Cardiac Devices · Module 1 of 7
Pacemaker Fundamentals
Build a clean foundation: what a pacemaker senses, when it paces, and why a pacing spike alone does not prove capture.
Learning objectives
PurposeUnderstand why permanent pacing is used.
SystemRecognize generator, leads and sensing/pacing functions.
TimingConnect atrial and ventricular events with basic pacing behavior.
What a pacemaker does
A pacemaker monitors cardiac electrical activity and can deliver pacing stimuli when programmed timing criteria are met. Depending on the system, sensing and pacing may occur in one or more chambers.
SENSEDetect intrinsic activity
TIMEApply programmed timing logic
PACEDeliver stimulus when indicated
VERIFYAssess resulting response
Basic pacing language
Intrinsic eventCardiac electrical activity originating from the patient's heart rather than the device.
Paced eventAn event initiated by an electrical stimulus from the pacing system.
InhibitionAppropriate sensed activity may prevent a scheduled pacing output, depending on the programmed mode.
Tech perspective
You see pacing spikes on telemetry
Do not judge function from the spike alone. Ask whether each stimulus is followed by the expected myocardial response and whether intrinsic events are being appropriately recognized.
A pacing spike is visible. What does that prove?
Educational scope: Device programming, implant decisions, therapy changes, alerts and patient management require appropriately credentialed clinicians, institutional protocols, and current manufacturer instructions.
Lesson progress
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