...Pacemakers 12/04 1-What is a pacemaker? 2- What does “intrinsic” mean? 3- How exactly do pacemakers work on the heart? 4- What are the parts of a pacemaker? 5- Are there different kinds of pacemakers? 6- What is the advantage of two wires over one? 7- How are pacemakers inserted? 8- What do they mean by transvenous, transcutaneous, and transthoracic? 9- How does the generator box work? 10- How long do the implanted batteries last? 11- How much electricity does the pacemaker use to actually pace the heart? 12- In English, please? 13- What is “capture threshold?” 14- Why do paced beats generated by a ventricular wire look like PVCs? 15- What does “asynchronous” mean, and what does “demand” mean? 16- What do those letters: VVI, DDD, etc. stand for? 17- What is “failure to capture?” 18- What is “failure to sense”? 19- How can an implanted pacemaker be reprogrammed? 20- What is the magnet thing? 21- What are some reasons for placing a permanent pacemaker? 22- What is an AICD? 23- Can AICD’s also function as pacemakers? 24- What problems do AICD’s have? 25- How do you stop an AICD from shocking the patient incorrectly? 26- Can you shock a patient with a pacemaker? 27- What is external cardiac pacing? 28- Who was Zoll, anyhow? 29- What else do I need to know about running the external pacemaker? 30- How do I know if capture has been achieved? 31- What’s the tricky part? 32- Does external pacing hurt? 33- How...
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...Jesse Smith Pacemakers For the Brain April 12, 2016 Pacemakers For the Brain Pacemakers for the brain are mainly used to treat Parkinson’s disease. Today’s researchers believe the pacemaker could be used to improve brain function and to ward off many different diseases. Hearts have been regulated by electronic implants longer than the brain. This paper will explain what brain pacemakers are and how it is evolving over the years. Nearly fifteen years ago, in France, pacemakers for the brain were implanted into humans. In 1997, the first United States use of pacemakers was approved. “Scientists have shown that using deep brain stimulations, a technique used to treat Parkinson’s disease, can boost memory by causing new brain cells to be formed” (Reporter, D.M). This procedure had been performed infrequently and not surprisingly, until very recently. Researchers say the science of the pacemaker just was not there and the majority of the outcomes were horrifying. But now, the science of the brain has become better understood, and the long-term outcomes of the pacemaker for the brain have shown to be both successful and harmless. However, this all could be about to change. “By the end of this year, the group hopes to begin using deep brain-electrical stimulation to try and awaken patients who suffered sever brain damage and live in cognitive limbo”(Regalado, A). In 2003, the first experiment on how the pacemaker was adapted to help people suffering from depression was run. “Four...
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...In the human heart, a natural pacemaker, known as the sinoatrial node, is located in the wall of the right atrium of the heart.1 This pacemaker is responsible for coordinating the rhythmic contraction of the heart by regulating electrical energy through the Purkinjes fibers in the heart (these fibers are analogous to conducting wires). There are cases where the natural pacemaker in certain individuals doesn’t function properly and, as a result, leads to erratic and uncoordinated heartbeats. In order to rectify this medical professionals make use of an internal pacemaker, which is implanted surgically. Thus the purpose of this electronic device is to maintain the regular heartbeat when the natural mechanisms decompose. The pacemaker can be...
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...Temporary Pacemaker WHAT IS A TEMPORARY PACEMAKER? A temporary pacemaker, also called a pulse generator, is an electrical device that helps control your heart rhythm. It sends electrical signals to your heart through wires and sensors. A temporary pacemaker is most often used in an emergency or during surgery to control your heart rhythm. This type of pacemaker is used only until your heart rhythm comes back to normal or until a permanent pacemaker is implanted. WHAT ARE THE DIFFRENT TYPES OF TEMPORARY PACEMAKERS? There are two types of temporary pacemakers: • Transcutaneous pacemaker. This is a programmed device that sends electrical signals through patches on your skin to your heart at a rate your health care provider sets it to. It is similar to an...
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...Pacemakers for the Brain Payton Jackson University of Louisiana at Monroe When hearing the word pacemaker, the first thought that comes to one’s mind is a cardiac pacemaker. With a pacemaker for the brain, the wires are implanted in the brain instead of heart. Some of the things that brain pacemakers have been seen to do with medical and technological advances are reducing seizures in people with epilepsy, controlling the tremors of people with Parkinson’s disease, the testing for treatments of bipolar disorder and depression. The modern medical and technological advances that have been made contributes to all of those things. A brain pacemaker, also known as a neurostimulator, is implanted through a surgical procedure called deep brain stimulation. This is an invasive, chronically implanted device that uses electrical stimulation to alleviate dysfunctions of the brain (Johansson, Garwicz, Kanje, Halldenius, Schouenborg, 2015). There are three components to this pacemaker which are a lead, an extension, and an implantable pulse generator. According to the National Institute of Neurological Disorders and Stroke (2015), “the lead (also called an electrode)—a thin, insulated wire—is inserted through a small opening in the skull and implanted in the brain. The tip of the electrode is positioned within the specific brain area. The extension is an insulated wire that is passed under the skin of the head, neck, and shoulder, connecting the lead to the implantable pulse generator...
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...Harvard Business School 9-698-004 July 8, 1997 We’ve Got Rhythm! Medtronic Corporation’s Cardiac Pacemaker Business The legacy of Medtronic Corporation, the company that created the cardiac pacemaker industry, is a proud one. Starting from its earliest pacemakers, which had to be carried outside the body, Medtronic had achieved dramatic improvements in the functionality, size and reliability of these devices. In so doing it had extended the lives, and improved the quality of life, for hundreds of thousands of people in whom pacemakers had been implanted. The pacemaker has been designated as one of the ten most outstanding engineering achievements in the world over the past 50 years, along with the digital computer and the Apollo 11 moon landing. 1 Medtronic, which in 1995 booked operating profit of $300 million on revenues of $1.7 billion, had been founded in 1957 in Minneapolis, Minnesota by Earl Bakken, a researcher and inventor who had to his credit patents on several of the crucial technologies that led to the modern heart pacemaker. Pacemakers were small, battery-powered devices which, when implanted within a patient, helped a malfunctioning heart to beat in a steady, fixed rhythm. Because Medtronic was the first entrant into the pacemaker field and built a strong technological lead, it enjoyed a substantial portion (over 70%) of the market share for cardiac pacing through the 1960s. Building upon Medtronic’s legacy of leadership was not easy, however...
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...team – will have to face the liability claims. External Patients – require pacemakers to stay alive. Doctors – install pacemakers. Government – helps to subsidize part of the business. Medical Council – the decision of the C ompany X will affect the pacemaker industry and its advancement in the future. Legal Considerations The legal considerations that should be accounted for in this case are the following. Pacemaker failures involving other components could result in potential lawsuits would reduce company’s reputation. As well as doctors that are incorrectly installing pacemakers could put the company under legal scrutiny. Financial Considerations Potential lawsuits will put a financial burden on the company. Revenue the Company X will get from the sale of the transistors. The Company X is interested in maximizing their shareholders’ value. Moral Considerations The company needs to act in the best interests of society by supplying the transistors. As well as to provide opportunity of life for patients needing the pacemakers installed. Actionable Alternatives Alternative 1 The first alternative from an ethical egoism perspective is to increase price, as an only supplier the company can act as a monopolist, continue with the supply of the transistors. As well as to renegotiate an agreement that would remove any liability for faulty mechanisms other than the transistors for pacemakers. As an ethical egoist the company will look to better their position and act in...
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...Pacemaker Behavior’s Behavior s Prof Glikson, Sandra Schor-Wider Nadav Hayman Patient Case Description • This is a patient with SSS + PAF with a DDDR pacemaker . He did not tolerate MVP in the past so we turned it off. • He recently complains of palpitations of two types : • Sudden events of rate around115 • Rate about 80 , general weakness that reminds him of the sense of temporary VVI pacing during clinic visits • He was able to record both episodes • We programmed the AHR diagnostics to detect relatively slow tachycardias which were indeed recorded . Pacemaker setup •RAAVD – OFF •SEARCH AV – OFF •MS- OFF •ACM & VCM – ON •SINUS PEREFERENCE –ON SINUS ON Patient Holter strip – Baseline Rhythm Tachycardia (the faster type ) in Holter strip Sudden termination of the tachycardia Episodes of AHR From the Pacemaker Memory Continued Episodes of AHR From the Pacemaker Memory – the “faster “ type Another AHR Episode From The Pacemaker – the “slower” type Questions • What do you think of the strips ? • Is there any “strange behavior” of the pacemaker ? strange behavior • What are the two Different diagnosis for the two strips ? • Th h ld , sensing and i Thresholds i d impedances are all within normal d ll ithi l ranges Think and …. Answer to The first rhythm – is it PMT? 1 2 3 4 5 6 7 8 VA conduction test performed in clinic by pacing V VA during testing is indeed very similar to VA in tachycardia: PMT most likely explanation ...
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...can agree whether removing Mrs. Margie Whitson pacemaker is actually ethical. Mrs. Margie Whitson has had a hard year so far and has come to the conclusion that she wants her pacemaker turned off because she believes it is prolonging her death, which is true because she is depended on it 100%. So based on this fact her pacemaker is the only thing keeping her heart beating at the moment. But despite that her doctor, Dr. Rana Vijay, refuses to turn it off due to fear of litigation or because of misperceptions of the ethical and legal acceptability. But despite her cardiologist refusal Mrs. Margie Whitson is very determined to have her way and calls for a social worker. This is when Jane Robison is called and decides to bring this case fort to the ethics committee 1. Information The Nursing Home Administrator Cindy Mackin believes that Mrs. Margie Whitson is at the moment going through a difficult time and is not thinking clearly. So far these last five years for Mrs. Margie Whitson have been difficult. She lost her husband of 68 years of marriage, her son died recently in the same nursing home, and her other child died around his 30s in a motorcycle accident. She is currently completely alone and this realization has rattled her. Not only is she alone her health is bad as well; she has had hip fracture that has slowed her down, and a heart attack, which resulted her in having put in the heart pacer. In the case, the pacemaker was placed for complete heart block and is prolonging...
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...Ethical Decision & Reflection 6 4. RECOMMENDATIONS 7 5. REFERENCES 7 INTRODUCTION The pacemaker is a very important device in the world today. It plays a very important part in the survival of patients around the world that suffer from heart problems that can lead to heart failure. The heart naturally contains a pacemaker called the “sinoatrial node,” which sends an electrical pulse to the heart and allows it to contract and send blood to the body. Many different disorders can cause the heart’s natural pacemaker to not work properly. Those include a block in the system where the electric pulses do not reach every part of the heart, also a stoppage of the pacemaker all together which will leads to death. In case of a pacemaker malfunction or failure an artificial pacemaker can be implanted. This pacemaker can either mimic a regular electric pulse to the heart on a continual basis or it can be operated to function only when the pacemaker is irregular. As of June 1992 there were approximately 1.5 million people worldwide with implanted pacemakers and about 700,000 of those residing in the United States.1 As the sole remaining provider of transistors to the pacemaker company it is our responsibility to determine whether or not we should continue to supply them transistors after obtaining the knowledge that they will be used in manufacturing cardiac pacemakers....
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...Cardiac cells are connective and autorhythmic. What does this mean? Connective cells, action potentials, (excitatory signals) can propagate from one cell to another via gap junctions. Autorhythmic cells can excite themselves spontaneously without stimulation of the nervous system and contract at a regular rhythm. 3. Cells from different parts of the heart’s conduction system have different natural rhythms. What are the average beats per minute at each of the following parts of the heart? a. Sinoatrial Node (SA) 100 bpm b. Atrioventricular Node (AV) 40-50 bpm c. Ventricles 20-40 bpm 4. What is the function of the SA Node? Describe how this happens. The healthy heart’s pacemaker, SA node triggers contraction because it depolarizes at a faster rate than other parts of the conduction system. 5. The AV node starts a series of events that leads to ventricular contraction. Describe this series of events. The AV node is the only connection between the atria and ventricles, once the signal passes the AV node, it propagates through the ventricular portion of the conduction system. AV bundle and left and right bundle branches, apex of the heart, larger diameter conduction myofibers (purkinje fibers), the conduction myofibers then directly stimulate the cardiac cells in the ventricles to contract. During ventricular contraction blood is squeezed...
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...pain has awakened him from sleep but does respond to NTG, which he has taken sublingually about 8 to 10 times over the past week. During the week he has also experienced increased fatigue. He states, “I just feel crappy all the time anymore.” A cardiac catheterization done several years ago revealed 50% occlusion of the right coronary artery (RCA) and 50% occlusion of the left anterior descending (LAD) coronary artery. He tells you that both his mother and father had CAD. He is taking amlodipine, metoprolol, lipitor, and baby ASA qd. Setting: Hospital, outpatient cardiac rehabilitation Index Words: coronary artery disease (CAD), hypertension, angina, lifestyle modification, medications, laboratory values, assessment, risk factors, pacemaker 1. What other information are you going to ask about his episodes of chest pain? [k] Use the following memory aid to obtain information from the patient who has chest pain. FACTOR QUESTIONS TO ASK PATIENT P Precipitating events What events or activities precipitated the pain (e.g., argument, exercise, resting)? Q Quality of pain What does the pain feel like (e.g., pressure, dull, aching, tight, squeezing, heaviness)? R Radiation of pain Where is the pain located? Does the pain radiate to other areas (e.g., back, neck, arms, jaw, shoulder, elbow)? S Severity of pain On a scale of 0 to 10 with 0 indicating no pain and 10 being the most severe...
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...Explanation of competitive advantages- Medtronic has announced the start of a clinical trial to confirm the safety and efficacy of its EnRhythm MRI SureScan pacing system, the first MR-safe pacemaker system. The first implant in the US clinical trial was performed by Brian Ramza, M.D., Ph.D., director of Electrophysiology Laboratory Services at the Mid America Heart Institute, Saint Luke’s Hospital, Kansas City, Mo.( Reportlinker.com) While Philips Medical System is known for equipping parts for pacemakers and defibulators Medtronic is in its testing phase for the MRI scanning machines. This machine has a way of eliminating the worry of having replacement parts for several years down the line. With the Permanent, Temporary, Artificial or the Epicardial pacemakers the Medtronic is the first of its kind to begin research on its product. Features- The Medtronic Care Link® Network is a prescription device indicated for use in the transfer of patient data from some Medtronic implantable cardiac devices based on physician instructions and as described in the product manual. This product is not a substitute for appropriate medical attention in the event of an emergency and should only be used as directed by a physician. (bing.com) Benefits- The benefits will be for the patient to spend less time in the hospitals operating room and less doctor visits. According to the clinic, patients have especially appreciated the ease-of-use and convenience of the portable Medtronic Care...
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...married for 68 years, most of them wonderful and successful years together, until the medical problems began. They had one other son, Jacob, who died in a motor vehicle accident in his 30s. As Margie sits in the quiet of her nursing home room, she faces the reality that she is utterly and completely alone in the world. She and Earl had hoped for grandchildren, but that never happened, and Margie’s family is simply all gone now. Margie’s own health is poor. A hip fracture 10 years ago slowed her down significantly, and a heart attack 2 years ago nearly took her life. But she survived due to good emergency medical care and quick placement of an electronic pacemaker. Margie’s heart rhythm is now 100% paced, meaning that her heart will not function effectively without the pacemaker; she is completely dependent on the pacemaker for her survival. Margie is a woman of great...
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...GA 14 Communication memo Heart Implants Dilemma Deborah Rojas:ID#65228 Masters Health Administration 25th April 2014 COMMUNICATION STRATEGY MEMO GUIDANT CORPORATION (A) DATE: November: 1, 2005 TO: Ms. Rachael Sullen, Corporate Communication, Vice President FROM: Deborah Rojas, Management Consultant SUBJECT: Heart Implants Dilemma INTRODUCTION Guidant Corporation (A) heart implants dilemma and the corrective action plan that is needed. Technical Research and analysis show (ICD) and pacemakers which were developed by Guidant Corporation (A) for the purpose of giving long life as stated in your company slogan “It’s a great time to be alive” has evidently been a source of recent deaths to patients. Assessing the situations that have arisen and determining the best course of action that is needed to alleviate the company image. We believe that proactive communication of all relevant information will enable better management of patients that utilize this therapy." Also, the merger with Johnson & Johnson will be greatly affected if the necessary actions are not taken. This is an internationally based sound organisation and because of this, drastic actions calls for drastic measures. Therefore it is necessary to refocus and realign this organisation whereby cutting losses and starting a new firm, with new vision and mission can be possible. BACKGROUND The organisation is globally located and is the second largest producers amongst two other defibrillators...
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