Pacemaker Function and Programming

Pacemakers
Basic Interrogation
&
Programming Steps
Jonathan Ho, MD
Assistant Clinical Professor
D
Department
t
t off Anesthesiology
A
th i l
David Geffen School of Medicine at
UCLA
Disclosures

none
Initial steps

Tools Menu

Educational Materials


Demos
Select Zephry DR 5826
Pacemaker Initial Interrogation Screen
Pacemaker Objectives



Identify the atrial and ventricular signals on
the programmers display. Illustrate atrial
and ventricular sensed or paced
p
beats/signals on the programmer.
Identify devices following interrogation;
identify key features such as current pacing
mode,, batteryy life,, history,
y, thresholds,, etc.
Identify programmed pacing rates briefly
p
g the LRL,, URL etc.
explaining
Bradytherapy Settings
Pacemaker Objectives



Demonstrate changing the pacing mode
from DDD or VVI etc to an asynchronous
(AOO/DOO) mode. Demonstrate how to
change
h
the
h rate. D
Demonstrate h
how to
change pulse amplitude.
Id tif rate
Identify
t adaptive
d ti feature
f t
settings.
tti
Demonstrate how to turn off the rate
adaptive feature
feature.
Demonstrate magnet response behavior of
the device.
Mode, Sensor, and Magnet
Pacing mode
Rate Settings
Adjusting Pulse Amplitude
Pacemaker Objectives


Demonstrate how to interrogate underlying
rhythm (or the presence/absence of one)
using
g specific
p
p
programmers.
g
Briefly identify other advanced featuresspecial algorithms that should be preferably
turned off before surgery. Rest rate,
hysteresis
y
Rate Adaptive Features
Testing Underlying Rhythm
End session and select next device
ICDs
Basic Interrogation
&
Programming Steps
Initial steps

Tools Menu

Educational Materials


Demos
Select Atlas II+ HF V
V-365
365
ICD Initial Interrogation Screen
ICD Objectives

Identify the settings and therapy history for
an ICD. Demonstrate how to deactivate the
ICD two ways.

One Step Option:


Touch “Tachytherapy
y
py is enabled” button on initial
screen to bring up option to disable tachy
therapy
Re-enable using same button.
ICD Objectives: deactivate the ICD
B Disabling
By
Di bli d
detection:
t ti




Enter “Parameters” and use the “Tachy” tab to
bring up “Zone
Zone Configuration
Configuration”
Touch “Zone Configuration” and change from “3
zones” to “off”
zones
off
Select “Program” and confirm
Re-enable using
g “Restore Last Settings”
g
Disabling tachyarrhythmia
therapy:
py One step
p option
p
Disabling tachyarrhythmia
therapy: Disabling detection
through tachytherapy settings
Disabling tachyarrhythmia
therapy:
py Zone configuration
g
to Off
Tachy Therapy Disabled
Restore VT/VF detection