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Cardiac Pacemakers
Terrance Healey, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Automatic implantable cardioverter defibrillator (AICD)
            • Synonyms

              • Permanent cardiac pacemaker
              • Biventricular pacemaker: Cardiac resynchronization therapy (CRT)
            • Definitions

              • North American Society of Pacing and Electrophysiology generic pacemaker code
                • 1st letter denotes chamber(s) paced
                  • A = atrium; V = ventricle; D = dual (both atrium & ventricle)
                • 2nd letter describes which chambers sense electrical signals
                  • A = atrium; V = ventricle; D = dual
                • 3rd letter denotes response to sensed events
                  • I = inhibition; T = triggering; D = dual (both inhibition & triggering)
                • 4th letter denotes activation of rate response feature (R)
                • 5th letter specifies location of multisite pacing
                  • O = no multisite pacing; A = atrium; V = ventricle; D = dual (both atrium & ventricle)

            IMAGING

            • General Features

              • Radiographic Findings

                • Fluoroscopic 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. Mitka M: First MRI-safe pacemaker receives conditional approval from FDA. JAMA. 305(10):985-6, 2011
                                          2. 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
                                          3. 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
                                          4. 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
                                          5. Brown DW et al: Epidemiology of pacemaker procedures among Medicare enrollees in 1990, 1995, and 2000. Am J Cardiol. 95(3):409-11, 2005
                                          6. Lamas GA et al: Evidence base for pacemaker mode selection: from physiology to randomized trials. Circulation. 109(4):443-51, 2004
                                          7. Loewy J et al: Reconsideration of pacemakers and MR imaging. Radiographics. 24(5):1257-67; discussion 1267-8, 2004
                                          8. Martin ET et al: Magnetic resonance imaging and cardiac pacemaker safety at 1.5-Tesla. J Am Coll Cardiol. 43(7):1315-24, 2004
                                          9. Trohman RG et al: Cardiac pacing: the state of the art. Lancet. 364(9446):1701-19, 2004
                                          10. Wiegand UK et al: Long-term complication rates in ventricular, single lead VDD, and dual chamber pacing. Pacing Clin Electrophysiol. 26(10):1961-9, 2003
                                          11. Daly BD et al: Nonthoracotomy lead implantable cardioverter defibrillators: normal radiographic appearance. AJR Am J Roentgenol. 161(4):749-52, 1993
                                          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

                                                      • Automatic implantable cardioverter defibrillator (AICD)
                                                    • Synonyms

                                                      • Permanent cardiac pacemaker
                                                      • Biventricular pacemaker: Cardiac resynchronization therapy (CRT)
                                                    • Definitions

                                                      • North American Society of Pacing and Electrophysiology generic pacemaker code
                                                        • 1st letter denotes chamber(s) paced
                                                          • A = atrium; V = ventricle; D = dual (both atrium & ventricle)
                                                        • 2nd letter describes which chambers sense electrical signals
                                                          • A = atrium; V = ventricle; D = dual
                                                        • 3rd letter denotes response to sensed events
                                                          • I = inhibition; T = triggering; D = dual (both inhibition & triggering)
                                                        • 4th letter denotes activation of rate response feature (R)
                                                        • 5th letter specifies location of multisite pacing
                                                          • O = no multisite pacing; A = atrium; V = ventricle; D = dual (both atrium & ventricle)

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • Fluoroscopic 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. Mitka M: First MRI-safe pacemaker receives conditional approval from FDA. JAMA. 305(10):985-6, 2011
                                                                                  2. 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
                                                                                  3. 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
                                                                                  4. 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
                                                                                  5. Brown DW et al: Epidemiology of pacemaker procedures among Medicare enrollees in 1990, 1995, and 2000. Am J Cardiol. 95(3):409-11, 2005
                                                                                  6. Lamas GA et al: Evidence base for pacemaker mode selection: from physiology to randomized trials. Circulation. 109(4):443-51, 2004
                                                                                  7. Loewy J et al: Reconsideration of pacemakers and MR imaging. Radiographics. 24(5):1257-67; discussion 1267-8, 2004
                                                                                  8. Martin ET et al: Magnetic resonance imaging and cardiac pacemaker safety at 1.5-Tesla. J Am Coll Cardiol. 43(7):1315-24, 2004
                                                                                  9. Trohman RG et al: Cardiac pacing: the state of the art. Lancet. 364(9446):1701-19, 2004
                                                                                  10. Wiegand UK et al: Long-term complication rates in ventricular, single lead VDD, and dual chamber pacing. Pacing Clin Electrophysiol. 26(10):1961-9, 2003
                                                                                  11. Daly BD et al: Nonthoracotomy lead implantable cardioverter defibrillators: normal radiographic appearance. AJR Am J Roentgenol. 161(4):749-52, 1993