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| Name | Permanent Pacemaker Implantation Tutorial - Patient 2 by Dr. Michael Joseph Agbayani |
| Video Uploader | Video From Asia Pacific Heart Rhythm Society |
| Upload Date | This Video Uploaded At 08-01-2024 07:31:45 |
| Video Discription | This video discusses the different steps and techniques in pacemaker implantation. It starts with patient preparation and measures to prevent infection and other possible complications. The different types of incisions are also discussed and the incision demonstrated in the video is one parallel to the deltopectoral groove. Creation of a subcutaneous pocket is shown, as well as one of the techniques for venous access: cephalic cut down. For the second lead, another technique for venous access is demonstrated: puncture of the extrathoracic subclavian vein. (Axillary vein puncture is shown in another video.) Positioning of both the right ventricular lead and right atrial lead is also shown as well as how to test sensing and pacing parameters. Chapter 1 (0:00:05) - Intro and Preparation: Patient prep is one of the most important steps in pacemaker implantation as the team enacts measures to prevent infection and other possible complications. Chapter 2 (0:01:43) - Incision, Creation of Pocket, and Cephalic Cut Down: The different kinds of incisions used for pacemaker implantation are discussed (incision parallel to the delto-pectoral groove is shown in the video). Creation of a subcutaneous pocket is demonstrated, as well as one of the techniques for venous access: cephalic cut down. Chapter 3 (0:09:35) - Right Ventricular Lead Positioning and Testing: The right ventricular lead is positioned after venous access via cephalic cut down. Deployment of the RV lead helix is shown and we discuss how the sensing and pacing parameters are tested. Chapter 4 (0:12:59) - Extrathoracic Subclavian Puncture and Right Atrial Lead Positioning: If it is too difficult to pass two leads into the cephalic vein, one has several options. This includes doing a separate puncture for the atrial lead. Extrathoracic subclavian (some implanters will still call this an axillary puncture but for this video, the portion of the vein within the borders of the first rib will be called subclavian) puncture technique is demonstrated here. We used a tined right atrial lead with pre-formed J curve and demonstrate how to position it in the right atrial appendage as well as how to test the sensing and pacing parameters. Chapter 5 (0:17:13) - Connecting Leads to the Pulse Generator: We demonstrate how to connect the leads to the pulse generator and how to position the pulse generator in the pocket. Chapter 6 (0:20:12) - Final Shots and Closing of Pocket: The final chapter! We demonstrate how to close the pocket and get the final fluoroscopy shots. |
| Category | Education |
| Tags | Education Download MP4 | Education Download MP3 | Education Download MP4 360p | Education Download MP4 480p | Education Download MP4 720p | Education Download MP4 1080p |
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