Term
| What are the 2 types of pacemakers? |
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Definition
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Term
| What does a pacemaker do? |
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Definition
| It provides overriding electrical simuli by causing a cardiac contraction if the unaided rhythm is bradycardia, tachycardia, asystole, or other undesirable dysrythmias |
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Term
| What pacemaker component is in contact with the heart? |
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Definition
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Term
| Where can the pacing leads be in contact with the heart? |
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Definition
Endocardial placement in adults
Epicardial placement in children |
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Term
| If placed permanently within the endocardium, where are some places the pacing leads might be anchored? |
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Definition
| Pace RA and/or LA (in rare situations) and possible two ventricle leads, one in the right ventricle and/or one in a venous branch of the coronary sinus pacing the LV |
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Term
| What are 3 types of pacing lead access? |
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Definition
| Transvenous, Transcutaneous, and Transthoracic |
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Term
| What access might the Cardiologist use transvenously to get the pacing leads to the heart? |
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Definition
| Subclavian vein, Axillary vein, Cephalic vein |
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Term
| Why are pacing leads placed in the epicardium in children? |
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Definition
| Leads become too short as the child grows. |
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Term
| What are the 2 types of pacing leads? |
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Definition
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Term
| On a bipolar lead, where is the negative and positive poles? |
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Definition
| The anchor (tip of the lead) is the negative pole and the positive pole is a few centimeters back up the wire. |
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Term
| On a unipolar lead, where is the negative and positive poles? |
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Definition
| The anchor (tip of the lead) is the negative pole and the generator case is the positive pole. |
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Term
| What 2 types of pulse generators are there? |
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Definition
| External and Implantable/Permanent |
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Term
| How long can a patient be on a temporary external pacemaker and why? |
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Definition
| Up to 10 days, because the lead anchors will begin to epithelialize. |
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Term
| What axis is signal amplitude and what is it measured in? |
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Definition
| The Y-axis, measured in millivolts |
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Term
| What axis is the pulse width or output duration and what is it measured in? |
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Definition
| The X-axis, measured in milliseconds |
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Term
| When a pulse successfully generates a depolarization event, this is known as? |
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Definition
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Term
| How is output amplitude set for a pacemaker? |
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Definition
| High enough to generate capture, but low enough to maintain battery life. |
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Term
| What are the 2 types of pulse generator mode of operation? |
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Definition
| Asynchronous Mode and Synchronous or Demand Mode |
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Term
What mode is this pulse generator set?
Impulse produced at a set rate. |
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Definition
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Term
What mode is this pulse generator set?
Senses intrinsic cardiac activity and impulses as needed. |
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Definition
| Sychronous or Demand Mode |
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Term
| What type of pulse generator mode of operation setting accomdates the patients lifestyle? |
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Definition
| Synchronous or Demand Mode |
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Term
| What type of pulse generator mode of operation setting ignores the patients lifestyle? |
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Definition
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Term
| What is a small but real danger with using a asynchronous pacemaker? |
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Definition
| There is a chance of that the pacemaker could generate a pulse that coincides with the relative refractory period of the myocardial cells action potential, known as the R or T Phenomenon which can immediately cause the heart to go into a life-threatening V-tach rhythm. |
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Term
| How is a temporary pacemaker powered? |
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Definition
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Term
| How is a permanent pacemaker powered? |
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Definition
Lithium-iodide battery
(Life-span 5-8 years) |
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Term
| What are the 4 types of lead anchors? |
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Definition
| Tined, Endocardial screw-in, epicardial screw-in, temporary non-tined |
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Term
| How is it possible to detect a fracture in a lead wire or insulator? |
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Definition
| Measure the resistance of the lead |
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Term
| What does increased resistance in a lead wire signify? |
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Definition
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Term
| What does decreased resistance in a lead wire signify? |
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Definition
| A break in the insulation |
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Term
| What does a pacemaker do? |
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Definition
| Generates an electrical pulse to stimulate the atrium, ventricle, or both to initiate contraction. |
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Term
| What is the physiologic response of a pacemaker and how do you know if there has been capture? |
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Definition
| The physiologic response is depolarization of the myocardial cells and you know there has been capture if either a P-wave or R-wave or both are present following a pacemaker generated spike. |
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Term
| What does ICD or IACD stand for? |
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Definition
| Implantable Automated Cardioverter-Defibrillator |
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Term
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Definition
| An anti-dysrhythmia pacemaker |
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Term
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Definition
| A computer guided electrical stimulation of myocardium in an attempt to defibrillate the heart out of a life-altering or life-threatening arrhythmia. |
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Term
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Definition
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Term
| What type of fluoroscopic images might be done in the Cardiac Catheter Lab? |
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Definition
| Coronary angiography, cardiac chambers, valvular disease pathology assessment |
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Term
| What is the function of the Cath Lab? |
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Definition
| To diagnose disease and severity, and to intervene to repair pathologic conditions or congenital abnormailties of the heart and vessles to and from |
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Term
| Where in the body is the only place that uses 100% of the O2 supplied? |
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Definition
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Term
| Name some anatomy that might be studied in the Cath Lab. |
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Definition
| Aorta, coronary arteries, peripheral vessels, pulmonary vessels |
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Term
| Name some possible interventional studies that might be performed in the Cath Lab. |
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Definition
| Plaque or thrombus reduction/removal, valvular replacement, peripheral intervention |
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Term
| Name some conditions that would be treated in the Cath Lab. |
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Definition
| Valvular disease, congenital heart disease, cardiomyopathy, cardiac tamponade, rupture of RV wall or papillary muscles, CHF, Shunts and other septal defects, initial and follow-up assessment of cardiac transplant |
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Term
| What are some right heart data that might be obtained in the Cath Lab? |
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Definition
| Right side pressures/waveforms, oxygen saturation/desaturation, valvular pressure gradients, angiography, cardiac output |
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Term
| What are some left heart data that might be obtained in the Cath Lab? |
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Definition
| Left side pressures/waveforms, valvular pressure gradients, coronary angiography, ventriculography, aortography |
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Term
| What are some contraindications for Cath Lab procedures? |
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Definition
| Uncontrolled CHF, pulmonary edema, elevated BP, arrhythmia, recent stroke (<1 month), infection or fever, electrolyte imbalance, acute GI bleeding or anemia, pregnancy, uncontrolled bleeding, renal failure, digitalis toxicity |
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Term
| What is the risk of experiencing cardiac arrest or death in the Cath Lab? |
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Definition
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Term
| What is the risk of experiencing MI in the Cath Lab? |
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Definition
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Term
| What is the risk of experiencing stroke in the Cath Lab? |
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Definition
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Term
| What is the risk of gaining a dysrhthmia from the Cath Lab? |
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Definition
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Term
| What are some complications that might result from the Cath Lab? |
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Definition
| Vascular injury, contrast reaction, cardiac tamponade |
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Term
| What types of vascular injury complications might result from the Cath Lab? |
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Definition
| Bleeding, pseudoaneurysm, thrombosis, air or other emboli, aortic dissection |
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Term
| Who is on the Catheterization Team? |
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Definition
| Invasive Cardiologist, RN, RT, RCIS Monitor Tech, RCIS Scrub Tech, RCIS Circulating Tech |
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Term
| What are the requirements for the Invasive Cardiologist? |
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Definition
| 3-5 years of cardiology fellowship, specialized in invasive cardiology, must be board certified, perform diagnositic cath procedures, may be Electrophysiologist |
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Term
| What are the requirements for the Registered Nurse? |
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Definition
| Critical Care background, ACLS certified, assists physician |
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Term
| What does ACLS stand for? |
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Definition
| Advanced Cardiac Life Support |
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Term
| What are the requirements for the Radiology Technologist? |
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Definition
| 2 year program, registered |
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Term
| What are the requirements for the Registered Cardiovascular Invasive Specialist? |
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Definition
| minimum of 2 year program, registered, trained in physiologic recording equipment |
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Term
| What imaging system is used in the Cath Lab? |
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Definition
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Term
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Definition
| Robotic arms support image intensifier and camera with 180 degrees range of motion |
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Term
| Who operates the Contrast Power Injector? |
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Definition
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Term
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Definition
| Cart that contains emergency drugs, artificial airways, intubation and suction, cardioverter/defibrillator, temporary external pacemaker |
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Term
| What is an Oxygen saturation/Content Analyzer? |
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Definition
| Measures hemogolobin concentration, O2 saturation, calculates ABG |
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Term
| What are some sterile procedural supplies that one might see in the Cath Lab? |
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Definition
| Syringes, needles, towels, drapes, gauze, valves, tubing, contrast, manifolds, closure devices, BP transducers, heparinized saline, standard cath drugs. |
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Term
| What is the heparinized saline used for? |
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Definition
| To help prevent clot formation in tubing. |
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