Wednesday, December 8, 2010

Cardiac Pacemaker for a General Radiologist

The attached xray shows multiple leads biventricular cardiac pacer in post sternotomy patient with Azygos lobe and possible perihilar oedema.


Cardiac pacemaker for a general radiologist-by Dr MGK Murthy.

 

 
Types of permanent pacing :
  • Single chamber cardiac pacers: lead terminates in right ventricle.
  • Dual chamber cardiac pacers: leads terminate in right atrial appendage and right ventricular apex.
  • Biventricular pacers: Left ventricular epicardial leads are used. The leads go directly to the surface of the left ventricle, and they are usually associated with typical pacing electrodes in the right atrial appendage and right ventricular apex. In other cases, the left ventricular pacing electrodes are introduced through the coronary sinus and wedged into a left ventricular cardiac vein.
Two components
(a) control unit: has lithium battery usually with sense amplifiers to sense the natural heart beats and computer logic to correct

 
(b)leads-number depending on the case, external casing of the control unit is made of inert titanium to avoid any immunological rejections

  
Note --MRI is contraindicated- but on demand pacemakers in future may permit MRI in future

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