written for students, physicians in training, and clinicians who are caring for patients with ICDs and pacemakers.
Features: Part I starts with the basics of paced ECGs and moves on to different troubleshooting techniques to interpret more complicated paced rhythms. Each section in this part includes a "test your knowledge" feature with subsequent explanations. At the end of each section, a concise bulleted summary highlights the important points. Part II is set up as a workbook for readers to practice interpreting paced ECGs and then check their interpretation against the author's. The book also includes a "what to do next" section with each ECG to help readers not only decipher the paced rhythm, but also guide them to the next step in pacemaker troubleshooting.
Assessment: This is a concise, well-written introduction to the interpretation of paced rhythms with many well-done recreated practice ECGs that both educate and challenge readers.
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Product Details

Meet the Author

Tom Kenny
Vice President Clinical Education & Training
St. Jude Medical
Austin, TX, USA

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Table of Contents

Preface.

Before We Start ….

Part I Timing Cycles and Troubleshooting Review.

1 Calculating Rates and Intervals.

2 Pacing Spikes.

3 The Basics of Capture and Sensing.

4 In Depth: Modes.

5 Ventricular Sensing.

6 Pacing Intervals.

7 Loss of Capture.

8 Oversensing.

9 In Depth: Sensing.

10 QRS Morphologies.

11 Fusion and Pseudofusion.

12 In Depth: Single-Chamber Timing Cycles.

13 Intermittent Oversensing.

14 Undersensing.

15 Hysteresis Intervals.

16 In Depth: Hysteresis.

17 Rate Response.

18 Annotated ECGs.

19 AV Synchrony.

20 Atrial Tracking.

21 AV Conduction.

22 States of Dual-Chamber Pacing.

23 Maximum Tracking Rate.

24 Pacemaker Multiblock.

25 Pacemaker Wenckebach.

26 Pacemaker-Mediated Tachycardia.

27 Mode Switching.

28 In Depth: Upper-Rate Behavior in Dual-Chamber Pacemakers.

29 Troubleshooting the Paced ECG.

30 More Troubleshooting the Paced ECG.

31 Automatic Capture Algorithms.

32 Capture Testing.

33 In Depth: Basic Troubleshooting Guide.

34 Navigating the Intracardiac Electrogram.

35 Tracings from a Programmer (Combining E-grams with the ECG).

36 Stored Electrograms.

37 In Depth: Electrograms.

38 Conclusion.

Part II Workbook.

Introduction to Workbook.

Easy.

Moderate.

Tough.

Scramble.

Index.

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