Cardiac Pacing

Author: Jan Hudec, MD, Daniela Charwátová, Roman Kula

Institution: Faculty of Medicine at Masaryk University in Brno

Medical discipline: Emergency Medicine

Keywords: cardiac pacing | sick cinus syndrome | bradycardia

Educational evel: Undergraduate level | Graduate

Abnormal heart rhythms (arrhythmias, also dysrhythmias) are one of the most common heart diseases. According to heart rate they can be divided into two groups - bradycardias and tachycardias. The main cause of arrhythmias is a disorder in impulse formation and conduction in myocardial muscle. Generally, the presence of so-called arrhythmogenic substrate is the underlying cause of cardiac arrhythmias. This substrate can be a scar after myocardial infarction, source of ectopic automatism or degenerative changes of the myocardium.
Algorithm Cardiac Pacing provides insight into management of acute arrhythmias. It is also focused on perioperative treatment of sinus bradycardia that leads to cardiac asystole. 

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This interactive algorithm describes very realistically a quite common situation, which can happen during operation to every anaesthesiologist. Bradycardias are always critical because anaesthesiologist has to make a right quick decision. Their etiology is important for prognosis of patients and for his next medical treatment. Vagal reaction on its irritation needs totally different approach than bradycardia caused by hypoxia or primary heart rhythm disorder. This model situation is using realistic information from monitors and tests results. A doctor solving this algorithm can do his own diagnosis and chose the right approach. The outcome of this algorithm is well created memory track with prompt recall in critical situation. Positive impact on patient is unambiguous. Great advantage of this interactive algorithm is its complexity. It shows not only operation complications but also therapy possibilities of this model hearth disease after stabilising the patient. Moreover, you will get to know typical ECG for used condition, induction to anaesthesia and transvenous cardiac pacing by interactive pictures and videos in this algorithm. 


publikováno: 25. 5. 2017 | last modified on: 13. 9. 2019