Specific Considerations with Cardiac Disease - Pacemakers
Pacemakers
A standardized five-letter code is used to describe the function of each pacemaker.
- The first letter designates the chamber paced (O, none; A, atrium; V, ventricle; D, dual [both atrium and ventricle]).
- The second letter describes the chamber sensed (O, none; A, atrium; V, ventricle; D, dual).
- The third letter describes the pacemaker's response to sensed events (O, none; I, inhibition of pacemaker output; T, triggering of pacemaker output; D, dual response: spontaneous atrial and ventricular activity inhibit atrial and ventricular pacing and atrial activity triggers a ventricular response).
- The fourth letter indicates the presence or absence of rate modulation (O, no rate modulation; R, rate modulation present).
- The fifth letter specifies the presence and type of multisite pacing (O, none; A, more than one stimulation site in either atrium, stimulation sites in each atrium, or a combination of the two; V, more than one stimulation site in either ventricle, stimulation sites in each ventricle, or a combination of the two; D, any combination of A and V).
- For example, a VVI pacemaker will sense and pace the ventricle yet will be inhibited and will not fire if an R wave is detected. A DDD pacemaker senses and paces both the atrium and ventricle. A VVIRV pacemaker has ventricular inhibitory pacing with rate modulation and multisite ventricular pacing. This mode is often used in patients with heart failure, chronic atrial fibrillation, or intraventricular conduction delay. A DDDRD pacemaker has dual-chamber pacing with rate modulation and multisite pacing in both the atrium (or atria) and ventricle(s).
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Citation
Pino, Richard M., editor. "Specific Considerations With Cardiac Disease - Pacemakers." Clinical Anesthesia Procedures, 9th ed., Wolters Kluwer, 2019. Anesthesia Central, anesth.unboundmedicine.com/anesthesia/view/ClinicalAnesthesiaProcedures/728125/all/Specific_Considerations_with_Cardiac_Disease___Pacemakers.
Specific Considerations with Cardiac Disease - Pacemakers. In: Pino RMR, ed. Clinical Anesthesia Procedures. Wolters Kluwer; 2019. https://anesth.unboundmedicine.com/anesthesia/view/ClinicalAnesthesiaProcedures/728125/all/Specific_Considerations_with_Cardiac_Disease___Pacemakers. Accessed August 31, 2024.
Specific Considerations with Cardiac Disease - Pacemakers. (2019). In Pino, R. M. (Ed.), Clinical Anesthesia Procedures (9th ed.). Wolters Kluwer. https://anesth.unboundmedicine.com/anesthesia/view/ClinicalAnesthesiaProcedures/728125/all/Specific_Considerations_with_Cardiac_Disease___Pacemakers
Specific Considerations With Cardiac Disease - Pacemakers [Internet]. In: Pino RMR, editors. Clinical Anesthesia Procedures. Wolters Kluwer; 2019. [cited 2024 August 31]. Available from: https://anesth.unboundmedicine.com/anesthesia/view/ClinicalAnesthesiaProcedures/728125/all/Specific_Considerations_with_Cardiac_Disease___Pacemakers.
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