CHAPTER1 Basicprinciplesofpacing - Wiley-Blackwell

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CADE: CHAP01 2005/11/23 16:13 PAGE1 #1CHAPTER 1Basic principles of pacingMalcolm KirkThe aim of this chapter is to give sufficient background and information aboutcardiac pacemakers to allow interpretation of electrocardiograms (ECGs) andtelemetry strips of normal pacemaker behavior. For more in-depth inform-ation, such as would be necessary for programming pacemakers, a standardpacin gtext should be consulted. Several of these are listed in the biblio italicized terms are defined in the glossary at the end of the pertinent anatomy for cardiac pacin gincludes the sinoatrial (SA) node,the atrioventricular (AV) node, and the His-Purkinje system (Figure ).The SA node is located at the superior aspect of thecrista terminalis(notpictured), near the junction with the superior vena cava. It is normally thedominant pacemaker in the heart, because its rate of depolarization exceedsthat of other areas that normally possess properties of automaticity, such asthe more inferior areas of thecrista terminalisand the His-Purkinje SA node can, in turn, be suppressed by an even faster rhythm, such as anatrial tachycardia, or pacin gby an implanted bundleIVCMitral valveTricuspid valveLeft bundlebranchRight bundlebranchPurkinje fibresAtrioventricular(AV) nodeRight atriumSinoatrial(SA) nodeSVCFigure of conduction system anatomy1CADE: CHAP01 2005/11/23 16:13 PAGE2 #22Chapter 1The AV node is normally t

CADE: “CHAP01” — 2005/11/23 — 16:13 — PAGE2—#2 2 Chapter1 The AV node is normally the only electrical connection between the atriaandtheventricles ...

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