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Arrhythmias, Coronary heart disease, Valvular diseases, Diabetes,…

- - - - Supraventricular
        
        arises from the SA node, the atrial myocardium, or the AV node.
      - Ventricular
        
        derives from the His bundle, the Purkinje system, or the ventricular myocardium.
- - - - 1a
        
        Quinidine, procainamide, and disopyramide
      - 1b
        
        Lidocaine (lignocaine) and mexiletine
      - 1c
        
        Flecanide and propafenone
    - - Propranolol, Metoprolol and atenolol
    - - Amiodarone and sotolol
    - - Verapamil and diltiazem
  - - - Pulse generator
      - Leads
      - types
        
        Single chamber pacemaker
        
        Dual chamber pacemaker
        
        Biventricular pacemaker
        
        Leadless pacemaker
        
        Complications
        
        Thrombus
        
        Pacemaker infection
        
        Air leak
        
        Problems with pacemaker
- - - - Conductive system of the heart
        
        1) SA Node
        
        2) AV Node
        
        3) Bundle of His
        
        4) Purkinje Fibers
        
        Pacemaker Physiology
        
        Phase 0: Depolarization
        L type Ca2+ channels open
        
        Phase 3: Repolarization
        Ca2+ channels close, K+ channels open
        
        Phase 4: Pacemaker Potential
        Specific Na+ channels open
      - Propagation of Cardiac AP
        
        Phase 0 : Fast voltage-gated Na+ channels open
        
        Phase 1 : Partial repolarization
        
        Phase 2 : Inward Ca++ current is balanced by outward K+ current
        
        Phase 3 : Repolarization
        
        Phase 4 : Stable resting membrane
    - - can result from
        
        (1) Alterations of impulse formation
        
        (2) Alterations of impulse conduction
        
        “Reentry” mechanism
        
        summary
        
        Alterations in automaticity of the sinus node
        
        Triggered Activity (Enhanced automaticity of latent pacemakers)
- - - - Non-CVD
        
        Genetic Factors
        
        Obesity
      - Hypertension
- - - - 1-Hypovolemia- fluid & or blood loss
      - 2- Hypoglycemia
      - 3- Environmental
      - 4- Toxicological
      - 5- Orthostatic Hypotension
      - 6- Vasovagal (Cardioneurogenic) Syncope
- - - - ECG is a tool used to visualise the electricity that flows through the heart using electrodes.
    - - Electrodes Placement