Matters Of The Heart-Misc.

Artifical Pacemakers-

People who have a severe heartblock would normally not have sufficient cardiac output to perform activities of daily living. However thanks to a relatively small battery, some wire, and a doctor who is brave enough to put them inside your chest, a patient with heart block can live many more years with adequate cardiac output to live an active and healthy life.

There are some importiant things to remember when caring for people who have artificial pacemakers:

1) Don't take their blood pressure on the arm closest to the pacer battery!! (Sorry, old CNA habit)

2) This type of rhythm will appear different from a regular PQRST complex, depending on where the pacer is positioned in the heart. Don't freak out if you see a tall, very narrow pacing spike followed by a wide ventricular complex; this just means the artificial pacer is in the ventricles.

3) There are different types of artificial pacers, someof them are temporary and worn outside of the body, some of then are internal, some of then also contain defibrillators (which show up as a REALLY TALL spike/waveform)

Heart Transplant

In a heart transplant, the portion of the patient's atria that has the SA node is not.removed when the new heart is put.in. Because of this, there will be two P waves on the PPQRST complex: the first one is native to the patient, the second from the donor heart.

A heterotopic heart transplant (in which the native heart is not removed) there are two sets of PQRST wavelengths. (Because the patient has two hearts). One is upright, and one is inverted.

This blog series has been my studies compiled from the book called 'Rapid Interpretation of EKG'S' By Dale Dubin.

If you are interested in learning about heart physiology and EKG interpretation, I highly recommend this book. :)