The Nuts and Bolts
of Implantable
Device Therapy
Pacemakers
,The Nuts
and Bolts
of Implantable
Device Therapy
Pacemakers
Tom Kenny, FHRS, CCDS
Director of Education, PrepMD, Braintree, MA, USA
,This edition first published 2015; © 2015 by John Wiley & Sons, Ltd.
Registered Office
John Wiley & Sons, Ltd., The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
Editorial Offices
9600 Garsington Road, Oxford, OX4 2DQ, UK
111 River Street, Hoboken, NJ 07030-5774, USA
For details of our global editorial offices, for customer services and for information about how to
apply for permission to reuse the copyright material in this book please see our website at
www.wiley.com/wiley-blackwell
The right of the author to be identified as the author of this work has been asserted in accordance with the
UK Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise,
except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of
the publisher.
Designations used by companies to distinguish their products are often claimed as trademarks. All brand
names and product names used in this book are trade names, service marks, trademarks or registered
trademarks of their respective owners. The publisher is not associated with any product or vendor
mentioned in this book. It is sold on the understanding that the publisher is not engaged in rendering
professional services. If professional advice or other expert assistance is required, the services of a
competent professional should be sought.
The contents of this work are intended to further general scientific research, understanding, and discussion
only and are not intended and should not be relied upon as recommending or promoting a specific
method, diagnosis, or treatment by health science practitioners for any particular patient. The publisher
and the author make no representations or warranties with respect to the accuracy or completeness of the
contents of this work and specifically disclaim all warranties, including without limitation any implied
warranties of fitness for a particular purpose. In view of ongoing research, equipment modifications,
changes in governmental regulations, and the constant flow of information relating to the use of medicines,
equipment, and devices, the reader is urged to review and evaluate the information provided in the package
insert or instructions for each medicine, equipment, or device for, among other things, any changes in the
instructions or indication of usage and for added warnings and precautions. Readers should consult with a
specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation
and/or a potential source of further information does not mean that the author or the publisher endorses
the information the organization or Website may provide or recommendations it may make. Further,
readers should be aware that Internet Websites listed in this work may have changed or disappeared
between when this work was written and when it is read. No warranty may be created or extended by any
promotional statements for this work. Neither the publisher nor the author shall be liable for any damages
arising herefrom.
Library of Congress Cataloging-in-Publication Data
Kenny, Tom, 1954– , author.
The nuts and bolts of implantable device therapy pacemakers / Tom Kenny.
p. ; cm.
Includes index.
ISBN 978-1-118-67067-5 (pbk.)
I. Title.
[DNLM: 1. Cardiac Pacing, Artificial–methods. 2. Pacemaker, Artificial. WG 168]
RC684.P3
617.4′120645–dc23
2014027299
A catalogue record for this book is available from the British Library.
Cover images: © iStock.com/angelhel; © iStock.com/RASimon
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not
be available in electronic books.
Set in 9.5/12pt Minion by SPi Publisher Services, Pondicherry, India
1 2015
, Contents
Preface, vi 14 Single-chamber timing cycles, 153
Acknowledgments, vii 15 Introduction to dual-chamber
timing cycles, 169
1 Cardiovascular anatomy and physiology, 1
16 Dual-chamber timing cycles: the atrial
2 Cardiac conduction system, 15
channel, 179
3 The cardiac cycle and hemodynamics, 21
17 Dual-chamber timing cycles: the ventricular
4 Heart disease, 29 channel, 195
5 Cardiac medications related to cardiac 18 Paced ECG and EGM analysis, 205
rhythm management devices, 37
19 Upper-rate behavior, 219
6 The basics of ecg and rhythm
interpretation, 48 20 Advanced dual-chamber timing, 233
7 Arrhythmia analysis, 58 21 Rate-responsive pacing, 242
8 Electricity 101, 78 22 Special features, 260
9 Pacing 101, 84 23 Automatic capture algorithms, 278
10 Indications for pacing, 104 24 Pacemaker follow-up, 297
11 Pacemaker implantation, 116 25 Follow-up and troubleshooting, 310
12 Connecting the leads to the pulse generator, 131 Key answer, 316
13 Pacemaker modes and codes, 140 Index, 320
v
of Implantable
Device Therapy
Pacemakers
,The Nuts
and Bolts
of Implantable
Device Therapy
Pacemakers
Tom Kenny, FHRS, CCDS
Director of Education, PrepMD, Braintree, MA, USA
,This edition first published 2015; © 2015 by John Wiley & Sons, Ltd.
Registered Office
John Wiley & Sons, Ltd., The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
Editorial Offices
9600 Garsington Road, Oxford, OX4 2DQ, UK
111 River Street, Hoboken, NJ 07030-5774, USA
For details of our global editorial offices, for customer services and for information about how to
apply for permission to reuse the copyright material in this book please see our website at
www.wiley.com/wiley-blackwell
The right of the author to be identified as the author of this work has been asserted in accordance with the
UK Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise,
except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of
the publisher.
Designations used by companies to distinguish their products are often claimed as trademarks. All brand
names and product names used in this book are trade names, service marks, trademarks or registered
trademarks of their respective owners. The publisher is not associated with any product or vendor
mentioned in this book. It is sold on the understanding that the publisher is not engaged in rendering
professional services. If professional advice or other expert assistance is required, the services of a
competent professional should be sought.
The contents of this work are intended to further general scientific research, understanding, and discussion
only and are not intended and should not be relied upon as recommending or promoting a specific
method, diagnosis, or treatment by health science practitioners for any particular patient. The publisher
and the author make no representations or warranties with respect to the accuracy or completeness of the
contents of this work and specifically disclaim all warranties, including without limitation any implied
warranties of fitness for a particular purpose. In view of ongoing research, equipment modifications,
changes in governmental regulations, and the constant flow of information relating to the use of medicines,
equipment, and devices, the reader is urged to review and evaluate the information provided in the package
insert or instructions for each medicine, equipment, or device for, among other things, any changes in the
instructions or indication of usage and for added warnings and precautions. Readers should consult with a
specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation
and/or a potential source of further information does not mean that the author or the publisher endorses
the information the organization or Website may provide or recommendations it may make. Further,
readers should be aware that Internet Websites listed in this work may have changed or disappeared
between when this work was written and when it is read. No warranty may be created or extended by any
promotional statements for this work. Neither the publisher nor the author shall be liable for any damages
arising herefrom.
Library of Congress Cataloging-in-Publication Data
Kenny, Tom, 1954– , author.
The nuts and bolts of implantable device therapy pacemakers / Tom Kenny.
p. ; cm.
Includes index.
ISBN 978-1-118-67067-5 (pbk.)
I. Title.
[DNLM: 1. Cardiac Pacing, Artificial–methods. 2. Pacemaker, Artificial. WG 168]
RC684.P3
617.4′120645–dc23
2014027299
A catalogue record for this book is available from the British Library.
Cover images: © iStock.com/angelhel; © iStock.com/RASimon
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not
be available in electronic books.
Set in 9.5/12pt Minion by SPi Publisher Services, Pondicherry, India
1 2015
, Contents
Preface, vi 14 Single-chamber timing cycles, 153
Acknowledgments, vii 15 Introduction to dual-chamber
timing cycles, 169
1 Cardiovascular anatomy and physiology, 1
16 Dual-chamber timing cycles: the atrial
2 Cardiac conduction system, 15
channel, 179
3 The cardiac cycle and hemodynamics, 21
17 Dual-chamber timing cycles: the ventricular
4 Heart disease, 29 channel, 195
5 Cardiac medications related to cardiac 18 Paced ECG and EGM analysis, 205
rhythm management devices, 37
19 Upper-rate behavior, 219
6 The basics of ecg and rhythm
interpretation, 48 20 Advanced dual-chamber timing, 233
7 Arrhythmia analysis, 58 21 Rate-responsive pacing, 242
8 Electricity 101, 78 22 Special features, 260
9 Pacing 101, 84 23 Automatic capture algorithms, 278
10 Indications for pacing, 104 24 Pacemaker follow-up, 297
11 Pacemaker implantation, 116 25 Follow-up and troubleshooting, 310
12 Connecting the leads to the pulse generator, 131 Key answer, 316
13 Pacemaker modes and codes, 140 Index, 320
v
