
Samad has a Medtronic pacemaker. It is placed on his right lower ventrical area, just under his
rib-cage.
The Medtronic EnRhythm® pacemaker is a small, implantable medical device prescribed for people with a slow or weak heart rhythm to stimulate the heart muscle with precisely timed pulses of electricity. The EnRhythm pacemaker, which delivers electricity to both the right atrium and right ventricle, promotes natural heart activity by significantly reducing unnecessary pacing in the heart’s right ventricle when normal heart conduction is present by automatically switching to pace the right atrium. The EnRhythm device is the first-ever pacemaker to offer this exclusive feature, called MVP® or Managed Ventricular Pacing. With MVP, the device can be programmed to deliver pacing pulses to the right ventricle less than 5 percent of the time, compared to 50 percent or more with typical dual-chamber pacing. This is an important clinical benefit since clinical studies have shown that unnecessary pacing in the right ventricle can increase the risk for heart failure and atrial fibrillation.
Every 45 days, Samad is seen at the pacemaker clinic at the Children's Hospital of Philadelphia. He has a rountine 1)ECG, a 2)Pacemaker Interrogation and every 6 months he has an 3)ECHOCARDIOGRAM.
1) An electrocardiogram or ECG allows us to measure the electrical activity in your child's heart. We perform an ECG by attaching electrodes (small patches) to your child's chest, arms and legs and connecting the electrodes to the ECG machine using lead wires. The ECG machine produces a printout or tracing that we examine to see if it varies from a normal tracing.
The ECG helps us to determine whether your child might have certain heart problems. If your child has had a pacemaker implanted, we may use an ECG to monitor the pacemaker's function. We may also use an ECG to help us monitor the effectiveness of a heart medication your child is taking or to check his heart after he has had a heart procedure such as cardiac catheterization, heart surgery or an electrophysiology study.
We will usually take a baseline or resting ECG as part of your child's physical examination. If your child has an exercise test, we compare the exercise ECG with the baseline or resting ECG to see if any changes occur with increasing stress on his or her heart
2) During an interrogation, a small magnetic device is placed overtop of the pacemaker site. It's linked to a computer which can communicate with the pacemaker using radio waves. Using a programmer we can "interrogate" the pacemaker and determine how efficiently it's pacing the different chambers of the heart, the remaining life of the pacemakers battery and if there have been any unusual events such as a life-threatening arrhythmia that the pacemaker picked up (even if the patient was unaware that they may have occurred). In addition, aside from just checking a pacemaker, we can reprogram the unit to behave more ideally for the individual patients problem. This periodic fine tuning of the pacemaker will help maximize the benefit that the patient gets from cardiac pacing and also help maximize the pacers battery life because we will adjust the pacemakers energy delivery to more finely match the amount required for that particular patient.
In a few years, Samad will have to undergo yet another surgery to have his pacemaker replaced because the unit that he has now, which is about the size of a fifty cent piece, will no longer support his growing heart and body.
3) During an echocardiographic study (a cardiac ultrasound or echo), we use very high frequency sound waves to form a moving, two-dimensional picture of your child's heart on a television screen. This enables us to:
rib-cage.
The Medtronic EnRhythm® pacemaker is a small, implantable medical device prescribed for people with a slow or weak heart rhythm to stimulate the heart muscle with precisely timed pulses of electricity. The EnRhythm pacemaker, which delivers electricity to both the right atrium and right ventricle, promotes natural heart activity by significantly reducing unnecessary pacing in the heart’s right ventricle when normal heart conduction is present by automatically switching to pace the right atrium. The EnRhythm device is the first-ever pacemaker to offer this exclusive feature, called MVP® or Managed Ventricular Pacing. With MVP, the device can be programmed to deliver pacing pulses to the right ventricle less than 5 percent of the time, compared to 50 percent or more with typical dual-chamber pacing. This is an important clinical benefit since clinical studies have shown that unnecessary pacing in the right ventricle can increase the risk for heart failure and atrial fibrillation.
Every 45 days, Samad is seen at the pacemaker clinic at the Children's Hospital of Philadelphia. He has a rountine 1)ECG, a 2)Pacemaker Interrogation and every 6 months he has an 3)ECHOCARDIOGRAM.
1) An electrocardiogram or ECG allows us to measure the electrical activity in your child's heart. We perform an ECG by attaching electrodes (small patches) to your child's chest, arms and legs and connecting the electrodes to the ECG machine using lead wires. The ECG machine produces a printout or tracing that we examine to see if it varies from a normal tracing.
The ECG helps us to determine whether your child might have certain heart problems. If your child has had a pacemaker implanted, we may use an ECG to monitor the pacemaker's function. We may also use an ECG to help us monitor the effectiveness of a heart medication your child is taking or to check his heart after he has had a heart procedure such as cardiac catheterization, heart surgery or an electrophysiology study.
We will usually take a baseline or resting ECG as part of your child's physical examination. If your child has an exercise test, we compare the exercise ECG with the baseline or resting ECG to see if any changes occur with increasing stress on his or her heart
2) During an interrogation, a small magnetic device is placed overtop of the pacemaker site. It's linked to a computer which can communicate with the pacemaker using radio waves. Using a programmer we can "interrogate" the pacemaker and determine how efficiently it's pacing the different chambers of the heart, the remaining life of the pacemakers battery and if there have been any unusual events such as a life-threatening arrhythmia that the pacemaker picked up (even if the patient was unaware that they may have occurred). In addition, aside from just checking a pacemaker, we can reprogram the unit to behave more ideally for the individual patients problem. This periodic fine tuning of the pacemaker will help maximize the benefit that the patient gets from cardiac pacing and also help maximize the pacers battery life because we will adjust the pacemakers energy delivery to more finely match the amount required for that particular patient.
In a few years, Samad will have to undergo yet another surgery to have his pacemaker replaced because the unit that he has now, which is about the size of a fifty cent piece, will no longer support his growing heart and body.
3) During an echocardiographic study (a cardiac ultrasound or echo), we use very high frequency sound waves to form a moving, two-dimensional picture of your child's heart on a television screen. This enables us to:
- Identify any abnormalities in the structure of your child's heart
- Evaluate how the heart muscle is functioning
- Measure the speed of blood flow through the heart
- Estimate blood pressure in the different chambers of the heart