How-to Manual for Pacemaker and ICD Devices: Procedures and Programming

 

Description:

A complete, how-to-do-it guide to planning, programming, implementing, and trouble-shooting today?s pacemakers and other implantable cardiac devices

Edited by a team of leading clinician-educators this is a practical, go-to reference for trainees and clinical staff who are new to or less experienced with the programming and management of implantable devices. It distills device best-practices into a single, quick-reference volume that focuses on essential tasks, common pitfalls, and likely complications. Each chapter follows a hands-on, how-to-do-it approach that helps readers quickly master even the most challenging device-related tasks?such as programming and how to respond confidently when complications arise.

Today?s pacemakers and other implantable EP devices are to earlier versions what smart phones are to rotary phones. They are not only smaller and more comfortable; they offer complex programming options that allow clinicians to adapt a device to individual patient requirements. As they continue to become smaller, smarter, and more adaptable, these devices also become more challenging for clinicians to set up, manage and monitor. This unique, quick-reference guide dramatically reduces the learning curve for mastering this essential technology by giving doctors and technicians the how-to information they need.

Focuses on tasks clinicians perform, including pre-implementation, planning, programming, management, troubleshooting, and more

Shows how expert clinicians achieve optimal outcomes in their own labs with real-world examples

Features more than 300 images, including ECGs, X-ray and fluoroscopy, images from device interrogation, intracardiac electrograms, and color electoanatomical maps

Provides eight videos on an accompanying website demonstrating key tasks and techniques

Also available in an digital version, enhanced with instructional videos, How-to Manual for Pacemaker and ICD Devices is an indispensable ?tool of the trade? for electrophysiologists, fellows in electrophysiology, EP nurses, technical staff, and industry professionals.

 

Table of Contents:

 

Part One

1 How to Access the Cephalic Vein Using a Cut-down Approach

Procedure Description

Potential Pitfalls and Complications

Conclusions

References

2 Extrathoracic Subclavian Vein Access

Venous Anatomy

Accessing the Extrathoracic Subclavian Vein

Extrathoracic Axillary Access

References

3 Subcutaneous Implantable Cardioverter-Defibrillator

Patient Selection

Anatomic Landmarks for Implantation and Prepping

Implantation Procedure

Two-Incision Technique for Implantation

Defibrillation Testing and Device Programming

Conclusions

Acknowledgments

References

4 Internal Jugular Venous Access and Lead Implantation for Cardiac Implantable Electronic Devices

Patient Selection and Preparation

Procedure

Long-Term Outcome

References

5 Implantation of the Left Ventricular Lead

Venous Access

Coronary Sinus Catheter

Coronary Venous Anatomy

Cannulation of the Coronary Sinus

Coronary Sinus Venogram

Lead Placement

Removal of Delivery Platform

Complications of CRT

References

6 How to Place a Lead in the Azygos Vein

Azygos Vein Anatomy

Implant Technique

Variation For Right-Sided Implants

Case Example

Limitations

Conclusions

References

7 Alternative Site Pacing: A Guide to Implantation Techniques

Bachmann’s Bundle Pacing

His Bundle Pacing

Right Ventricular Outflow Tract (Septal) Pacing

Conclusions

References

8 How to Maximize CRT Response at Implant

Pre-implantation Evaluation

Assessment of Coronary Vein Anatomy

Transvenous LV Lead Implantation

Targeting LV Lead Placement

Alternative LV Lead Placement Techniques

Position of the RV Lead

Device Optimization at Implant

Atrial Fibrillation

Device Upgrades

Peri- and Postoperative Period

Conclusions

References

9 How to Perform Sub-pectoral Device Implants

Venous Access for Lead Placement

Technique

Comparison of Subcutaneous and Sub-pectoral Implants

Defibrillation Threshold and Efficacy

Generator Replacement

Conclusions

References

10 Device Extractions

Background

Indications

Qualifications

Preparation for Device Extraction

Lead Extraction Procedure

Complications

Acknowledgments

References

11 How to Extract Pacemaker and Defibrillator Leads from the Femoral Approach

Femoral Lead Extraction Approach Within the Larger Context of the Lead Extraction Procedure

Tools for Femoral Extraction

Using the Tools

Special Situations

Precautionary Measures

Complications

Why is Less Force Required to Extract Leads from Femoral Approach than Superior Approach?

Conclusions

References

12 How to Extract Leads from the Jugular Approach

Background

Internal Transjugular Approach

Complex VEA Extraction

Conclusions

References

13 How to Perform Venoplasty for Access

Background

Safety of Subclavian Venoplasty

Utility of Subclavian Venoplasty

Step-by-Step Approach to Subclavian Venoplasty

Balloon Options

Wire Exchange

Focused Force Venoplasty

How to Cross a Difficult Subclavian Occlusion

Combining Femoral Extraction and Venoplasty

How to Make a Subclavian Obstruction Difficult to Cross

References

14 How to Perform Defibrillation Threshold Testing

Reasons for DFT Testing

Arguments Against Routine DFT Testing

Decision to Perform DFT Test

DFT Testing Strategies

How to Manage High DFTs

References

15 Use of Chest X-ray, Computed Tomography and 3-D Imaging to Evaluate Lead Location

Chest X-ray Identification of Lead Insertion Site

X-Ray Right Ventricular Lead Tip Localization

X-ray Left Ventricular Lead Tip Localization

X-ray Identification of Alternative LV Lead Implantation Techniques

X-Ray Identification of Alternative Defibrillator Lead Implantation Techniques

X-ray Identification of Device Implant Complications

X-ray Identification of Lead Failure

CT and 3-D Imaging for Identifying Lead Location

Conlusions

References

16 How to Evaluate Postoperative Device Complications

Lead Dislodgement

Pneumothorax

Bleeding, Swelling, and Hematoma

Pain

Erosion

Infection

Inadvertent Left Ventricular Lead Placement

Lead Block Connection Problems

Lead or Insulation Damage

Lead Fracture

Rising Threshold and Exit Block

Extracardiac Stimulation

Cardiac Perforation, Tamponade, and Pericarditis

Thrombosis

Conclusions

References

Part Two

17 How to Program Pacemakers for Patients With Sinus Node Disease

Pacing Mode Programming in Different Forms of SND

Mode Switching

Lower Rate Programming

Upper Sensor Rate and Sensor Programming

Upper Tracking Rate

AV Delay: Sensed and Paced

Rate Adaptive AV Delay

AV Hysteresis Algorithms

Automatic AAI(R)↔ DDD(R) Switching Algorithms

Atrial Sensitivity and AF Detection

PMT Intervention, PVC Reaction

Non-competitive Atrial Pacing (NCAP®)

Atrial Preventive Pacing

Memory Functions

References

18 How to Interpret Pacemaker Electrocardiograms

Normal ECG, in PM Patients: Basic Principles of Interpretation

Classifications of PM Functions by NBG Code (NASPE and BPEG Generic)

Mode of PM Programming

Particular Aspects of the Dual-Chamber Pacing (DDD) Identifiable on the Surface ECG

Blanking Period and the Ventricular Safety Pacing (Committed)

Mechanisms of Control of High Ventricular Pacing Rates

Pacemaker-Dependent Arrhythmias

Electrocardiographic Signs of Biventricular Pacing

PM Malfunctions

References

19 How to Perform Pacemaker Troubleshooting

Pacemaker Options and Programming Characteristics

The First Step: Interrogation

The Second Step: Pacemaker Troubleshooting

Defining Pacemaker and/or Lead Problems

Conlusions

20 How to Program an ICD to Program ATP, and Program for VT/VF Storm

Anti-Tachy Pacing Therapy

ATP Therapy Efficacy and Programming Recommendation

ATP Therapy in Cardiac Resynchronization Therapy Defibrillators

ATP Therapies in Electrical Storms

References

21 How to Troubleshoot An ICD

Basics of Ventricular Tachyarrhythmia Detection

Implant-Related Problems

Clinical Reasons to Assess ICD Function

Inappropriate ICD Therapy for Oversensing

Lead or Connector Failure

Evaluation of Appropriateness of ICD Therapy for Tachycardia

Programming to Avoid Inappropriate Therapy

Effectiveness of Shocks

Battery Status

Charge Time

References

22 Management of ICD Device and Lead Failures and Recalls

Monitoring of ICD and Lead Performance

Definition of Recall

Management of ICD Recalls or Failure

Management of Lead Recall or Failure

Conclusions

References

23 How to Program an ICD to Minimize Inappropriate Shocks

Programming

Pharmacologic Considerations

Catheter Ablation

Subcutaneous ICD

Conclusions

Guide to Programming

References

24 How to Perform CRT Optimization

Defining Response to CRT

Pre-Implant Optimization

Implant Optimization

Post-Implant Optimization

Echocardiographic-based CRT Optimization

Device-based CRT Optimization

Conclusions

References

25 How to Manage Device Infections and When to Reimplant After Device Extraction

Risk Factors

Clinical Presentation of CIED Infection

Aetiology

Diagnosis

Therapy

Transvenous Lead Removal

Timing of Reimplantation

References

26 How to Implement a Remote Follow-up Program for Patients with Cardiac Implantable Electronic Devices

Staff

Qualifications

Documentation and Data Management

Transmission Devices

Conduct of the Remote Follow-up

Scheduling and Managing the Patient’s Expectations

Managing Alerts

Missed Transmissions

Coding and Reimbursement

TTM

Frequency

Conclusions

References

27 How to Set Up an HF Monitoring Service

Monitoring Based on Self-Reporting Via Telephone Contacts

Invasive Monitoring Via Implantable Sensors

Automatic Remote Monitoring Based on Cardiac Electronic Implantable Devices

References

28 How to Deactivate Cardiac Implantable Electric Devices in Patients Nearing the End of Life and/or Requesting Withdrawal of Therapies

Why is ICD Deactivation Important?

Legally and Ethically, Can CIEDs be Deactivated?

How to Communicate With Patients About CIED Deactivation

How to Deactivate a CIED

Who Should Deactivate the ICD?

Where Should Deactivation be Performed?

References

Index

End User License Agreement

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An aparitie	23 Feb 2018
Autor	A Al–Ahmad
Dimensiuni	216 x 280 x 16 mm
Editura	Wiley
Format	Paperback
ISBN	9781118820599
Limba	Engleza
Nr pag	296