Types of Pacers

• Single Chamber
• one lead in either RA or RV
• Dual Chamber
• one lead in RA and one in RV
• BiVentricular (CRT - Cardiac Resynchronization Therapy)
• leads on both sides of Ventricular Septum

LBBB Pattern

• because the pacer depolarizes RV the delay in reaching LV results in LBBB pattern
• use Sgarbossa Criteria

Magnet

• Pacer - sets to default asynchronous pacing at set rate
• ICD - turns off shock function but will continue to pace

Complications

• AMI
• Infection - at pocket or in leads
• Hematoma at pocket
• Hardware Problems
• Failure to Capture
• Dx - Insufficient generator impulse
• Tx - Temporary Pacing
  
• Lead Migration / Fracture
• Dx - Lead movement or damage
• Tx - Temporary Pacing
  
• Runaway Pacemaker
• Dx - Pacer failure leading to tachycardia
  
• Tx - Magnet, emergent interrogation
  
• Oversensing
• Dx - Artifactual sensing of cardiac activity resulting in pacer inhibition
  
• Tx - Magnet, temporary pacing, emergent interrogation
• Undersensing
• Dx - Pacer fails to sense intrinsic cardiac activity
  
• Tx - Emergent interrogation