What will you learn?
- how to conduct one of the most important manoeuvres
- what to expect and pay attention to
- how to avoid potential pitfalls
About this scenario
How to do extra-stimulus pacing?
1. Pick channel with a good quality and good capture (usually CS or HRA for atrial stimulation and RVA for ventricular one).
2. Set stimulation mode to extra-stimulus pacing.
3. Set S1 pacing CL lower than heart CL (i.e. 500 ms) - you want to be faster than the heart itself.
4. Set S2 lower than S1 i.e. 480 ms – you determine starting S1-S2 coupling interval at 480 ms. This means that first S2 stimulus will be delivered 480 ms after last S1 stimulus
5. Set numbers of beats in train - you determine how many S1 pacing signals (drive train) should be delivered prior to S2 pacing (usually 7-8)
6. Set Rest Time between sets to 2 or 3 seconds in order to give patient and his heart a break between sets. This determines how low stimulator will wait after delivery of S2 pacing prior to new S1 drive train.
7. Set S2 limit to 200 ms - you want to have a safety limit and avoid S2 stimulation below 200 ms.
8. Set Pre-Int -10 ms - this means simulator will decrease S1-S2 coupling interval by 10 ms every new S1-S2 train. If you choose +10 ms it will add extra 10ms in every round.
