Types of Permanent Pacemaker PPM

There are various types of PPM that pace different chambers of the heart. The choice of pacemaker system used depends very much on the patient s condition and the underlying rhythm of the patient. Most systems are inserted in theatre or a cardiac catheterization lab using fluoroscopic imaging to position the leads, which are inserted through a vein (i.e. the cephalic or Subclavian vein). There are several different modes a pacemaker can be set to. To distinguish between these different settings pacemakers are given a code to define their type and function. Table 8.1 summarises these pacemaker codes. 

This may seem at first glance quite complicated but as with ECG recognition it gets easier the more you practice and the more you see in clinical settings in patients notes. Two examples of commonly encountered pacanaker system are A VVI pacemaker describes a PPM system that paces the ventricle, senses the ventricle and inhibits pacing if it detects the patients intrinsic rhythm. A DDDR 

Low level X-ray imaging is used to position the pacemaker leads in the correct position in the relevant heart chamber(s). 

This image shows an electrode positioned in the patients right ventricle. 

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