Cardiac pacing

Cardiac pacing
A typical pacemaker device
Specialty	{{#statements:P1995}}
ICD-10-PCS	Z95.0
ICD-9-CM	37.8
MeSH	D010191

Cardiac pacing is a medical intervention used to regulate the heart rate by delivering electrical impulses to the heart muscles. This technique is primarily used to treat bradycardia, a condition characterized by an abnormally slow heart rate, and other cardiac arrhythmias. The device used for cardiac pacing is known as a pacemaker.

History

The development of cardiac pacing began in the 1950s with the invention of the first external pacemaker by Dr. Paul Zoll. The first implantable pacemaker was developed by Dr. Rune Elmqvist and Dr. Åke Senning in 1958. Since then, pacemaker technology has advanced significantly, with modern devices being smaller, more reliable, and capable of more complex functions.

Indications

Cardiac pacing is indicated in several conditions, including:

• Bradycardia: A heart rate that is too slow, often less than 60 beats per minute.
• Heart block: A condition where the electrical signals are partially or completely blocked between the atria and ventricles.
• Atrial fibrillation with slow ventricular response.
• Heart failure: In some cases, pacing can help improve the heart's efficiency.

Types of Pacemakers

There are several types of pacemakers, including:

• Single-chamber pacemaker: This device has one lead placed in either the right atrium or right ventricle.
• Dual-chamber pacemaker: This device has two leads, one in the right atrium and one in the right ventricle, allowing for coordinated pacing of both chambers.
• Biventricular pacemaker: Also known as cardiac resynchronization therapy (CRT), this device has leads in both ventricles and sometimes the right atrium, used primarily in heart failure patients.

Procedure

The implantation of a pacemaker is a surgical procedure typically performed under local anesthesia. The leads are inserted through a vein and positioned in the heart under fluoroscopic guidance. The pacemaker generator is then placed under the skin, usually near the collarbone.

Complications

While generally safe, pacemaker implantation can have complications, such as:

• Infection at the implantation site.
• Lead displacement or malfunction.
• Pneumothorax (collapsed lung).
• Hematoma (bruising) at the site of implantation.

Follow-up and Maintenance

Patients with pacemakers require regular follow-up to ensure the device is functioning correctly. This includes checking the battery life, lead integrity, and adjusting the settings as needed. Most pacemakers last between 5 to 15 years before the battery needs replacement.

Also see

• Electrophysiology
• Implantable cardioverter-defibrillator
• Heart rhythm disorders
• Cardiology

Cardiovascular disease A-Z

Most common cardiac diseases

• Cardiac arrhythmia‎
• Cardiogenetic disorders‎
• Cardiomegaly‎
• Cardiomyopathy‎
• Cardiopulmonary resuscitation‎
• Chronic rheumatic heart diseases‎
• Congenital heart defects‎
• Heart neoplasia‎
• Ischemic heart diseases‎
• Pericardial disorders
• Syndromes affecting the heart‎
• Valvular heart disease‎

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

A

• Accelerated idioventricular rhythm
• Acute decompensated heart failure
• Arteriosclerotic heart disease
• Athletic heart syndrome
• Atrial flutter
• Atrioventricular fistula
• Cardiovascular disease in Australia
• Autoimmune heart disease

B

• Brown atrophy of the heart

C

• Ebb Cade
• Cardiac allograft vasculopathy
• Cardiac amyloidosis
• Cardiac asthma
• Cardiac tamponade
• Cardiogenic shock
• Cardiogeriatrics
• Cardiorenal syndrome
• Cardiotoxicity
• Carditis
• Coronary artery aneurysm
• Coronary artery anomaly
• Coronary artery disease
• Spontaneous coronary artery dissection
• Coronary artery ectasia
• Coronary occlusion
• Coronary steal
• Coronary thrombosis
• Coronary vasospasm
• Cœur en sabot
• Coxsackievirus-induced cardiomyopathy

D

• Duke Treadmill Score
• Duroziez's disease

E

• Eisenmenger's syndrome
• Embryocardia
• Endocardial fibroelastosis
• Eosinophilic myocarditis

H

• Heart attack
• Heart failure
• Heart failure with preserved ejection fraction
• Heart to Heart (1949 film)
• High-output heart failure
• Hyperdynamic precordium

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

I

• Idiopathic giant-cell myocarditis
• Interventricular dyssynchrony
• Intraventricular dyssynchrony
• Isolated atrial amyloidosis

K

• Keshan disease

L

• Loeffler endocarditis

M

• Mydicar
• Myocardial bridge
• Myocardial disarray
• Myocardial rupture
• Myocardial scarring
• Myocardial stunning
• Myocarditis

N

• Nonbacterial thrombotic endocarditis

O

• OLR1
• Ostial disease

P

• Papillary fibroelastoma
• Pathophysiology of heart failure
• Postpericardiotomy syndrome
• Pulmonary vein stenosis

R

• Right axis deviation
• Roemheld syndrome

S

• Saturated fat and cardiovascular disease
• SCAR-Fc
• Shone's syndrome
• Strain pattern
• Subacute bacterial endocarditis
• Sudden cardiac death of athletes

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

T

• Traumatic cardiac arrest

V

• Ventricular aneurysm
• Vibroacoustic disease
• Viral cardiomyopathy

W

• Waon therapy