[graciev]

If you are AV pacing a patient (for example post cardiac surgery via epicardial leads) and the patient goes into afib with a slow ventric response, would you continue the AV or just use the V???? Several nurses I work with have given me several different answers.....
thanks,
Gracie

[Janet Barclay]

Originally Posted by graciev

If you are AV pacing a patient (for example post cardiac surgery via epicardial leads) and the patient goes into afib with a slow ventric response, would you continue the AV or just use the V???? Several nurses I work with have given me several different answers.....
thanks,
Gracie

AV pacing is preferable because of the atrial "kick". (IMHO)

[Dinith88]

Originally Posted by graciev

If you are AV pacing a patient (for example post cardiac surgery via epicardial leads) and the patient goes into afib with a slow ventric response, would you continue the AV or just use the V???? Several nurses I work with have given me several different answers.....
thanks,
Gracie

Thats a good question! Obviously AV pacing would be desirable (as mentioned by previous poster re:atrial kick).
I think what you're asking is whether or not you can obtain an adequate p-wave/atrial systole from a pacer if the atria are fibrillating??? My first response would be 'no'. I dont beleive you can atrial-pace an a-fib and thus would be limited to pacing the ventricle. However, the longer i sit here and think about it, the more i'm questioning myself If you dont get the answer here in a day or two, i'll find out as now i'm curious myself!

[travlr99]

Originally Posted by Dinith88

Thats a good question! Obviously AV pacing would be desirable (as mentioned by previous poster re:atrial kick).
I think what you're asking is whether or not you can obtain an adequate p-wave/atrial systole from a pacer if the atria are fibrillating??? My first response would be 'no'. I dont beleive you can atrial-pace an a-fib and thus would be limited to pacing the ventricle. However, the longer i sit here and think about it, the more i'm questioning myself If you dont get the answer here in a day or two, i'll find out as now i'm curious myself!

Hi - your right - if you're in atrial fib you can not atrial pace - you can just vent pace. Then treat the underlying ryhthm with prescribe drugs - dig, amiodarone, corvert, whatever is appropriate for the situation - fast or slow, hypotensive etc.!!

[Trauma-tizedRN]

Originally Posted by travlr99

Hi - your right - if you're in atrial fib you can not atrial pace - you can just vent pace. Then treat the underlying ryhthm with prescribe drugs - dig, amiodarone, corvert, whatever is appropriate for the situation - fast or slow, hypotensive etc.!!

Ditto your answer.

[eprn]

I double-ditto. The atrial rate for a patient in a-fib can be much greater than 300 bpm. You can't overdrive pace it. There are pacemakers that can deliver extra atrial pacing when a pt. has pac's to keep them out of a-fib, but once it's there, you have to try other things to stop it.