Cover -- Dedication -- Title page -- Copyright page -- Contents -- List of Contributors -- In Memoriam-Dr Mark Allen Wood -- Preface -- CHAPTER 1: Indications for permanent and temporary cardiac pacing -- Introduction -- Anatomy and physiology of the conduction system -- Sinus node -- Atrioventricular node -- His-Purkinje system -- Indications for permanent pacemakers -- Sinus node dysfunction -- Indications for permanent pacing in sinus node dysfunction -- Acquired atrioventricular block -- Indications for permanent pacing in acquired AV block -- Chronic bifascicular block -- Indications for pacing in chronic bifascicular block -- Reflex syncope -- Indications for pacing in neurally-mediated syncope and hypersensitive carotid sinus syndrome -- Idiopathic orthostatic hypotension -- Specific conditions associated with cardiac conduction disease -- Chronic neuromuscular disorders -- Infiltrative and inflammatory disorders -- Genetic cardiomyopathies -- Dilated cardiomyopathy -- Hypertrophic cardiomyopathy -- Indications for permanent pacing for hypertrophic cardiomyopathy (adapted from guidelines published in 201146) -- Pacing for systolic heart failure -- Indications for pacing in heart failure and impaired LV systolic function -- Pacing to prevent or terminate tachycardias -- Indications for permanent pacing to prevent or terminate tachycardias -- Pacing for children and adolescents (including all patients with congenital heart block) -- Indications for permanent pacing in children and adolescents -- Permanent pacing after the acute phase of myocardial infarction -- Indications for permanent pacing following acute myocardial infarction -- Pacing after cardiac surgery and transcatheter aortic valve implantation -- Indications for temporary cardiac pacing -- Acute myocardial infarction -- Temporary pacing for procedural interventions.

Drug-induced bradycardia -- Other indications for temporary pacing -- Temporary pacing for tachycardias -- Summary -- Acknowledgment -- References -- CHAPTER 2: Components of a pacing and ICD system: basic concepts of pacing -- Introduction -- Electrophysiological considerations -- Electrical excitability of the cardiac myocyte -- Propagation of electrical stimuli -- Basic concepts of pacing -- Bipolar versus unipolar sensing -- Bipolar versus unipolar stimulation -- Pacing impedance -- Sensing impedance -- Stimulation threshold -- Polarization -- Anodal stimulation -- Electrode-myocardial interface maturation -- Current of injury -- Time-dependent changes in sensing, impedance, and threshold -- Automated capture -- Automated sensing -- Considerations of time-dependent changes in the context of device programming -- Impact of clinical variables on pacing threshold -- Biventricular pacing -- Pacemaker hardware -- Lead designs, materials, and functional characteristics -- Monitoring, detecting, and reporting of lead malfunction and failure -- Pulse generators -- Magnetic resonance compatible pacemakers and leads -- Rate-adaptive pacing and other sensors -- Types of sensors -- Dynamic AV and VV interval programming -- Programming of pacemaker sensor algorithms -- Choosing the right sensor -- Conclusion -- References -- CHAPTER 3: Hemodynamics of cardiac pacing and pacing mode selection -- Introduction -- Correction of bradycardia -- Chronotropic incompetence and rate modulation -- Exercise physiology -- Chronotropic incompetence -- Advantages and clinical benefits of rate modulation -- Atrioventricular synchrony -- Advantages -- Effects of optimal atrioventricular interval timing -- Determination of optimal atrioventricular interval -- Pacemaker syndrome -- Detrimental effects of right ventricular pacing.

Strategies to minimize right ventricular pacing -- Alternative site right ventricular pacing -- Left ventricular pacing and cardiac resynchronization therapy -- Suboptimal response to cardiac resynchronization therapy -- Pacing in hypertrophic obstructive cardiomyopathy -- Pacemaker mode selection -- References -- CHAPTER 4: Temporary cardiac pacing -- Introduction -- Cardiopulmonary resuscitation -- Reversible causes of severe bradycardia -- Temporary pacing options -- Transcutaneous pacing -- Temporary endocardial pacing -- Temporary epicardial pacing -- Transesophageal pacing -- Temporary dual chamber pacing -- Other means of pacing -- Insertion of an endovascular temporary pacemaker -- Complications -- Clinical application -- Conclusion -- References -- CHAPTER 5: Techniques of pacemaker implantation and removal -- Introduction -- Physician qualifications -- Logistical requirements -- Assessment of the patient -- Special issues -- Infection -- Kidney disease -- Anticoagulants and antiplatelet agents -- Subclavian vein anomalies -- Prior mastectomy -- Tricuspid valve disease -- Patients at risk for asystole -- Cost effectiveness -- Informed consent -- Pre-implantation orders -- Patient preparation -- Implant procedure -- Site -- Venous access -- Cephalic vein approach -- Subclavian vein approach -- Pacemaker pocket -- Lead implantation -- Ventricular lead positioning -- Atrial lead implantation -- Epicardial lead placement -- Single lead VDD pacing -- Generator insertion -- Revision of the implanted pacemaker system and pulse generator change -- Post-procedure management -- Complications of implantation -- Venous access -- Lead placement -- Other lead complications -- Venous thrombosis -- Generator -- Infection -- Complications of biventricular pacing -- Lead extraction -- General principles -- Indications -- Risks -- Technique.

Tools for extraction -- Superior approach -- Femoral approach -- Accufix wire fragment retrieval -- Extraction of coronary venous leads -- Thoracotomy for lead extraction -- Lead abandonment -- Medicolegal aspects of implantation -- References -- CHAPTER 6: Pacemaker timing cycles and special features -- Introduction -- Pacing nomenclature -- Pacing modes -- Single or dual chamber asynchronous pacing (AOO, VOO, DOO) -- Single chamber (atrial or ventricular) inhibited pacing (AAI, VVI) -- Single chamber triggered mode (without inhibition) pacing (AAT, VVT) -- Dual chamber pacing and sensing with inhibition and tracking (DDD) -- Dual chamber pacing and sensing with inhibition but without tracking (DDI) -- Ventricular pacing with inhibition and dual chamber sensing (VDI) -- Atrioventricular sequential, ventricular inhibited pacing (DVI) -- Ventricular pacing, dual chamber sensing with P-synchronous ventricular pacing and inhibition (VDD) -- Timing cycles -- Blanking and refractory periods -- Timing cycles based on pacing mode -- Atrioventricular interval, cross-talk, and safety pacing -- Ventriculoatrial interval (VAI) -- Total and post-ventricular atrial refractory periods -- Rate-modulated pacing -- Single chamber inhibited and rate-modulated pacing -- Single chamber and dual chamber rate-modulated asynchronous pacing -- Dual chamber rate-modulated pacing (DDDR, DDIR) -- Base-rate behavior -- Ventricular-based timing -- Atrial-based timing -- Comparison of atrial- and ventricular-based systems -- Effects of ventricular- and atrial-based timing systems on rate-modulated pacing modes -- Hybrid-based timing -- Upper rate behavior -- Rate enhancements -- Base rate during mode switch/fallback -- Rate smoothing/stabilization -- Rate-modulated pacing (sensor input to base rate pacing) -- Algorithms to allow intrinsic sinus rate.

Algorithms for cardioinhibitory neurogenic syncope -- Mode switch -- Algorithms for atrial arrhythmia detection and atrial pace/sense competition -- Blanked flutter search -- 2:1 Lock-in protection algorithm -- Atrial flutter response -- Non-competitive atrial pacing -- Atrial protection interval -- Algorithms to prevent atrial fibrillation -- Algorithms to minimize right ventricular pacing -- Pacemaker-mediated tachycardia -- Algorithms to prevent, identify, and terminate pacemaker-mediated tachycardia -- Biventricular pacing -- Timing cycles -- Loss of biventricular pacing -- Noise reversion -- Magnet response -- Summary -- References -- CHAPTER 7: Evaluation, troubleshooting, and management of pacing system malfunctions -- Introduction -- General considerations -- approach to evaluate pacemaker function and malfunction -- Differential diagnosis of device malfunction -- Abnormalities in the mechanical components of a pacing system -- Pulse generator hardware and software -- Leads -- Radiographic imaging of pacer systems -- Electrocardiographic manifestations of pacer malfunction -- Interpretation of the electrocardiogram -- Interpretation of intracardiac electrograms -- Problems with sensing -- Undersensing -- failure to sense -- Oversensing -- Cross-talk -- Oversensing cardiac signals -- Oversensing non-cardiac signals -- Problems with capture -- Pacing at an unexpected rate or sudden change in pacing rate -- Special algorithms -- Triggered pacing -- Pacemaker-mediated tachycardia and repetitive non-re-entrant ventriculoatrial synchrony -- Sensor-driven pacing -- Runaway pacemaker -- Analysis of stored device data -- Basic device data -- Event counters and histograms -- Arrhythmia logbook and stored electrograms -- Summary -- References -- CHAPTER 8: The implantable cardioverter-defibrillator -- Indications and supporting evidence.

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