Lesson Objectives:

• Understand indications for pacemakers, ICDs, and catheter ablation.

• Differentiate coronary interventions (PCI vs. CABG).

• Review the role of valve replacement (TAVR vs. surgical).

Pacemakers & ICDs

🔹 Permanent Pacemaker (PPM):
✔️ Indications: Symptomatic bradycardia, 3rd-degree AV block, high-risk Mobitz II block.
✔️ Types:

• Single-chamber (right atrium or ventricle).

• Dual-chamber (RA + RV, mimics normal conduction).

🔹 Implantable Cardioverter Defibrillator (ICD):
✔️ Indications:

• Survivors of sudden cardiac arrest (SCA) due to VT/VFib.

• EF <35% due to ischemic/nonischemic cardiomyopathy (high SCD risk).
  ✔️ Function: Detects and shocks VT/VFib to restore rhythm.

🔹 Catheter Ablation:
✔️ Indications:

• Refractory SVT (e.g., AVNRT, WPW).

• Atrial fibrillation (AFib) when meds fail.

• Ventricular tachycardia in structural heart disease.