The Nuts and bolts of Paced ECG Interpretation [NOOK Book]

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.


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The Nuts and bolts of Paced ECG Interpretation

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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

  • ISBN-13: 9781444357073
  • Publisher: Wiley
  • Publication date: 9/7/2011
  • Series: Nuts and Bolts Series (Replaced by 5113) , #10
  • Sold by: Barnes & Noble
  • Format: eBook
  • Edition number: 1
  • Pages: 488
  • Sales rank: 1,212,594
  • File size: 29 MB
  • Note: This product may take a few minutes to download.

Meet the Author

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

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Table of Contents

Preface vii

Before We Start ..., 1

Part I Timing Cycles and Troubleshooting Review

1 Calculating Rates and Intervals 5

2 Pacing Spikes 8

3 The Basics of Capture and Sensing 11

4 In Depth: Modes 14

5 Ventricular Sensing 17

6 Pacing Intervals 19

7 Loss of Capture 22

8 Oversensing 24

9 In Depth: Sensing 26

10 QRS Morphologies 28

11 Fusion and Pseudofusion 31

12 In Depth: Single-Chamber Timing Cycles 34

13 Intermittent Oversensing 36

14 Undersensing 38

15 Hysteresis Intervals 40

16 In Depth: Hysteresis 42

17 Rate Response 44

18 Annotated ECGs 46

19 AV Synchrony 49

20 Atrial Tracking 51

21 AV Conduction 53

22 States of Dual-Chamber Pacing 55

23 Maximum Tracking Rate 57

24 Pacemaker Multiblock 60

25 Pacemaker Wenckebach 63

26 Pacemaker-Mediated Tachycardia 66

27 Mode Switching 68

28 In Depth: Upper-Rate Behavior in Dual-Chamber Pacemakers 71

29 Troubleshooting the Paced ECG 73

30 More Troubleshooting the Paced ECG 75

31 Automatic Capture Algorithms 77

32 Capture Testing 80

33 In Depth: Basic Troubleshooting Guide 83

34 Navigating the Intracardiac Electrogram 86

35 Tracings from a Programmer (Combining E-grams with the ECG) 93

36 Stored Electrograms 96

37 In Depth: Electrograms 99

38 Conclusion 101

Part II Workbook

Introduction to Workbook 105

Easy 107

Moderate 237

Tough 313

Scramble 409

Index 475

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