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Cardiac Conduction Devices
Cristina Fuss, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Cardiac implantable electronic devices (CIEDs)
                • Implantable cardioverter defibrillator (ICD)
                • Biventricular pacemaker: Cardiac resynchronization therapy (CRT)
              • Right atrium (RA); right ventricle (RV); left atrium (LA); left ventricle (LV); atrioventricular (AV)
            • Definitions

              • North American Society of Pacing and Electrophysiology generic pacemaker code
                • Position I: Denotes chamber(s) paced
                  • A = atrium; V = ventricle; D = dual (both atrium and ventricle)
                • Position II: Refers to chambers sensed
                  • A = atrium; V = ventricle; D = dual; O = absence of sensing
                • Position III: How pacer responds to sensed event
                  • I = inhibition; T = triggering; D = dual-response modes (restricted to dual chamber systems)
                • Position IV: Relates to rate modulation (rate responsive or rate adaptive pacing)
                  • R = pacemaker has rate modulation; O = rate modulation unavailable or disabled
                • Position V: Rarely used, location or absence of multisite pacing
                  • O = no multisite pacing; A = multisite pacing in atrium (atria); V = multisite pacing in ventricle(s); D = dual multisite pacing (both atrium and ventricle)

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Khan K et al: Innovations in cardiac implantable electronic devices. Cardiovasc Drugs Ther. ePub, 2021
                                        2. Chun KJ et al: Is transjugular insertion of a temporary pacemaker a safe and effective approach? PLoS One. 15(5):e0233129, 2020
                                        3. Wald G et al: Retained temporary epicardial pacing wires: a systematic review and treatment algorithm. Ann Plast Surg. 85(S1 Suppl 1):S44-9, 2020
                                        4. Beurskens NEG et al: Leadless cardiac pacing systems: current status and future prospects. Expert Rev Med Devices. 16(11):923-30, 2019
                                        5. Ng JB et al: Simultaneous leadless pacemaker and subcutaneous implantable cardioverter-defibrillator implantation-when vascular options have run out. J Arrhythm. 35(1):136-8, 2019
                                        6. Sterman J et al: Implantable electronic stimulation devices from head to sacrum: imaging features and functions. Radiographics. 39(4):1056-74, 2019
                                        7. Vijayaraman P et al: His bundle pacing. J Am Coll Cardiol. 72(8):927-47, 2018
                                        8. Dandamudi G et al: History of His bundle pacing. J Electrocardiol. 50(1):156-60, 2017
                                        9. Mitka M: First MRI-safe pacemaker receives conditional approval from FDA. JAMA. 305(10):985-6, 2011
                                        10. Zikria JF et al: MRI of patients with cardiac pacemakers: a review of the medical literature. AJR Am J Roentgenol. 196(2):390-401, 2011
                                        11. Beck H et al: 50th Anniversary of the first successful permanent pacemaker implantation in the United States: historical review and future directions. Am J Cardiol. 106(6):810-8, 2010
                                        12. Parry SW et al: Implantable loop recorders in the investigation of unexplained syncope: a state of the art review. Heart. 96(20):1611-6, 2010
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Clinical Issues

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Cardiac implantable electronic devices (CIEDs)
                                                      • Implantable cardioverter defibrillator (ICD)
                                                      • Biventricular pacemaker: Cardiac resynchronization therapy (CRT)
                                                    • Right atrium (RA); right ventricle (RV); left atrium (LA); left ventricle (LV); atrioventricular (AV)
                                                  • Definitions

                                                    • North American Society of Pacing and Electrophysiology generic pacemaker code
                                                      • Position I: Denotes chamber(s) paced
                                                        • A = atrium; V = ventricle; D = dual (both atrium and ventricle)
                                                      • Position II: Refers to chambers sensed
                                                        • A = atrium; V = ventricle; D = dual; O = absence of sensing
                                                      • Position III: How pacer responds to sensed event
                                                        • I = inhibition; T = triggering; D = dual-response modes (restricted to dual chamber systems)
                                                      • Position IV: Relates to rate modulation (rate responsive or rate adaptive pacing)
                                                        • R = pacemaker has rate modulation; O = rate modulation unavailable or disabled
                                                      • Position V: Rarely used, location or absence of multisite pacing
                                                        • O = no multisite pacing; A = multisite pacing in atrium (atria); V = multisite pacing in ventricle(s); D = dual multisite pacing (both atrium and ventricle)

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Khan K et al: Innovations in cardiac implantable electronic devices. Cardiovasc Drugs Ther. ePub, 2021
                                                                              2. Chun KJ et al: Is transjugular insertion of a temporary pacemaker a safe and effective approach? PLoS One. 15(5):e0233129, 2020
                                                                              3. Wald G et al: Retained temporary epicardial pacing wires: a systematic review and treatment algorithm. Ann Plast Surg. 85(S1 Suppl 1):S44-9, 2020
                                                                              4. Beurskens NEG et al: Leadless cardiac pacing systems: current status and future prospects. Expert Rev Med Devices. 16(11):923-30, 2019
                                                                              5. Ng JB et al: Simultaneous leadless pacemaker and subcutaneous implantable cardioverter-defibrillator implantation-when vascular options have run out. J Arrhythm. 35(1):136-8, 2019
                                                                              6. Sterman J et al: Implantable electronic stimulation devices from head to sacrum: imaging features and functions. Radiographics. 39(4):1056-74, 2019
                                                                              7. Vijayaraman P et al: His bundle pacing. J Am Coll Cardiol. 72(8):927-47, 2018
                                                                              8. Dandamudi G et al: History of His bundle pacing. J Electrocardiol. 50(1):156-60, 2017
                                                                              9. Mitka M: First MRI-safe pacemaker receives conditional approval from FDA. JAMA. 305(10):985-6, 2011
                                                                              10. Zikria JF et al: MRI of patients with cardiac pacemakers: a review of the medical literature. AJR Am J Roentgenol. 196(2):390-401, 2011
                                                                              11. Beck H et al: 50th Anniversary of the first successful permanent pacemaker implantation in the United States: historical review and future directions. Am J Cardiol. 106(6):810-8, 2010
                                                                              12. Parry SW et al: Implantable loop recorders in the investigation of unexplained syncope: a state of the art review. Heart. 96(20):1611-6, 2010