Pacemaker interrogation

Whenever we have an order for it a representative from the actual pacemaker company comes to interrogate it.

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Just about to complete my first year as a Cardiac Device Nurse. I am an RN-BSN with ICU experience. Had to have strong understanding of cardiac rhythms.....rest of training has been on the job. Our clinic interrogates and troubleshoots pacers, ICDs, CRT devices.

We call St. Jude or Medtronic. Usually they come early the next morning, but if it's something needed stat I'm sure they have someone on call. I do not believe they have RN training.

We call the electrophysiology lab and it is usually a cardiac physician that comes to the bedside to interrogate implanted permanent pacemakers. I'm also in a university teaching hospital.

Can I just say, that I am always thankful when this is done. :) I always feel uneasy when I'm unsure of a patient's pacemaker settings/device type.

(The original post was made back in Dec, fyi, but what the hey).

The actual interrogation could be taught in a matter of minutes. The expertise comes into play in interpreting the results and making adjustments. In my 240 bed hospital, specific pacemaker reps perform those duties. We don't have an EP lab. The few pacer reps I know are all unlicensed folks with varied backgrounds in psychology, cardiac monitor techs, etc with lots of specialized pacer training. I've not seen that any of those duties are done by the bedside RN.

All the staff in our Cardiac Device Clinic are RN-BSN nurses. We do not work for a cardiac device manufacturer and do not work for a hospital. We work with a team of cardiologists/EP doctors. And the actual interrogation can NOT be taught in minutes. Where did you get that idea? The thought that interrogation could be taught in minutes is uninformed and dangerous. Are you aware that when you use a programmer you have control of a patient's heart? There are dependent patients who MUST be paced and the potential exists in the programmer to cause pacing to be at voltages that are less than necessary to capture the heart. I have heard of patients passing out on the floor because an uneducated person attempted to interrogate their device and caused prolonged pauses in therapy causing syncope. Further, each manufacturer's programmer has it's own format and different devices can have different platform appearance within the programmer. All the nurses in our clinic have been trained to use the programmer from each manufacturer.

The cardiac device representatives in our area are highly educated....some with PhD's and are nurses, engineers or other professionals who have received extensive education in cardiac device technology. Some are licensed, others are not, all are educated professionals.

Believe me, cardiac devices are extremely sophisticated pieces of medical machinery that are FAR beyond the failure to sense and failure to capture that we were all taught in nursing school.

Nevermind.

I am a cardiac device tech and have been for 6 years. I don't have any fancy credentials after my name but I know more than most RN's when it comes to devices. I also don't work for a device company or for a hospital I work for a group of EP's. The devices can be checked by simply calling the device company of the particular model (ie. Medtroinc, Boston Scientific, St. Jude, or Biotronik)that the patient has implanted. To learn this skill it takes most a minimum of a year-2 years to feel completely comfortable doing routine checks and troubleshooting on a device. All of my training was on the job, I had taken an EMT-B course so I had some previous medical knowledge.

Hey, I am interested in becoming a Cardiac device nurse. What would be the steps I would need to take to becoming a cardiac device nurse? I currently work on a cardiac care unit. Thanks for your time!

I am a cath lab RN and I do a lot of the device checks in our hospital when a patient comes in. Since we are rural and reps have to come out from a long way they were more than happy to train me - I have had extensive training on it, but not enough where I am comfortable changing settings unless I have the Biotronik/Medtronic, etc rep on the phone walking me through it after I have gone over the situation with them. If you want to take some classes and move over to devices I would suggest getting in contact with your local device reps. The cath/EP labs should have their info.

I am a cardiac device RN. First, you have to work at a facility that has cardiac device nurses. These places are kind of few and far between. I live in the 6th biggest city in the US (metro area of 3.5 million people) and we are the only hospital with dedicated cardiac device nurses. I honestly got the job because I became friendly with a cardiac device RN, and the manager's mantra is they would sooner train someone who gets along with everyone then hire a cardiac expert. I had no cardiac experience beyond ACLS.

That said, the field is brutally difficult to learn. I liken it to learning how to speak a foreign language by being dumped in a foreign country (that happened to me too). Electrophysiology is extremely abstract. There is simply no go-to place to learn all of the devices / companies. It takes lots of time and hands on experience to learn the job. 18 months into the job, I am finally comfortable doing most interrogations and troubleshooting. Or at the very least, I know what I don't know and know how / where to get help as needed.

So the only way into the field that I know about is networking. Or you can apply directly to one of the device companies and see if they will train you.