Troubleshooting

In the context of a cardiovascular implantable electronic device (CIED), troubleshooting usually means diagnosing a clinical problem and optimizing programming or correcting a fault in the CIED systemLess commonly, the solution is unrelated to the CIED, such as correcting metabolic abnormalities or pharmacologic therapyThis chapter focuses on the former, but it considers the latter when relevantIt begins with introductory material; then follows with foundational material for troubleshooting sensing, which is common to all CIEDs, and then proceeds to specific sections on pacemakers, implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT)Audible tones or vibrations from ICDs or CRT defibrillators indicate a patient alert caused by a detected arrhythmia or abnormal diagnosticAtrial sensing in dual-chamber ICDs must be reliable at fast ventricular rates, a technically challenging requirement.