The patient has a permanent pacemaker inserted.The provider has set the pacemaker to the demand mode at a rate of 60 beats per minute.The nurse realizes that
A) the pacemaker will pace only if the patient's intrinsic heart rate is less than 60 beats per minute.
B) the demand mode often competes with the patient's own rhythm.
C) the demand mode places the patient at risk for the R-on-T phenomenon.
D) the fixed-rate mode is safer and is the mode of choice.

Question

Quizplus · Accepted Answer

Pacemakers can be operated in a demand mode or a fixed-rate (asynchronous)mode.The demand mode paces the heart when no intrinsic or native beat is sensed.For example,if the rate control is set at 60 beats per minute,the pacemaker will only pace if the patient's heart rate drops to less than 60.The fixed-rate mode paces the heart at a set rate,independent of any activity the patient's heart generates.The fixed-rate mode may compete with the patient's own rhythm and deliver an impulse on the T wave (R-on-T phenomenon),with the potential for producing ventricular tachycardia or fibrillation.The demand mode is safer and is the mode of choice.

The Patient Has a Permanent Pacemaker Inserted