Cardiac Pacing and ICDs Fourth Edition Cardiac Pacing and ICDs Fourth Edition Kenneth A. Ellenbogen, MD Kontos Professor of Medicine Director, Electrophysiology and Pacing Laboratory Virginia Commonwealth University Medical Center Richmond,Virginia Mark A. Wood, MD Professor of Medicine Assistant Director, Electrophysiology and Pacing Laboratory Virginia Commonwealth University Medical Center Richmond,Virginia © Kenneth A.Ellenbogen,MD,2005 Blackwell Publishing,Inc.,350 Main Street,Malden,Massachusetts 02148-5018,USA Blackwell Publishing Ltd,9600 Garsington Road,Oxford OX4 2DQ,UK Blackwell Publishing Asia Pty Ltd,550 Swanston Street,Carlton,Victoria 3053,Australia All rights reserved.No part of this publication may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems,without permission in writing from the publisher,except by a reviewer who may quote brief passages in a review. 05 06 07 08 5 4 3 2 1 ISBN-13:978-1-4051-0447-0 ISBN-10:1-4051-0447-3 Library of Congress Cataloging-in-Publication Data Cardiac pacing and ICDs / [edited by] Kenneth A.Ellenbogen,Mark A.Wood.—4th ed. p. ; cm. Includes bibliographical references and index. ISBN-13:978-1-4051-0447-0 (pbk.) ISBN-10:1-4051-0447-3 (pbk.) 1. Cardiac pacing. 2. Implantable cardioverter-defibrillators.[DNLM: 1. Cardiac Pacing,Artificial. 2. Defibrillators, Implantable. 3. Pacemaker,Artificial. WG 168 C26333 2005] I. Ellenbogen,Kenneth A. II. Wood,Mark A. RC684.P3C29 2005 617.4¢120645—dc22 2004026975 A catalogue record for this title is available from the British Library Acquisitions:Nancy Duffy Development:Selene Steneck Production:Debra Murphy Cover design:Electronic Illustrators Group Typesetter:SNP Best-set Typesetter Ltd.,Hong Kong Printed and bound by Edwards Brothers in Ann Arbor,MI For further information on Blackwell Publishing,visit our website:www.blackwellmedicine.com Notice:The indications and dosages of all drugs in this book have been recommended in the medical literature and conform to the practices of the general community.The medications described do not necessarily have specific approval by the Food and Drug Administration for use in the diseases and dosages for which they are recommended.The package insert for each drug should be consulted for use and dosage as approved by the FDA.Because standards for usage change, it is advisable to keep abreast of revised recommendations,particularly those concerning new drugs. The publisher’s policy is to use permanent paper from mills that operate a sustainable forestry policy,and which has been manufactured from pulp processed using acid-free and elementary chlorine-free practices.Furthermore,the publisher ensures that the text paper and cover board used have met acceptable environmental accreditation standards. To my wife, Phyllis, whose support and encouragement helped make this project successful, and to my children, Michael,Amy, and Bethany for their patience and love. —Kenneth A. Ellenbogen, MD To my wife, Helen E.Wood, PhD, for her unquestioning love and support, and to my parents,William B.Wood, PhD, and Donna S.Wood, EdD, for their enduring examples of scholarship. —Mark A.Wood, MD Contents Contributors viii Preface x 1. Indications for Permanent and Temporary Cardiac Pacing 1 Pugazhendhi Vijayaraman, Robert W. Peters, and Kenneth A. Ellenbogen 2. Basic Concepts of Pacing 47 G. Neal Kay 3. Hemodynamics of Cardiac Pacing 122 Richard C.Wu and Dwight W. Reynolds 4. Temporary Cardiac Pacing 163 Mark A.Wood and Kenneth A. Ellenbogen 5. Techniques of Pacemaker Implantation and Removal 196 Jeffrey Brinker and Mark G. Midei 6. Pacemaker Timing Cycles 265 David L. Hayes and Paul A. Levine 7. Evaluation and Management of Pacing System Malfunctions 322 Paul A. Levine 8. The Implantable Cardioverter Defibrillator 380 Michael R. Gold 9. Cardiac Resynchronization Therapy 415 Michael O. Sweeney 10. ICD Follow-up and Troubleshooting 467 Henry F. Clemo and Mark A.Wood 11. Follow-up Assessments of the Pacemaker Patient 500 Mark H. Schoenfeld and Mark L. Blitzer Index 545 vii Contributors Mark L. Blitzer, MD David L. Hayes, MD Instructor in Medicine Chair, Cardiovascular Diseases Yale University School of Medicine Mayo Clinic Hospital of Saint Raphael Professor of Medicine New Haven, Connecticut Mayo Clinic College of Medicine Rochester, Minnesota Jeffrey Brinker, MD Professor of Medicine G. Neal Kay, MD Johns Hopkins University School of Professor of Medicine Medicine University of Alabama at Birmingham Johns Hopkins Hospital University of Alabama Hospital Baltimore, Maryland Birmingham,Alabama Henry F. Clemo, MD, PhD Paul A. Levine, MD Associate Professor of Medicine Clinical Professor of Medicine Virginia Commonwealth Loma Linda University School of University School of Medicine Medicine Richmond,Virginia Loma Linda University Medical Center Michael R. Gold, MD, PhD Loma Linda, California Michael E.Assey Professor of Vice President and Medical Director Medicine St. Jude Medical CRMD Chief, Division of Cardiology Sylmar, California Medical Director, Heart and Vascular Center Mark G. Midei, MD Medical University of South Carolina Assistant Professor of Medicine Charleston, South Carolina Johns Hopkins University School of Medicine Midatlantic Cardiovascular Associates Baltimore, Maryland viii CONTRIBUTORS Robert W. Peters, MD Michael O. Sweeney, MD Professor of Medicine Assistant Professor University of Maryland School of Harvard Medical School Medicine Cardiac Arrhythmia Service Chief of Cardiology Brigham and Women’s Hospital Veterans Administration Medical Center Boston, Massachusetts Baltimore, Maryland Pugazhendhi Vijayaraman, MD Dwight W. Reynolds, MD Assistant Professor of Medicine Professor of Medicine and Virginia Commonwealth Chief, Cardiovascular Section University School of Medicine The University of Oklahoma Health Co-Director, Cardiac Electrophysiology Sciences Center Lab Chief of Staff McGuire VA Medical Center OU Medical Center Richmond,Virginia Oklahoma City, Oklahoma Richard C.Wu, MD Mark H. Schoenfeld, MD Attending Physician, Clinical Clinical Professor of Medicine Electrophysiology Laboratory Yale University School of Medicine Assistant Professor of Medicine Director, Cardiac Electrophysiology and Cardiac Arrhythmia Research Institute Pacer Laboratory The University of Oklahoma Health Hospital of Saint Raphael Sciences Center New Haven, Connecticut Oklahoma City, Oklahoma ix