The Intern At Work: Internal Medicine 280. Catching the Beat- Indications for Pacemakers
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May 4, 2025 Alyssa Chow, an Internal Medicine Resident with a focus on cardiology, dives into the fascinating world of pacemakers. She shares the innovative history behind these lifesaving devices and their critical role in managing bradyarrhythmias. Alyssa discusses assessment strategies for patients and highlights the importance of diagnosing syncope. Additionally, she explains the mechanisms behind different types of pacemakers, including essential guidelines from the 2018 American College of Cardiology. Tune in for a deep dive into cardiac care!
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John Hopps' Pacemaker Legacy
- About 25,000 pacemakers are implanted yearly, thanks to John Hopps, the biomedical engineer who invented the first pacemaker.
- He later needed a pacemaker himself, personally testing his invention's impact.
Heart Electrical System Basics
- The heart's electrical system starts in the sinoatrial node and moves through the AV node and His-Purkinje system.
- AV blocks are classified by location: nodal, intrahissian, or infrahissian, affecting treatment decisions.
Assess Stability and Prepare
- Check hemodynamic stability in bradyarrhythmia patients before proceeding with assessment or intervention.
- Prepare for emergency by applying transcutaneous pacing pads and consider transvenous pacing if needed.