Introducing OpenAnesthesia Summaries

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.