BMP and Mg
CXR
ECG
Troponin
Interrogation
Each company has on-call representatives who will come interrogate a device 24/7 (phone numbers above)
Most cath labs will have machines capable of interrogating each brand
Each company has on-call representatives who will come interrogate a device 24/7 (phone numbers above)
Most cath labs will have machines capable of interrogating each brand
Absence of pacer artifact indicates intrinsic depolarization
With newer pacemakers, pacer spikes may not appear on some or all paced beats, depending on EKG machine
Pacing artifacts preceding depolarizations indicate successful pacing and capture
Leads in RV apex produce LBBB pattern with appropriate discordance
New RBBB pattern may indicate lead in LV
Bi-ventricular devices can produce paced QRS complexes that are either narrow or wide and bizarre, depending on device programming
Simultaneous depolarization of ventricles produces dominant R wave in V1
With newer pacemakers, pacer spikes may not appear on some or all paced beats, depending on EKG machine
Obtain PA/Lateral Films to confirm pulse generator, manufacturer, lead placement/number/integrity
R atrial lead J shaped(tip medially on AP) entering right atrial appendage
RV leads point downward with tip between left spine and cardiac apex--lateral XR shows inferior and anterior
Coronary sinus lead- courses posteriorly on lateral XR
Extra leads may be appropriately abandoned and capped
ICD component appears as thickened shock coil
Implantable Cardioverter-Defibrillator complication
Acute arterial ischemia
Pacemaker complication
Acute coronary syndrome 
Left ventricular assist device complications
Cardiac ablation complications
Aortic endograft complications
Myocardial rupture