Cardiac Pacing and Holter Monitors for Bradycardia
Among the many diseases that affect your heart, bradycardia is a serious one. Often, it is caused by a blockage in the heart’s electrical system. The blockage can cause the heart to slow down and become irregular, leading to a heart attack. However, the condition can be treated with various drugs, including ACE inhibitors, beta-blockers, and diuretics. It is also possible to treat the condition temporarily through cardiac pacing or Holter monitors.
Heart block
Having a heart block can be a serious medical condition that causes a slow heart rate. It can be caused by a variety of medical conditions. A slow heart rate can cause problems, including fatigue, dizziness, chest pain, shortness of breath, fainting, and cardiac arrest.
The most common cause of heart block is coronary artery disease. If you’re suffering from heart block, your doctor may recommend a specialized test. You may be required to have an electrocardiogram, a test that measures the electrical activity of your heart. Then, your doctor may prescribe a certain medicine to treat the condition.
Some people may have a heart block without ever having symptoms. The condition may occur in the upper chambers of the heart or in the conductive tissue of the ventricles.
A person’s heart rate may slow down to less than 60 beats per minute, a condition called bradycardia. While bradycardia may be a normal rate for some people, it can be too slow for others. If the patient experiences symptoms such as dizziness, fatigue, or shortness of breath, he or she should seek treatment.
If the patient has a high degree of heart block, transcutaneous pacing may be required to treat it. Transcutaneous pacing is a procedure that involves inserting a small battery-operated device under the skin of the chest. The device sends frequent electrical pulses to the heart, which helps maintain a regular heart rate.
Sinus node disease
Symptoms of sinus node disease and bradycardia include fatigue, dizziness, and shortness of breath. This condition may also cause syncope. A pacemaker may be needed to regulate the heart rate. It is important to discuss treatment options with your doctor.
In order to diagnose sinus node disease, your physician will evaluate your symptoms and your ECG. If your physician suspects the condition, you will be asked to participate in exercise stress testing. This test will help you understand how your heart reacts to a variety of physiologic demands.
Sinus node disease and bradycardia can be caused by a number of conditions. Your physician may also recommend medications to help control symptoms. You may be referred to a cardiologist for further evaluation.
A pacemaker is a small, battery-powered device that helps your heart beat in a stable rhythm. It is placed under the skin of your chest. The wires on the pacemaker will stimulate your heart when you need it.
A pacemaker is a good option for those with sinus node disease. It can be permanent or temporary. However, permanent pacing is not always useful and can be harmful. Permanent pacing can increase the risk of atrial fibrillation.
Medications are also used to help control symptoms of sick sinus syndrome. These medications may be used alone or in combination with a pacemaker. You may also be given blood thinners.
Hypothyroidism
Besides being an octave of Orion, my steroid-induced hypothyroidism has also been accompanied by bradycardia. The aforementioned condition was thought to play a significant role in the development of heart failure, but in fact, was only a minor component of my otherwise healthy patient’s condition. Nevertheless, it was a fact I was well aware of and had been working around, but not on.
The aforementioned condition was first diagnosed on the basis of clinical manifestations and laboratory findings. It was also accompanied by a myriad of other symptoms, including osteoarthritis and hyperlipidemia. I was referred to a specialist in cardiac surgery, who recommended conversion to sinus rhythm. In the intervening months, my condition continued to deteriorate and I was admitted to a hospital’s transitional care unit. My blood pressure was 110/74 and my pulse oximetry was 96% on room air. The above chart depicts my condition prior to the aforementioned hospital visit. It was at that point that I was no longer the same patient I had been a few days prior. During the course of my hospital stay, I suffered from a few strokes, which were not unusual in patients with this type of cardiovascular condition. Eventually, I was transferred to a nursing home, where I passed away after two days. It was a sad day, but it was an unfortunate one.
On the other hand, the most notable occurrence was the fact that the antibiotics prescribed for me were not administered for three hours. This was not only the most inconvenient hospital visit of my life but also the most improbable case of a patient being rushed to the ER and receiving antibiotics while undergoing coronary bypass surgery.
Drugs
During a surgical procedure, perioperative hemodynamic instabilities such as bradycardia and hypotension may occur. Medications may be used to treat these problems. However, the most effective drug to administer should be tailored to the individual patient’s needs.
The most important part of treatment is to determine the cause of the problem. Several drugs are available for this purpose. Dopamine, esmolol, and calcium channel blockers are used to normalize the heart’s rhythm.
Another medication used to counter bradycardia is epinephrine. It is available in prefilled 10-ml syringes and can be administered by IV. A small dose may be required, but the most effective dosage is in the 0.05-0.1-mg range.
Dexmedetomidine is another alpha-adrenergic agonist, but it has some other effects as well. It increases hemodynamic stability, decreases systolic blood pressure, and blunts the hemodynamic response to intubation. Moreover, it has antinociceptive effects and sedative properties.
Other drugs used to counter bradycardia are nitroprusside, ephedrine, and glycopyrrolate. Each of these drugs has its own pros and cons. For instance, nitroprusside may be effective in treating hypertension, but it can cause bradycardia if used inappropriately. Ephedrine may be effective in treating postoperative nausea. Likewise, glycopyrrolate may be effective in treating postoperative tachycardia.
Finally, dexmedetomidine may be useful in patients undergoing vascular surgery, as it is believed to reduce the risk of cardiac arrest. However, bradycardia is a rare occurrence in these patients.
Holter monitors
Using Holter monitors for Bradycardia is a non-invasive procedure that allows doctors to get a better picture of your heart. Holter monitors are devices that record your heart’s electrical activity over a period of 24 hours or 48 hours.
Holter monitors are usually placed on a patient’s chest, but they can also be placed on the wrist, arm, or shoulder. The device uses electrodes to record the heart’s electrical activity. The electrodes must be attached securely to the patient’s skin. The electrodes may need to be shaved or cleaned to ensure that they stick.
Holter monitors are designed to monitor heart rate and activity, but they can also capture arrhythmias. They can tell your provider about your heart condition and heart medicines.
You’ll be asked to keep a diary of your activities during the testing period. You should write down any symptoms that occur, as well as the activities that you do. You may also be asked to perform exercises while being monitored.
When you’re wearing a Holter monitor, you should avoid magnetic materials. You also don’t want to use an electric blanket. Electric toothbrushes or iPods can also affect the monitor. You should also keep your electronic devices at least six inches away from the event monitor.
You should also keep a record of your symptoms and activities, as well as the results of your heart test. This will help the technician understand your symptoms and correlate them with the results of the test.
Temporary cardiac pacing
Whether it is used for emergency or prophylactic purposes, temporary cardiac pacing for bradycardia is a life-saving procedure. The American College of Cardiology recommends it for patients with high-grade AV blocks. A temporary pacing wire can also be used for bradycardia-induced ventricular arrhythmias.
The purpose of this study was to examine the indications and complications of temporary cardiac pacings. The outcomes of this study were evaluated on 101 attempted pacings on 100 patients. Overall, the mortality rate was 17.6%. The most common complication was lead dislodgement.
The risks of this approach are similar to those of the femoral vein approach. However, the risks of deep vein thrombosis, infection, and right ventricular perforation are increased. The procedure requires the patient to remain supine with his or her leg straight.
The risk of lead dislodgement is greater with passive fixation leads than with active fixation leads. This may be due to inadequate adhesion of the pads to the chest wall.
The incidence of lead dislodgement may be reduced by the use of fluoroscopy during lead placement. However, it should be noted that fluoroscopy increases the risk in patients with hemodynamic instability.
If permanent pacing is indicated, permanent endocardial leads can be inserted. They are available for placement anywhere in the right ventricle. They should be superior to the ventricular apex. The ventricular threshold should be less than 1 Volt. The rate should be 60 to 70 beats per minute.
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U.S. National Library of Medicine. (n.d.). https://www.ncbi.nlm.nih.gov/
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Health A-Z. (2022, April 26). Verywell Health. https://www.verywellhealth.com/health-a-z-4014770
Harvard Health. (2015, November 17). Health A to Z. https://www.health.harvard.edu/health-a-to-z
Health Conditions A-Z Sitemap. (n.d.). EverydayHealth.com. https://www.everydayhealth.com/conditions/
