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Cardiac resynchronisation therapy (CRT or CRT-P) is the insertion of electrodes in the left and right ventricles of the heart, as well as on occasion the right atrium, to treat heart failure by coordinating the function of the left and right ventricles via a pacemaker, a small device inserted into the anterior chest wall.
The need for an alternative is most obvious in children, including premature newborn babies, where size mismatch and the fact that pacemaker leads do not grow with children are a problem. [1] A more biological approach has been taken in order to mitigate many of these issues.
Percussive pacing, also known as transthoracic mechanical pacing, is the use of the closed fist, usually on the left lower edge of the sternum over the right ventricle in the vena cava, striking from a distance of 20 – 30 cm to induce a ventricular beat (the British Journal of Anaesthesia suggests this must be done to raise the ventricular pressure to 10–15 mmHg to induce electrical activity).
Illustration of Implantable Cardioverter Defibrillator (ICD) An implantable cardioverter-defibrillator (ICD) or automated implantable cardioverter defibrillator (AICD) is a device implantable inside the body, able to perform defibrillation, and depending on the type, cardioversion and pacing of the heart.
Crosstalk can only occur in a dual chamber or biventricular pacemaker. It happens less often in more recent models of dual chamber pacemakers due to the addition of a ventricular blanking period, which coincides with the atrial stimulus. This helps to prevent ventricular channel oversensing of atrial output.
Transcutaneous pacing is no longer indicated for the treatment of asystole (cardiac arrest associated with a "flat line" on the ECG), with the possible exception of witnessed asystole (as in the case of bifascicular block that progresses to complete heart block without an escape rhythm).
The pacing electrode is advanced through the vein under fluoroscopic and electrocardiographic guidance. An X-ray after the procedure is always obtained to confirm placement of the pacing electrode. The greater use of atropine and epinephrine or external pacing may make transvenous pacing unnecessary by stabilizing patients early in the process ...
Pacing is an activity management technique for managing a long-term health condition or disability, aiming to maximize what a person can do while reducing, or at least controlling, any symptoms that restrict activity. [citation needed] Pacing is commonly used to help manage conditions that cause chronic pain or chronic fatigue. [1]: 134