Artificial Pacemaker

Natural Pacemaker: The rhythmic action of the heart is started by periodic recueeing action potentials due to Electrochemical impulses originating at the natural cardiac pace maker called Sinoartial node.(SA node) Each pacing impulse is propagated into entire myocardium,spreading over surface of atria to atrial ventricular node( AV node). After a delay at AV node , the impulseis rapidlu conducted to the ventricles to depolarize the ventricular muscles. The healthy heart beat ie..NSR (Normal Sinus Rhythm) is based on performance of SA node. Any change in NSr is called as arrhythmia(abnormal rhythm) Radicardia: Due to SA node disease heart beat is much paced at lower rate than the normal range between 30 to 50 beats per minute (bpm) Under this condition heart can not pump sufficient blood to meet the demand. Due to which dizziness, loss conciousnes occurred Heart block : Heart block is classified into three types First degree block: An excessing implse delay at av node occurs that caluses PR interwal in ECG to exceed 0.2 secs. Second degree block: Intermident complete inhibition of pacing impulse at AV node. Third degree block Its other name is complete heart block. Total signal blockage at any conduction block. In all these conditions, pacing is generally required to ensure sufficient blood circulation to entire body. A device capable generating pacing impulses and delivering then to heart . It is called as Artificial Pacemaker.

It consists of pulse generator and appropriate electrodes. Electrical pulses are generated by pacemaker applied directly to chest or internally to heart muscle In cardiac stand still pacemaker is used temporarily and electrical impulses externally to chest. This type of pacemakers are called as external Pacemaker. In terms of long term pacing , the pacemaker is surgically implanted into the body and electrodes are in direct contact with heart. This type of pacemaker is called Internal Pacemaker

Competitive pacing: The competitive pacing is used to compete with natural pulse generated (may be weak) in the heart. This simplest pacemaker is asynchronous pacemaker and it produces pulses at fixed rate independent of cardiac pulses. The battery life is shrt due to continuous constant operation. Non-Competitive Pacing : Here control of heart will be either ventricular program or articular program Ventricular- programmed R- wave inhibited (demand) type: Suppose no R-wave is generated, the pacemaker will generate to activate heart. R-wave Trigger (standby): The impulse produced to strengthen the natural R- pulse. Atrial Programmed P- wave Synchronised: In place of complete heart block where atria used to depolarise but impulse depolarise the ventricles, Atrial synchronous pacing is required.