Demand pacemaker

A demand pacemaker is a kind of pacemaker or a specific programmed mode in the new generations of automatic pacemakers. When activated, it adjusts the stimulation of the heart based on the demand of the blood circulation system at any given time, and therefore, it will create the closest possible status to the natural physiologic demand for the heart beats.[1][2]

The program of this feature in automatic pacemakers is designed somehow that the built-in system can be over-ridden by the heart's natural rate at any moment that it gets back to a non-pathologic normal sinus rhythm and can reinitiate influencing the electric activity in the heart when the pathologic event happens again.[3]

A "ventricular-demand pacemaker" produces a narrow vertical spike on the ECG, just before a wide QRS. The spike of an "atrial-demand pacemaker" appears just before the P wave.[4]

Comparably, a Triggered Pacemaker is activated immediately after an electrical activity is commenced in the heart tissue by itself. A "ventricular triggered pacemaker" produces the impulse just after a pulse is created in the ventricular tissue and it appears as a simultaneous spike with QRS. An "atrial triggered pacemaker" is the mode in which an impulse is produced immediately after an electrical event in the atrium. It appears as a discharge following the p wave but prior to the QRS which is commonly widened.[5]

References
  1. Demand pacemaker using an artificial baroreceptor reflex, retrieved 10 September 2018
  2. Cardiac implantable demand pacemaker, retrieved 2018-09-10
  3. Dubin, Dale (2000). Rapid Interpretation of EKG's: An Interactive Course. Cover Publishing Company. ISBN 9780912912066.
  4. "UpToDate". www.uptodate.com. Retrieved 2018-09-10.
  5. Baltazar, Romulo F. (2012-03-28). Basic and Bedside Electrocardiography. ISBN 9781451147919.
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