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Transvenous pacemakers are generally used in emergencies, when temporary pacing is needed, or until a pacemaker can be surgically implanted, for control of heartrate and during cardiac electrophysiologic studies. Impulses are delivered through an electrode catheter that is inserted through the vein into the heart.
1. Two types of external pacemakers are available: single and dual chamber pacemakers. Both are recommended for cardiac pacing.
2. All external pacemakers should have adjustable rate, output amplitude, and sensitivity settings.
3. Single chamber pacemakers can pace only a single chamber of the heart, while dual chamber pacemakers can pace both chambers.
4. The single chamber external invasive electrode pacemakers are used in VVI mode, while dual chamber external invasive electrode pacemakers are used in DDD mode.
5. Patients undergoing open-heart surgery, whom prophylactic placement of both atrial and ventricular epicardial leads is common use dual chamber pacemakers.
6. External, invasive electrode pacemakers are available as either constant-current or constant voltage devices, while implant pacemakers only offer constant voltage output.
7. Temporary pacemaker systems use an external pulse generator with leads placed via transvenous cardiac pacemaker approaches. Transcutaneous leads are the easiest to use but transvenous cardiac pacemaker leads are the most reliable options for temporary pacemakers.
8. It is not recommended to use dual chamber pacemakers for single chamber pacing, though it is possible. The dual type is more complex, and therefore requires more training and experience to achieve and maintain proficiency.
Before you purchase your External Pacemaker, we recommend you ask the seller the following questions:
Cardiac pacemakers are surgically implanted beneath the skin, and electrodes are positioned in or on the heart. Reprogramming of parameters can be done noninvasively and some are rate-responsive. These pacemakers are used as a permanent treatment for bradycardia, and certain cardiac arrhythmias . They include a battery, electronic circuits for producing electrical pulses and sensing cardiac activity electrodes, and leads for conducting electrical signals.
1. Physicians are in the best position to decide on the pacemaker specifications, based on patient illness and specific requirements. Different patients need pacemakers with different operating modes, levels of adjustability, and other capabilities. In the selection process, facilities should include cardiologists, cardiovascular surgeons, and electro physiologists.
2. A hermetically sealed pulse generator and either one or two insulated conductive leads should be in each implantable pacemaker, as well as a programmable mode, rate, sensitivity, pulse width, and amplitude.
3. Pulse generators should be compatible with IS-1/VS-1 leads or encountered lead connectors.
4. These implantable pacemakers display four available categories. The pacing modes common to each are listed in brackets. Many manufacturers offer at least one model of each of these four types of cardiac pacemakers:
5. · Multiprogrammable, single chamber (VVI, AAI, VOO)
6. · Multiprogrammable, single chamber with rate modulation (VVIR)
7. · Multiprogrammable, dual chamber (DDD)
8. · Multiprogrammable, dual chamber with rate modulation (DDDR)
9. Suppliers should offer each type of pacemaker with either a unipolar or bipolar lead configuration. All units should be capable of transmitting patient information and the pacemaker's operating parameters to the programmer. These transmittable parameters may include: programmed settings, battery status, lead impedance, identification number, model number, serial number, and measurements of pacing rate, pulse amplitude, and pulse width.
10. Each cardiac pacemaker unit should operate for at least five years at 100% pacing, and should include a low battery indicator.
11. All leads should be pre-sterilized and double packaged in hermetically sealed individual containers. These packages should be clearly labeled with the following information: manufacturer, model, serial number, expiration date, connector type and size, and tip electrode type.
12. The expiration date on the leads should not be less than one year from the delivery date.
13. These are the main factors to consider when selecting a pacemaker: technology, service issues, and reliability.