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[no dialogue].
(Mr. Irvin Jean-Charles). This is group five,
and our topic is, we're going to begin
with maintaining the engine of human life.
The human heart, one of the most important organs in the human
body beats approximately 72 times per minute.
The heart pumps blood, which carries all the vital materials,
which help our body function and removes
the waste products that we do not need.
Some interesting facts about the heart is that it
beats more than 100,000 times a day, pumping about
2,000 gallons of blood, and it's only the size of your fist.
It's located between the lungs behind
your sternum in between the lungs.
It consists of four major chambers, the right atrium,
the right ventricle, left atrium, and the left ventricle,
and there's a wall of muscle called the septum that
separates the left and right ventricles into two cavities.
The function of the right side of your heart is to collect
de-oxygenated blood in the right atrium from the body and pump it
via the right ventricle into the lungs so that carbon dioxide
can be dropped off and oxygen picked up.
The left side collects oxygenated blood from
the lungs into the left atrium.
From the left atrium the blood moves to
the left ventricle which pumps it out to the body.
Here's a quick video.
[no dialogue].
(male narrator). Your heart is a pump,
its a muscular organ about the size of your fist and
is located slightly left of center in your chest.
Your heart is divided into the right and left side,
the division protects oxygen-rich blood
from mixing with oxygen poor blood.
Together your heart and blood vessels comprise your
cardiovascular system, which circulates blood
and oxygen around your body.
In fact, your heart pumps about 5 quarts of blood every minute,
and it beats about 100,000 times in one day.
That's about 35 million times in a year.
Oxygen poor blood, blue blood returns to the heart
after circulating through your body.
The right side of the heart composed of the right atrium and
ventricle collects and pumps the blood to the
lungs through the pulmonary arteries.
The lungs refresh the blood with a new supply
of oxygen, making it turn red.
Oxygen-rich blood, red blood then enters the left side
of the heart composed of the left atrium and ventricle
and is pumped through the aorta through the
body to supply tissues with oxygen.
Four valves within your heart keep
your blood moving the right way.
The tricuspid, mitral, pulmonary, and
aortic valves work like gates on a fence.
They open only one way and only when pushed on.
Each valve opens and closes once per
heartbeat or about once every second.
A beating heart contracts and relaxes, contraction
is called systole and relaxing is called diastole.
During systole, your ventricles contract forcing
blood into your lungs and body, much like
ketchup being forced out of a squeeze bottle.
The right ventricle contracts a little bit
before the left ventricle does.
Your ventricles then relax during diastole
and are filled with blood coming from the
upper chambers, the left and right atria.
Then the cycle starts over again.
Your heart is nourished by blood too.
Blood vessels called coronary arteries extend over the surface
of your heart and branch into smaller capillaries.
Here you can see just the network of blood vessels
that feed your heart with oxygen-rich blood.
Your heart also has electrical wiring which keeps it beating.
Electrical impulses begin high in the right atrium and
travel through specialized pathways to the ventricals,
delivering the signal to pump.
The conduction system keeps your heart beating in a coordinated
and normal rhythm, which in turn keeps blood circulating.
The continuous exchange of oxygen-rich blood with
oxygen-poor blood is what keeps you alive.
(Mr. Jean Charles). The conduction system
in your heart, there are electrical impulses
from your heart muscles that causes your
heart to beat, which makes it contract.
This electrical signal begins in the SA node,
located at the top right of the atrium,
which you can see in this diagram over here.
The SA node is also known as the heart's
natural pacemaker because this is where the electrical
impulse starts to create the contraction.
When an electrical impulse is released from the SA node,
it causes the atria to contract.
The signal then passes through the AV node.
The AV node checks the signal and sends it through the muscle
fibers of the ventricles, also causing them to contract.
Due to time constraints, we're going to skip the video,
and we're going to keep going.
Complications of the heart, as we just learned in the
conduction slide before, the pumping of the
heart is caused by electrical activity.
When the sequence is disturbed, arrhythmia is caused.
Arrhythmia is an abnormal rhythm of the heartbeat.
Arrhythmia causes the heart to pump blood less effectively.
Most cardiac arrhythmias are temporary and benign.
Some people can grow out of it, like I had
a heart murmur and I grew out of it.
Types of arrhythmias, tachycardia, this an abnormal
heartbeat that exceeds 100 beats per minute.
You might have fluttering, racing beats in your chest,
a little feeling of weakness or dizzy.
The treatments for these are intravenous medication,
implantable, defibrillator, or even surgery
for extreme conditions.
Bradycardia is an abnormally slow heart beat.
This is usually defined as a heart beat that
is less than 60 beats per minute.
You may feel a bit tired, sluggish, dizzy,
and chest discomfort.
The treatment for this is the pacemaker.
(Mr. Muhhamad Rizwan). Heart is an engine of
human body, and when this engine
starts creating problems then you need some treatment.
One of the treatments is a pacemaker.
Pacemaker is a small device that placed in the chest
or abdomen to help control the heart rhythm.
It stimulates or makes heartbeats by means of
electrical impulses and usually it is implanted when the heart's
own natural electrical conduction system
does not function properly and basically
the pacemaker is placed in the body.
The battery-powered device emits impulses that
trigger heart muscles contraction at a rate
that is preset or determined by the doctors.
It is a very small device at 2.5 centimeters and 14 grams of
weight only, and more than half a million Americans
are using this pacemaker device.
It is basically developed in 1960, and pacemaker
originally sent 1 steady beat to the heart.
And modern versions can even monitor your heart activity,
and it is only work when it is necessary.
Who needs a pacemaker?
Doctors recommend pacemakers for a number of reasons.
The most common reasons are bradycardia and heart block.
Bradycardia is a slower than normal heartbeat.
Heart block is a problem with the heart's electrical system.
There are some other reasons like sick sinus
and heart medicines when you are using
heart medicines they might slow your heartbeat.
We have how basically we can use this and
how doctors recommend this pacemaker.
There are different tests or diagnostic tests
on the basis of these tests.
Doctors basically recommend this device.
The first test is the electrocardiogram, and this test
basically is a painless test and record the heartbeat and holter
and event monitor test, this test basically monitors your
activity for a long time basically 24 hours to 48 hours.
Then ECG basically, ECG uses sound waves then
electrophysiology study and stress test,
these are different tests.
On the basis of these tests, the doctor can recommend all of
these tests or specific one or two tests to the patient.
Types of pacemakers, we have a different type of pacemakers,
single chamber pacemaker, dual chamber pacemaker, rate
responsive pacemaker, and demand pacemakers.
Single chamber pacemaker uses a single wire in heart chamber.
Dual pacemaker uses two wires, one in the
atrium and the other the ventricle.
Then we have rate responsive pacemakers, as well.
These are basically automatically
adjusted when required.
Demand pacemakers are used when there is some
electromagnetic interference.
These pacemakers are used at that time.
I just wanted to show a video.
(male narrator). Implantable pacemakers and
defibrillators are devices that apply
electric shocks to maintain the rhythm
of the heart and, if necessary, restart it.
As the technology improves and the list of treatable conditions
grows, the number of devices being implanted is increasing
steadily and now exceeds half a million a year.
The heart is made up of four chambers,
two atria and two ventricles.
One each side, the atrium is connected it to the
ventricle by a one-way valve.
Blood is pumped as these chambers
contract and relax in turn.
The beating of a healthy heart is regulated
by electrical impulses.
The sequence begins as the atria fill with de-oxygenated
blood from the body on the right and oxygenated
blood from the lungs on the left.
An electrical signal from the sinoatrial node then causes the
atria to contract, forcing blood into the ventricals.
The electrical signal is then picked up by the
atrioventricular node and directed into the
Purkinje fibres in the ventrical walls,
causing the ventricles to contract.
And the blood is then pumpled through the pulmonary valve on
the right to the lungs and the aortic valve
on the left to the rest of the body.
These valves close and the cycle then restarts.
When the sinoatrial node fails to function correctly, an
artificial pacemaker can be fitted to help regulate the
heart beat with small evenly timed electric shocks.
This involves implanting electrodes into one
or more of the heart's chambers by inserting
leads into a vein near the collar bone and implanting
a device called the generator just under the skin.
For more severe heart conditions an implantable defibrillator or
ICD can be used, which is also capable of sensing
a stopped heart and delivering an electric
shock powerful enough to restart it.
For some conditions, an even more sophisticated
device called a CRT-ICD can be implanted.
This uses a third lead inserted into the left ventricle to
resynchronize the ventricals when necessary.
However, all these leads can cause problems of their own.
Patients with ICDs have a 20% chance of a lead failure
within ten years and replacing leads can require
open heart surgery in about 2% of cases.
This has resulted in several efforts to develop new
pacemakers that do not depend on leads inside the heart.
One design, the Subcutaneous ID, places the lead outside the
heart under the patient's skin and wireless designs are now
being developed that may eventually do away
with the need for leads altogether.
(Mr. Rizwan). So this is how
a pacemaker works.
Good evening friends, my name is Pranit.
I am going to explain about different types of
pacemakers and the latest technology pacemakers
that we are going to use.
So before explaining about a pacemaker, let me explain
a brief fundamental thing about a heart.
It's like our brain has to say to our heart
whether to pump the heart.
Our brain has to send a signal to the heart
to pump, pump, pump.
So, if the SA node, there is a small part in the heart called
the SA node, if the SA node is not able to catch the signal
from the brain or if SA node is not working,
then we are going to use the pacemakers.
Previously, there were different types of pacemakers like single
chamber, dual chamber, as my friend Rizwan has said.
They were having a lot of problems because previous
pacemakers they used to keep the wires outside of the human
body, and they were having a lot of infections and stuff.
But because the new technology, the rate responsive pacemaker,
you can see the size of the pacemaker,
it's a picture of the x-ray.
That's going to be the size of the pacemaker.
I see the pacemaker as an electronic medical device.
This is used to send the electrical impulses to the
heart, if there is any irregularity in the
heartbeat, okay, okay.
Since these are extremely programmed well, we can,
because the heartbeat, the heart rhythm, everything is
going to be changed depending on the age
and the situations and the problems of the patient.
This device is programmed, for us we can program, we can do
that and keep a particular store [unclear dialogue] or remote.
We even have remote control so we are going to store all the
particular values in that remote control.
There are a lot of problems that the heart has,
and some of the problems doctors made pacemakers
to keep sinus syndrome and AV Block.
AV Block is nothing but atrium and ventricle block, next slide.
There are three important parts of a pacemaker,
that is the electrical pulse generator,
power source, and the lead system.
I'll just briefly explain about each
and every single part of it.
So, in order to give an electrical impulse,
the pulse generator needs a power source.
The power source is nothing but a battery, the lifetime of a
battery is going to be 15 years or 20 years depending upon the
model of the pacemaker that we are going to use.
The lead system is connected to the heart, and the information
about the heart is going to keep the pacemaker
generated through this lead system.
Electrical pulse generator is going to [unclear dialogue]
electrical pulse to the heart, next slide.
So I'm saying lead, lead, lead, what is this lead?
It's nothing but electrical connection
between the pulse and the heart.
There are two types of lead that we are going to use, uni polar
lead system and bi polar lead system.
It depends upon the problem the patient to have.
Okay, I said like in this technology,
we use a lot of sensors.
There are different types of sensors we use, next slide.
They are the single, next slide.
Activity sensors, metabolic sensors, breathing sensors, lot
of sensors that they are going to use in this technology, let
me explain briefly about the important sensors they are going
to use, the activity sensors and the breathing sensors.
The pacemaker is going to give the electrical impulse
to the heart, but when?
It has to, the person has to know, if I am doing exercises or
if I'm sleeping, the heart is going to be different for
different particular time.
The pacemaker has to detect, has to know, when what should be the
heartbeat if the person is doing exercise.
What should be the heartbeat if the person is sleeping?
This is called activity sensors.
If you are going to do some exercises, there is a some piece
of electrical crystal which can capture the muscular waves of
the human body and it can view the information
about the muscular [unclear dialogue] electrical impulse
that is a pacemaker.
Breathing sensor, it is going to know how much breathing the
human is taking and depending upon all these values, even
there is a metabolic sensors is going to [unclear dialogue]
stress environments, like when or if you are in stress,
blood has to flow more.
Depending, by taking all this information, the pacemaker is
going to decide whether to give an impulse or not,
it's going to be done within seconds.
As I said, single chamber sensors and dual chamber
sensors, single chamber sensors are not able to do all the, they
are not able to, they cannot do, they are not able to decide how
much the heartbeat should be in the daytime and how much the
heartbeat should be in the nighttime.
With the help of dual sensors, all these problems have been
rectified and my friend is going to explain about all the
problems and drawbacks and warnings in the
pacemakers that they have.
(Mr. SubbaPraneeth Karnati). Hi all, so far, so good.
If a person is recommended to wear a pacemaker,
he's going to wear it and he will be happy.
But in order to be happy, he should be aware of
the concepts like the warnings and the precautions.
And the warnings, defibrillation, defibrillation
is the process in which it is a type of a pacemaker,
but it is an external one.
It is allowed for the pumping of the beating of the heart, but it
is quite related to the [unclear dialogue] area as one of my
friends said that defibrillation is a process related
to the [unclear dialogue] and the pacemaker
is related to the [unclear dialogue].
The pacemaker has nothing to do with this and the defibrillation
has nothing to do with the slow heartbeat.
And defibrillation is the process in which involves a 361
per second of power, so once it has been tested on the lab in
the pacemaker so it works in an exact way
and it doesn't lose any property.
So when at all possible, it is better to disconnect the
pacemaker and then test the pacemaker.
That's the reason why I said the defibrillator
and the cardio version.
And next we have line powered equipment.
One should be aware of this because we can see the
pacemaker lead is there.
It is connecting to the myocardio,
which is the middle membrane of the heart.
It is a very sensitive part of the heart.
The lead should be very carefully handled there, and the
person who wears it should be very careful and
also the physician who is going to
[unclear dialogue] should be very careful.
Next the electrosurgical units and the
electrosurgical units are nothing but the electronic
units that are in the vicinity of the person.
Those should be grounded when the surgery is going on.
Because as I said, the pacemaker lead [unclear dialogue] it may
have an effect on that, and the person
may even lose his breath then.
Coming to the precautions, I have like random
failures of the battery depletion and all that.
The battery used in it is a lithium [unclear dialogue].
And other than that, we can not use the other things, and we
better prefer for the bi-polar lead systems, these have more
resistance for the magnetic or electric [unclear dialogue].
Environmental precautions and one should be very careful
while handling it, the spilling fluid on the
pacemaker is not recommended.
It may act in different situations,
depending on the temperatures.
And adverse effects of this is if it is not controlled well,
there is a chance of getting a disease called [unclear
dialogue] and then concluding, that is all.
(Dr. Wafeek Wahby). Thank you very much.
[audience applause].