Gastric POCUS, 3-Part Episode
April 2024 OA-POCUS Case of the Month
Anesthesia Services in Tanzania and Kenya
OA-Global Health Equity Ask the Experts - April 2024
REPOST: October 2021 – Pediatric Tracheal Extubations
April 2024 OA-SPA Ask the Expert
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Question of the Day
Which of the following pacemaker modes would be MOST appropriate for a patient with bradycardia from sick sinus syndrome who has coexistent persistent atrial fibrillation?
Explanation
Atrial fibrillation has been classified into the following types:
Paroxysmal: AF terminates spontaneously within 7 days of onset
Persistent: AF that continues and requires electrical or pharmacologic cardioversion
Longstanding: AF > 1 year where cardioversion is not indicated or attempted
Permanent: AF that cannot be successfully terminated by electrical cardioversion
Pacemaker codes define the function of the device. Position I is the pacing chamber, position II is the sensing chamber, position III is the response of the pacemaker to sensing, position IV is the rate responsive programmability, and position V (rarely reported conventionally) is the presence and action of anti-tachycardia function. Pacemakers are typically reserved for treatment of atrial fibrillation when medications and ablation are inadequate for symptom management. When patients have sinus node dysfunction or atrioventricular node dysfunction with concomitant bradycardia in the setting of paroxysmal or persistent atrial fibrillation, dual chamber pacing (DDDR) is indicated which provides rhythm and rate control. When atrial fibrillation is considered to be permanent in the setting of atrioventricular conduction disturbances, ventricular rate responsive pacing (VVIR) is indicated for heart rate control.
References:
Matusik P, Lelakowski J, Malecka B, Bednarek J, Noworolski R. Management of Patients with Atrial Fibrillation: Focus on Treatment Options. J Atr Fibrillation. 2016;9(3):1450. Published 2016 Oct 31. doi:10.4022/jafib.1450 Markides V, Schilling RJ. Atrial fibrillation: classification, pathophysiology, mechanisms and drug treatment. Heart. 2003;89(8):939-943. doi:10.1136/heart.89.8.939 Cardiac Implantable Electronic Devices: PacemakersOA Series: April 2024
06:08
OA-POCUS Case of the Month
Gastric POCUS, Part 1 of 3Eric R. Heinz, MD, PhD, George Washington University, Yuriy Bronshteyn, MD, FASE, Duke University Health System
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17:46
OA-POCUS Case of the Month
Gastric POCUS, Part 2 of 3Eric R. Heinz, MD, PhD, George Washington University, Yuriy Bronshteyn, MD, FASE, Duke University Health System
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04:43
OA-POCUS Case of the Month
Gastric POCUS, Part 3 of 3Eric R. Heinz, MD, PhD, George Washington University, Yuriy Bronshteyn, MD, FASE, Duke University Health System
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41:04
OA Global Health Equity Ask the Expert
Anesthesia Services in Tanzania and KenyaSamuel Percy, MD, Children's Hospital Colorado
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16:40
OA-SPA Ask the Expert
REPOST: October 2021 – Pediatric Tracheal ExtubationsDebnath Chatterjee, MD, FAAP, Children’s Hospital Colorado
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