Troubleshooting Part I. Objectives:. Understand the four basic steps used to solve troubleshooting problems Identify ECG abnormalities that result from pacing system malfunction and pseudomalfunction Recognize data and resources available to aid in troubleshooting pacing system anomalies
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...Though no activity is present
Marker channel shows intrinsic activity...
Loss of capture
Pacing output delivered; no evidence of pacing spike is seen
Pseudomalfunctions are defined as:
ECG findings that appear to result from pacemaker malfunction but that represent normal pacemaker function
VVIR / 60 / 120
Hysteresis Rate 50 ppm
Lower Rate 70 ppm
DDDR / 60 / 125 / 200 / 225
PAV delay with no activity: 150 ms
PAV with activity: 120 ms
Long PVARP with little activity
Shorter PVARP with increased activity
DDD / 60 / 120 PVARP 310 ms
“An assortment of symptoms related to the adverse hemodynamic impact from the loss of AV synchrony.”
Medtronic pacemakers are indicated for rate adaptive pacing in patients who may benefit from increased pacing rates concurrent with increases in activity (Thera, Thera-i, Prodigy, Preva and Medtronic.Kappa 700 Series) or increases in activity and/or minute ventilation (Medtronic.Kappa 400 Series).
Medtronic pacemakers are also indicated for dual chamber and atrial tracking modes in patients who may benefit from maintenance of AV synchrony. Dual chamber modes are specifically indicated for treatment of conduction disorders that require restoration of both rate and AV synchrony, which include various degrees of AV block to maintain the atrial contribution to cardiac output and VVI intolerance (e.g., pacemaker syndrome) in the presence of persistent sinus rhythm.
The Medtronic 9790 Programmers are portable, microprocessor based instruments used to program Medtronic implantable devices.
The Model 9462 Remote Assistant™ is intended for use in combination with a Medtronic implantable pacemaker with Remote Assistant diagnostic capabilities.
Medtronic pacemakers are contraindicated for the following applications:
· Dual chamber atrial pacing in patients with chronic refractory atrial tachyarrhythmias.
· Asynchronous pacing in the presence (or likelihood) of competitive paced and intrinsic rhythms.
· Unipolar pacing for patients with an implanted cardioverter-defibrillator because it may cause unwanted delivery or inhibition of ICD therapy.
· Medtronic.Kappa 400 Series pacemakers are contraindicated for use with epicardial leads and with abdominal implantation.
Pacemaker patients should avoid sources of magnetic resonance imaging, diathermy, high sources of radiation, electrosurgical cautery, external defibrillation, lithotripsy, and radiofrequency ablation to avoid electrical reset of the device, inappropriate sensing and/or therapy.
Operation of the Model 9462 Remote Assistant™ Cardiac Monitor near sources of electromagnetic interference, such as cellular phones, computer monitors, etc. may adversely affect the performance of this device.
See the appropriate technical manual for detailed information regarding indications, contraindications, warnings, and precautions.
Caution: Federal law (U.S.A.) restricts this device to sale by or on the order of a physician.
For Indications, Contraindications, Warnings, and Precautions for Medtronic Leads, please refer to the appropriate Leads Technical Manual or call your local Medtronic Representative.
Caution: Federal law restricts this device to sale by or on the order of a Physician.
This presentation is provided for general educational purposes only and should not be considered the exclusive source for this type of information. At all times, it is the professional responsibility of the practitioner to exercise independent clinical judgment in a particular situation.