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This contrasts with the pseudofusion beat wherein the pacemaker impulse does not affect the complex of the natural beat of the heart. Pseudofusion beats are normal. Rare or isolated fusion beats caused by pacemakers are normal as well, but if they occur too frequently may reduce cardiac output and so can require adjustment of the pacemaker. [3]
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).
Ectopic beat is a disturbance of the cardiac rhythm frequently related to the electrical conduction system of the heart, in which beats arise from fibers or group of fibers outside the region in the heart muscle ordinarily responsible for impulse formation (i.e., the sinoatrial node).
While the sinoatrial node typically regulates the heartbeat during normal sinus rhythm, PACs occur when another region of the atria depolarizes before the sinoatrial node and thus triggers a premature heartbeat, [1] in contrast to escape beats, in which the normal sinoatrial node fails, leaving a non-nodal pacemaker to initiate a late beat.
During ventricular activation, one bundle tract's area of slow conduction activates the other tract's bundle fibers post block after the rest of the ventricle has recovered. This resulting in an extra beat. Reentry can produce single ectopic beats, or it can trigger paroxysmal tachycardia.
A normal resting heart rate is 60 to 100 beats per minute. A resting heart rate of more than 100 beats per minute is defined as a tachycardia. During an episode of SVT, the heart beats about 150 to 220 times per minute. [9] Specific treatment depends on the type of SVT [5] and can include medications, medical procedures, or surgery. [5]
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 ...
Since pacemaker correction of the third-degree block requires full-time pacing of the ventricles, a potential side effect is pacemaker syndrome, and may necessitate the use of a biventricular pacemaker, which has an additional 3rd lead placed in a vein in the left ventricle, providing more coordinated pacing of both ventricles. [citation needed]