By Kenneth A. Ellenbogen MD, Bruce L. Wilkoff MD, G. Neal Kay MD, Chu Pak Lau
Medical Cardiac Pacing, Defibrillation and Resynchronization remedy, 4th variation, by means of Drs. Kenneth A. Ellenbogen, Bruce L. Wilkoff, G. Neal Kay, and Chu-Pak Lau, is helping you carry improved medical results utilizing the most recent, so much profitable cardiac electrophysiology options. Expertly and virtually comprise state-of-the-art technical advancements in gadget and ablation treatments into your perform, and remain at the fringe of this quickly advancing box. boost your talents in difficult new components like ICD treatment in hereditary arrhythmias, interventional recommendations for gadget implantation, implantable cardiovascular displays, leadless pacing, and the biologic pacemaker. Watch specialists practice those state-of-the-art tactics on-line at www.expertconsult.com to aid maximize your potency and resolve a broader variety of middle rhythm demanding situations than ever prior to. deal with extra sufferers and deal with a broader diversity of stipulations by means of following the most recent criteria in pacing, defibrillation, and resynchronization applied sciences. practice the newest methods with information from international specialists who give a contribution clean views at the not easy scientific quarter of cardiac electrophysiology. optimistically deal with your sufferers with the most recent, state of the art strategies for atrial and ventricular pacing modes; ICD remedy in hereditary arrhythmias; interventional ideas for equipment implantation; guidance for handling gadget and lead advisories; implantable cardiovascular displays; leadless pacing and ICDs; and the biologic pacemaker. replicate the functionality of the specialists as they practice step by step strategies in intervention, implantation, and ablation remedies within the on-line movies. seek the whole contents on-line, hyperlink to PubMed, obtain the picture gallery, assessment perform instructions, and consider all the video clips at www.expertconsult.com. deal with extra sufferers and recover results with the most recent tactics in pacing, defibrillation and resynchronization remedy from Dr. Ellenbogen.
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Additional info for Clinical Cardiac Pacing, Defibrillation and Resynchronization Therapy 4th Edition: Expert Consult Premium Edition - Enhanced Online Features and Print
A unipolar system has only one electrode in contact with myocardium. The effects of unipolar and bipolar configurations on sensing are profound, as covered in Chapter 2, and the engineering aspects are equally important, as discussed in Chapter 3. In an ordinary unipolar pacing system, one electrode—the cathode—is in contact with myocardium. The metal case of the pulse generator is the anode. Bipolar leads may have higher stimulation thresholds than unipolar leads if the two electrodes are of equal size.
Constant-current thresholds are related to constant-voltage thresholds by impedance. However, impedance is not constant during the pulse. It increases with polarization. Therefore, constant-current strength-duration curves can have slightly different shapes than constant-voltage curves. , iridium oxide, fractal, platinized platinum, or “activated” carbon surfaces) have relatively low-polarizing electrodes. These tend to have a lower-voltage rheobase and a somewhat higher chronaxie than highly-polarizing electrodes135 (Figs.
These very low impedance values are not likely to be encountered clinically in a properly functioning pacing system. (From Barold SS, Winner JA: Techniques and significance of threshold measurements for cardiac pacing. ) (measured in coulombs), and Cpg is the capacitance of the capacitor (measured in farads). Obviously, what is delivered through the lead wire to the pulse generator is not truly a constant-voltage pulse. The change in voltage over the pulse duration (“droop”) is directly proportional to the total charge delivered (Q*) during the pulse.