In the rapidly evolving field of treating cardiac arrhythmias, the importance of direct management of patients with implantable cardiac devices is growing. The devices have become increasingly complex, and understanding their algorithms and growing programming options is essential for physicians who implant and manage them. Written by experts and world authorities in the field, Pacemakers and Implantable Cardioverter Defibrillators: An Expert's Manual provides electrophysiologists, fellows in training, nurses, and cardiovascular technicians involved in day-to-day management of device patients with detailed information about the many device algorithms and interactions.

• Heavily illustrated with over 300 figures and tables
• Uniquely meets the day-to-day needs of all direct management professionals
• Focuses in detail on algorithms
• Describes device interactions, addressing every major manufacturer
• Provides in-depth insight into pacing, including biventricular pacing
• Discusses arrhythmia detection and device classification, testing, and therapy

PART 1: PACEMAKER SYSTEMS

1 Pacemaker Systems: The Basics of Pulse Generator Design
and Engineering
Hugh Thomas McElderry, John C. Evans, Jeffrey A. Keeney, and Jose Osorio

2 Pacemaker and Implantable Cardioverter Defibrillator Lead Design
Andrea M. Russo

3 Pacemaker Timing Cycles: Ventricular Based and Atrial Based
Fred Kusumoto

4 Algorithms for Minimizing Right Ventricular Pacing
Michael O. Sweeney

5 Normal Pacemaker Sensing, Abnormal Sensing, and Automatic Sensing
Carsten W. Israel

6 Pacemakers and Atrial Arrhythmias: Detection and Treatment
David S. Kwon and Byron K. Lee

7 Miscellaneous Pacing Algorithms
George H. Crossley and Robert Andrew Pickett

8 Automatic Threshold Measuring Algorithms
Marco V. Perez, Henry H. Hsia, Paul C. Zei, Mintu P. Turakhia,
Paul J. Wang, and Amin Al-Ahmad

9 Sensor-Driven Pacing
Chu-Pak Lau, Chung-Wah Siu, and Hung Fat Tse

10 Interpretation of Device Diagnostics
Jordan M. Prutkin and Robert W. Rho


PART 2: IMPLANTABLE CARDIOVERTER DEFIBRILLATORS

11 Basic ICD Systems
Jane Chen

12 ICD Lead Design
Gautham Kalahasty and Kenneth A. Ellenbogen

13 Sensing in ICDs
Sergio L. Pinski

14 ICD Therapy—ATP
Karin K. M. Chia, Luigi Di Biase, Paolo Pieragnoli, Giuseppe Ricciardi, Laura Perrotta, Robert Canby, Amin Al-Ahmad, Mark S. Wathen, Andrea Natale, and Luigi Padeletti

15 ICD Therapy—Shock
T. Jared Bunch, Jeffrey S. Osborn, and John D. Day

16 Discrimination Algorithms and Arrhythmia Detection
Irina Suman Horduna and Paul Khairy

17 Pacing with an ICD System: What Are the Issues?
Robert F. Rea

18 Assessing Defibrillation Efficacy at ICD Implant
Charles D. Swerdlow and Paul J. DeGroot


PART 3: BIVENTRICULAR PACING SYSTEMS


19 Basics of Biventricular Pacing Systems: Principles and Timing Cycles
Ravi Ranjan and Joseph E. Marine

20 Programming to Avoid Phrenic Nerve Stimulation during
Left Ventricular Pacing
Paul J. Wang, Amin Al-Ahmad, Henry H. Hsia, Paul C. Zei, and Mintu P. Turakhia

21 AV and VV Optimization
Jeffrey H. Chung, Robert J. Kim, and Kenneth M. Stein

22 Electromagnetic Interactions from Magnetic Resonance Imaging
in Patients with Implantable Arrhythmia Devices
Saman Nazarian and Henry R. Halperin


Index of Devices by Manufacturer
Index

Contributors:

T. Jared Bunch, MD, Intermountain Heart Rhythm Specialists, Cardiovascular Department, Intermountain Medical Center, Murray, Utah
Robert Canby, MD, Department of Biomedical Engineering, University of Texas, Austin, Texas
Jane Chen, MD, FHRS, FACC, Associate Professor of Medicine, Director,Electrophysiology Fellowship Program, Washington University School of Medicine, St. Louis, Missouri
Karin K. M. Chia, MBBS, FRACP, Cardiac Arrythmia Service, Department of Medicine, Cardiovascular Medicine, Stanford University, California
Jeffrey H. Chung, MD, Fellow, Maurice & Corinne Greenberg Division of Cardiology, Department of Medicine, Weill Medical College of Cornell University, New York, New York
George H. Crossley, MD, FHRS, FACC, Clinical Professor of Medicine, St. Thomas Research Institute and the University of Tennessee College of Medicine, Nashville, Tennessee
John D. Day, MD, Intermountain Heart Rhythm Specialists, Cardiovascular Department, Intermountain Medical Center, Murray, Utah
Paul J. DeGroot, MS, Medtronic, Inc., Minneapolis, Minnesota
Luigi Di Biase, MD, Texas Cardiac Arrhythmia Institute, St. David’s Medical Center, Austin, Texas; Department of Cardiology, University of Foggia, Foggia, Italy; Department of Biomedical Engineering, University of Texas, Austin, Texas
John C. Evans, MD, Fellow, Clinical Cardiac Electrophysiology, Stanford University School of Medicine, Stanford, California
Henry R. Halperin, MD, MA, Division of Cardiology/Cardiac Arrhythmia, Johns Hopkins University, Baltimore, Maryland
Irina Suman Horduna, MD, CCDS, Electrophysiology Fellow, Electrophysiology Service, Montreal Heart Institute, University of Montreal, Canada
Henry H. Hsia, MD, FACC, Associate Professor of Medicine, Cardiac Electrophysiology and Arrhythmia Service, Stanford University Medical Center, Stanford, California
Carsten W. Israel, MD, Assistant Professor of Medicine and Cardiology, J. W. Goethe University, Frankfurt, Germany; Head of the Department of Cardiology, Evangelical Hospital, Bielefeld, Germany
Gautham Kalahasty, MD, Assistant Professor of Medicine, Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia
Paul Khairy, MD, PhD, Associate Professor of Medicine, Canada Research Chair in Electrophysiology and Adult Congenital Heart Disease, and Director of the Adult Congenital Heart Center, Montreal Heart Institute, University of Montreal, Canada
Robert J. Kim, MD, Assistant Professor of Medicine, Maurice & Corinne Greenberg Division of Cardiology, Department of Medicine, Weill Medical College of Cornell University, New York, New York
Fred Kusumoto, MD, Associate Professor of Medicine, Mayo School of Medicine, Director of Electrophysiology and Pacing, Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic Florida, Jacksonville, Florida
David S. Kwon, MD, PhD, Electrophysiology Fellow, Cardiac Electrophysiology and Arrhythmia Service, Division of Cardiology, University of California, San Francisco, California
Chu-Pak Lau, MD, FRCP, FRACP, Honorary Clinical Professor, Division of Cardiology, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
Byron K. Lee, MD, Assistant Professor of Medicine, Cardiac Electrophysiology and Arrhythmia Service, Division of Cardiology, University of California, San Francisco, California
Joseph E. Marine, MD, Associate Professor of Medicine, Johns Hopkins University School of Medicine; Director of Electrophysiology, Johns Hopkins Bayview Medical Center; Staff Electrophysiologist, Johns Hopkins Hospital, Baltimore, Maryland
Hugh Thomas McElderry, MD, Division of Cardiovascular Diseases, University of Alabama, Birmingham, Alabama Saman Nazarian, MD, Division of Cardiology/Cardiac Arrhythmia, Johns Hopkins University, Baltimore, Maryland
Jeffrey S. Osborn, MD, Intermountain Heart Rhythm Specialists, Cardiovascular Department, Intermountain Medical Center, Murray, Utah
Luigi Padeletti, MD, Department of Heart and Vessels, University of Florence, Florence, Italy
Marco V. Perez, MD, Fellow, Cardiac Electrophysiology, Division of Cardiovascular Medicine, Stanford University, Stanford, California
Laura Perrotta, MD, Department of Heart and Vessels, University of Florence, Florence, Italy
Robert Andrew Pickett, MD, St. Thomas Research Institute, Nashville, Tennessee
Paolo Pieragnoli, MD, Department of Heart and Vessels, University of Florence, Florence, Italy
Sergio L. Pinski, MD, Head, Section of Cardiac Pacing and Electrophysiology, Cleveland Clinic Florida, Weston, Florida
Jordan M. Prutkin, MD, MHS, Acting Assistant Professor, Division of Cardiology, University of Washington, Seattle, Washington
Ravi Ranjan, MD, PhD, Fellow, Clinical Electrophysiology, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Robert F. Rea, MD, Associate Professor of Medicine; Consultant, Cardiovascular Diseases; Director, Implantable Cardiac Electrical Device Service; Mayo Clinic, Rochester, Minnesota
Robert W. Rho, MD, Associate Professor of Medicine, Division of Cardiology, University of Washington, Seattle, Washington
Giuseppe Ricciardi, MD, Department of Heart and Vessels, University of Florence, Florence, Italy
Andrea M. Russo, MD, FACC, FHRS, Professor of Medicine, UMDNJ/Robert Wood Johnson Medical School; Director, Cardiac Electrophysiology; Director, Cardiac Ablation and Arrhythmia Services; Cooper University Hospital, Camden, New Jersey
Chung-Wah Siu, MBBS, Cardiology Division, University Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
Kenneth M. Stein, MD, FACC, Senior Vice President and Associate Chief Medical Officer, Cardiac Rhythm Management Group, Boston Scientific Corporation, Natick, Massachusetts
Michael O. Sweeney, MD, Director, Cardiac Pacing and Implantable Device Therapies, Brigham and Women’s Hospital; Associate Professor of Medicine, Harvard Medical School, Boston, Massachusetts
Charles D. Swerdlow, MD, Division of Cardiology, Department of Medicine, Cedars-Sinai Medical Center, and the David Geffen School of Medicine, UCLA, Los Angeles, California
Hung Fat Tse, MD, PhD, FRCP, FHKCP, Specialist in Cardiology, William M. W. Mong Professor in Cardiology, Academic Chief, Cardiology Division, University Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
Mintu P. Turakhia, MD, MAS Instructor of Medicine, Stanford University, Stanford, California; Director, Cardiac Electrophysiology, Palo Alto Veterans Affairs Health Care System, Palo Alto, California
Mark S. Wathen, MD, Heart and Vascular Center, Cookeville Regional Medical Center, Cookville, Tennessee
Paul C. Zei, MD, Clinical Assistant Professor, Stanford University School of Medicine, Stanford, California

Amin Al-Ahmad, MD, FACC, FHRS, Assistant Professor, Department of Medicine, Stanford University School of Medicine, Associate Director of the Cardiac Arrhythmia Service, and Director of the Cardiac Electrophysiology Laboratory, Stanford University, Stanford, California

Kenneth A. Ellenbogen, MD, FACC, FAHA, FHRS, Kontos Professor of Medicine, Chair of the Division of Cardiology, and Director of Cardiac Electrophysiology in the Department of Internal Medicine , Virginia Commonwealth University, Richmond, Virginia

Andrea Natale, MD, FACC, FHRS
Executive Medical Director, Texas Cardiac Arrhythmia Institute, St. David’s Medical Center, Austin, Texas; Consulting Professor, Division of Cardiology, Stanford University, Stanford, California; Clinical Associate Professor of Medicine, Case Western Reserve University, Cleveland, Ohio; Senior Clinical Director, EP Services, California Pacific Medical Center, San Francisco, California; and Director of Interventional EP, Scripps Green, San Diego, California

Paul J. Wang, MD, FACC, FHRS, Professor, Department of Medicine, Stanford University School of Medicine, and Director of the Cardiac Arrhythmia Service, Stanford University, Stanford, California