The pacemaker
- 1. The Pacemaker Presented by : Mahmoud Ali Ebada 51015325 Supervised by : Dr. Doaa Talhaa & Eng.Nada Hegazy & Eng. Abdallah Samir FACULTY ALLIED OF MEDICAL SCIENCE REGULATION OF MEDICAL DEVICES AND DAIGNOSTICS 1
- 2. What is a pacemaker? • A pacemaker (or artificial pacemaker) is a medical device which uses electrical impulses, delivered by electrodes contracting the heart muscles, to regulate the beating of the heart 2
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- 4. History of pacemakers • In 1838 Carlo Matteucci a Professor of Physics at the University of Pisa - discovered that an electric current accompanies each heartbeat. 4
- 5. • 1926- Dr. Albert Hyman created an electromechanical instrument which many believe may be the first successful pacemaker 5
- 6. • 1950 a Canadian electrical engineer - John Hopps paired with Dr. Wilfred Bigelow • The new pacemaker was a great advancement but still had some shortcomings like large and heavy • The externally placed electrode sent electric impulses great deal of pain for the patient. 6
- 7. • 1951-Dr. Paul Zoll a cardiologist from Boston The pacemaker used modern transistors but still was large, heavy and relied on AC power. • In 1957 - A part time TV repairmen Earl Bakken.,developed a smaller pacemaker that could be worn around the neck • Less pain for patients,he leads were surgically attached to the outside of the myocardium. 7
- 8. • In 1956 bekkan read an article related to amplification of sound • He started to work on amplification of battery for the power to pacemaker 8
- 9. • Created pacemaker with mercury battery that supplied 9.4 volts and co founded medtronics company 9
- 10. • After these period with the size of pacemakers and the short battery life, the idea of implanting a pacemaker into a patient was unthinkable • Greatbatch -an electrical engineer founded a implanting pacemaker • Greatbatch joined with medtronics and created lithium iodine battery that still using in pacemakers 10
- 11. • In 1958 Dr. Ake Senning and team done first succesful pacemaker implantation to a patient named “Arne larsson with stoke – adam syndrome 11
- 12. • There was some problems with pacemakers so he required 5 different lead systems and 22 pulse generators of 11 different models in his lifetime • lived to be 86 years old dying in December 28 2001 of cancer. 12
- 13. Types • Implantable pulse generators with endocardial or myocardial electrodes for long- term or permanent use( permenant pacemakers) 13
- 14. 2 • External, miniaturized, transistorized, patient portable, battery-powered, pulse generators with exteriorized electrodes for temporary transvenous endocardial or transthoracic myocardial pacing. (temporary pacemakers) 14
- 15. what is a permenant pacemaker • A permenant pacemaker is an electronic device, approximately the size of a pocket watch, that senses intrinsic heart rhythms and provides electrical stimulation when indicated 15
- 16. Parts of a pacemaker system 16
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- 18. Pulse generator • Lithium batteries lasting 6 years or more are used in most pacemakers. • Nuclear powered pacemakers (Plutonium238 source) can last 20 years or more. • It controls energy output, heart rate and pacing node. 18
- 19. Energy output • It refers to the intensity of the electrical impulse delivered by the pulse generator to the myocardium. • Measured in milliampers(M.A) • A setting of 1.5 MA usually is sufficient to cause depolarization 19
- 20. PACEMAKER LEADS • Pacemaker leads are electrical conductors (wires), covered with insulation. They transmit the electrical impulses from the pulse generator to the heart, and from the heart to the pulse generator. • They will attach to the heart in different ways 20
- 21. Rate response • Most of the pacemekers available today are rate responsive ,it have various sensors that will active while patient during activities and adjust the rate . 21
- 22. Active fixation • in active fixation a screw (also known as a helix) is used to fix the lead to the heart. 22
- 23. Passive fixation • In passive fixation the lead has tines ,which are designed to engage the trabeculae on the inner surface of the heart 23
- 25. Single Chamber pacing • With this device, 1 pacing lead is implanted in the right atrium or ventricle 25
- 26. Double chamber pacing With this device, 2 pacing leads are implanted (1 in the right ventricle and 1 in the right atrium); this is the most common type of implanted pacemaker 26
- 27. Implantable Cardioverter- Defibrillator( ICD) • An implantable cardioverter-defibrillator (ICD) is a specialized device designed to directly treat a cardiac tachydysrhythmia • ICDs have revolutionized the treatment of patients at risk for sudden cardiac death due to ventricular tachyarrhythmias 27
- 28. • TEMPORARY PACEMAKERS Temporary cardiac pacing involves electrical cardiac stimulation to treat a bradyarrhythmia or tachyarrhythmia until it resolves or until long-term therapy can be initiated 28
- 29. • Turn the pacemaker on, and choose the pacing mode • The demand mode is usually preferable and should be used initially • the pacing threshold is usually less than 80 mA 29
- 30. BENEFITS TO HEART FAILURE PATIENTS • • • • • • • Reduction in ventricular electromechanical delay Improved ventricular function Reduced metabolic costs Improved functional mitral regurgitation Favorable remodeling Reduction of cardiac chamber dimensions Improved exercise capacity 30
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