The Nuts and Bolts of Implantable Device Therapy

Tom Kenny, FHRS, CCDS Tom Kenny has always been an educator. From his start as a Critical Care Educator for the North Broward Hospital District in Fort Lauderdale, Florida, to serving as Director of Education at PrepMD in Braintree, Massachusetts, Tom has focused on providing real-world, practical education for clinicians. Although he has served on faculty at Broward Community College and lectures for the Heart Rhythm Society and the Food and Drug Administration, Tom has always believed that it was imperative to educate the “front lines” of healthcare, the men and women clinicians across the country who treat patients day in and day out. He has served at Intermedics and St. Jude Medical in corporate medical device education, where he sought to make highly complicated therapies easily understood. In his tenure at both companies, he expanded training programs and developed educational materials. Finding that there was little in the way of pacemaker training for educated clinicians who just did not happen to know pacing, Tom brought his style of training to the classroom and now to book form. Tom is a native New Yorker who currently divides his time between Massachusetts and Texas. He has five children.

Preface, vi

Acknowledgments, vii

1 Cardiovascular anatomy and physiology, 1

2 Cardiac conduction system, 15

3 The cardiac cycle and hemodynamics, 21

4 Heart disease, 29

5 Cardiac medications related to cardiac rhythm management devices, 37

6 The basics of ecg and rhythm interpretation, 48

7 Arrhythmia analysis, 58

8 E lectricity 101, 78

9 Pacing 101, 84

10 Indications for pacing, 104

11 Pacemaker implantation, 116

12 Connecting the leads to the pulse generator, 131

13 Pacemaker modes and codes, 140

14 Single-chamber timing cycles, 153

15 Introduction to dual-chamber timing cycles, 169

16 Dual-chamber timing cycles: the atrial channel, 179

17 Dual-chamber timing cycles: the ventricular channel, 195

18 Paced ECG and EGM analysis, 205

19 Upper-rate behavior, 219

20 Advanced dual-chamber timing, 233

21 Rate-responsive pacing, 242

22 Special features, 260

23 Automatic capture algorithms, 278

24 Pacemaker follow-up, 297

25 Follow-up and troubleshooting, 310

Key answer, 316

Index, 320