What are the types of artificial pacemakers?

When they talk about chambers they are talking about where the pacemaker fires and senses. Your atrial is one chamber, your ventricles are another. All pacers. It is completely different from the type of pacer. One is a type (temp, or permanent) the other is the mode to which it is set.

Wow thank you! That really helped me!

But how about the Atrioventricular Pacemakers(Physiologic Pacing)??

Why is it not classified as Temporary or Permanent?

It's permanent. After AV node ablation it is implanted in the node to function as a pacemaker rather than having wires extend into atrium/ventricles.

I think most of the boxes they most use where I work can do everything, but are usually programmed to just do what's needed. Heck, if I were to get a device implant, I'd get the top of the line and have everything turned on. It would be like carrying my own ED around in my body.

Here is a quick rundown.

Pacemaker types: permanent (implanted) and temporary (external). Of the temporaries, there are 3 types -- epicardial (pacing leads that are threaded into the heart and out of the chest cavity, typically placed during cardiac surgery), tranvenous (leads threaded through a central venous access), and transcutaneous (this is pacing off a defibrillator unit with the patches, not leads/wires. Typically used in emergencies only.) I didn't know about physiologic pacing but it sounds like this is a newer variety of a permanent pacemaker.

Within these 4 types, there is a huge variety of settings that are available. The permanent pacemakers are the most sophisticated and can be programmed to function in many ways. Even the temporary boxes are pretty sophisticated and can be programmed for dual chamber use. You can't do a lot with a transcutanous pacemaker but the intention is for emergency use only and if you really need the pacer, someone should come in and put in another type (tranvenous pacemakers can put be placed in the cath lab with on call staff if needed pretty quickly at most bigger hospitals.)

Pacemaker settings are too complex to list in one posting. Many institutions will have you go to a full day class to learn about the types, settings, how to program, troubleshoot, etc. I can understand your confusion. There is a lot to know about pacemakers. I have worked with them for 10+ years (temporary ones, in the hospital setting) and I feel that I just have a good working knowledge of what they do....not everything by any means.

Or just see your Boston Scientific rep. She'll load you up with more info than you can digest, plus a free pair of strip calipers.

Here's a wikipedia article on pacers. Here are the revisions of the chart showing the generic codes for describing pacers.

It's understandable that your textbook caused some confusion. Pacemakers can be divided into two main groups: permanent and temporary. Atrioventricular (AV) pacemakers are subgroup of both of these main categories.

Atrioventricular (AV) pacing, or "physiologic" pacing, refers to pacing both the atria and the ventricular in a coordinated way in order to improve cardiac output. When used for treatment of bradycardia, a pacemaker that is solely V-paced is not as effective as one that causes an atrial contraction as well just prior to the ventricular contraction. This is because AV pacing restores the "Atrial Kick" that results from an atrial contraction just prior to contraction of the ventricles. The Atrial Kick is considered to be responsible for as much as 30% of cardiac output my maximizing the filling and pressure within the ventricles.

Bi-Ventricular pacing is also a type of physiologic pacing that coordinates the contractions of the L and R ventricles. This is reserved for patients with more severe symptoms of heart failure and can significantly improve the ejection fraction in patients with very low EF's related to bundle blocks or pacer dependent rhythms.

I have a somewhat similar question: Do pacemakers only treat bradycardia, or can some of them handle tachy episodes? And if a pacemaker can be placed to control tachycardia, how would it work? How would it take control of the rapidly firing heart? Just curious, because on our tele unit I see paced rhythms that become ST all the time.

I have a somewhat similar question: Do pacemakers only treat bradycardia, or can some of them handle tachy episodes? And if a pacemaker can be placed to control tachycardia, how would it work? How would it take control of the rapidly firing heart? Just curious, because on our tele unit I see paced rhythms that become ST all the time.

Start a new thread, post in critical care. The answer is yes and no but I'm not well versed enough to give all the details. Implanted pacer/defibrillators can definitely treat ventricular tachycardia. There are means to treat atrial tachyarrhythmias as well with a pacer but I am not sure if those are available on an implanted pacemaker. I know our Medtronic temporaries have that capability but I am not sure that an implanted one that runs on it's own would be "smart" enough to know when to utilize that type of functionality.

Somewhere on this site there must be an EP nurse.