CORE IM Profile picture
Medicine Podcast || Inspiring curiosity & critical thinking || 5 Pearls || Mind the Gap || Hoofbeats || At the Bedside || Gray Matters || Biweekly Wed.

Apr 13, 2023, 15 tweets

1/ What better way to end off a week of pacemakers and ICDs than recapping and revisiting our #12LeadThursday series!

🧵

2/ Which patients get pacemakers?

Think of 2 big buckets: conduction disease and heart failure

3/ Let’s start with conduction disease!

Refresh your memory with this past byte - 80 y/o M with hx of CABG…what's the rhythm?
bit.ly/40cAry0

4/ One way to think about Class I indications for pacemakers is by their relation to the AV node

5/ Now onto heart failure!

Remember this byte?! 60 y/o M with symptomatic heart failure on guideline-directed medical therapy comes into your office…
bit.ly/3o7vfOz

6/ There’s three indications for CRT! Test your knowledge with this slide

7/ Let’s review! What are the PPM indications for dual chamber pacemakers?

What about BiV pacemakers?

8/ Where are the leads located for single chamber, dual chamber, and BiV pacemakers?!

9/ You can use EKGs to determine where leads are located!

Remember this byte?! New patients being admitted for heart failure…
bit.ly/3UwyT0i

10/ Use this graphic to review how lead placements will show up on an EKG!

For example, if the lead is in the RV apex, the EKG will result in a LBBB-like morphology

11/ What does the following look like ECG?
- V-paced
- A-paced
- A-sensed and V-paced
- A-paced and V-paced

12/ What about monitoring?

Remember this byte? Your patient presents for routine follow up in cardiology clinic! What’s the rhythm?
bit.ly/3KWgS8H

13/ Atrial activity should be assessed in all patients! Regardless of the presence of a pacemaker.

If they have an atrial arrhythmia, remember to evaluate for anticoagulation!

14/ What a packed week of pacemakers! Let’s review what we talked about:

- Pacemakers indications
- Using EKGs to determine lead location and sensing
- Monitoring patients with pacemakers

15/ Check out our latest podcast on all things pacemakers and ICDs for more information! Shoutout to @SamuelMaidman and Vorada Sakulsaengprapha for this awesome byte!

🎧
link.chtbl.com/PacersICDs
Notes: bit.ly/PacersICDs

Share this Scrolly Tale with your friends.

A Scrolly Tale is a new way to read Twitter threads with a more visually immersive experience.
Discover more beautiful Scrolly Tales like this.

Keep scrolling