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Summary of the Day

Epidermolysis Bullosa

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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?

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?
Your Anwser
Correct Anwser

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.

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