PACEMAKER/DEFIBRILLATOR CLINICS IN MANITOBA
HISTORY
1970
First nurse managed Pacemaker Clinic in Canada was established at Winnipeg’s Health Sciences Centre. It was managed by Darlene Foster RN under the direction of Dr. T.E. Cuddy. Clinics were later stablished at St. Boniface and Misericordia Hospitals in Winnipeg and Brandon General Hospital in Brandon, Manitoba.
1980’s
In the late 1980’s the Defibrillator Clinic was established in conjunction with the Pacemaker Clinic at Health Sciences Centre.
1993 The first ICD (defibrillator) was implanted at Health Sciences Centre. Prior to this time patients received their ICD implants in London, Ottawa, or Toronto, Ontario.
1999
The Misericordia Pacemaker Clinic closed. Patients were transferred to Health Sciences Centre or St. Boniface Hospital.
2006
Amalgamation of Adult Cardiac Services at St. Boniface Hospital, Winnipeg, Manitoba.
CURRENT
PACEMAKER/DEFIBRILLATOR CLINIC
Located in the Bergen Cardiac Care Centre at St. Boniface Hospital, Winnipeg, Manitoba.
Who they are:
- Nurse run clinic with support from cardiologists from the arrhythmia service.
- Medical Director – Dr. Clarence Khoo
- Clinic Co-ordinator – Maggie Lukianchuk RNBN, CCN(C)
- 6 full time nurses
- 3 part time nurses
- 5 cardiologists/electrophysiologists
- 4 unit clerks
Clinic Demographics
- The current patient population consists of individuals with implantable cardiac devices that include permanent pacemakers (PPM), implantable cardioverter defibrillators (ICD), cardiac resynchronization pacemakers/defibrillators (CRT-D) and Implantable Loop Recorders (ILR).
- 4,500 pacemaker patients.
- 1,500 ICD/CRT-D patients.
- Population served: Manitoba, Northwestern Ontario and Nunavut.
What they do:
Approximately 50-70 patients per day receive service.
Duties include....
- Scheduled in clinic device follow-ups, remote transmissions, requests for device assessment by Emergency Room, Operating Room and other departments.
- A variety of patients with PPM/ICD/CRT-D and Implantable Loop Recorders (ILR) from all manufacturers throughout the day are seen and assessed. Patient assessment includes...
- Device interrogation and review of device settings.
- Evaluation of device and lead function including battery longevity estimates.
- Targeted cardiac assessment of patient signs and symptoms and medication review.
- Assessment of cardiac rhythm, device pace/sense characteristics and extended diagnostics.
- Device programming as required.
- Identification, documentation and reporting of atrial and ventricular arrhythmias, heart failure diagnostics, significant findings and data sent to the appropriate family physicians/cardiologists/specialists.
- Pre-operative assessment/teaching for patients receiving PPM/ICD/CRT-D/ILR devices which includes a review of the procedure by a nurse, watching a video, having blood work and EKG completed.
- Post op device interrogation, programming, and discharge teaching.
- Appropriate documentation in a variety of sources including the hospital chart and data bases.
- Reviewing issues with the clinic coordinator and cardiologists as needed.
Required Qualifications:
- Registered Nurse.
- Post basic Critical Care Course or equivalent.
- Critical Care Nursing experience.
- Excellent assessment skills.
- Understanding of cardiac and paced rhythms.
- Works and collaborates well with others and members of the health care team.
- Works independently.
- Excellent communication skills, problem solving and decision making abilities.
- Assumes responsibility for professional development.
CARDIAC DEVICE IMPLANT ROOM & ELECTROPHYSIOLOGY LAB
- They are the only adult Electrophysiology (EP) lab in Manitoba.
- There are two procedure rooms located on the second floor of the Bergen Cardiac Care Centre at St. Boniface Hospital.
What they do:
- Implant cardiac devices such as Pacemakers, ICD’s, CRT’s and Loop Recorders.
- Perform cardiac EP studies on patients with atrial and ventricular arrhythmias. They also work with the pediatric team from Health Sciences Centre to perform pediatric EP procedures.
- Perform ablations to inhibit cardiac arrhythmias.
- Each year their highly trained physicians and ICU trained nurses perform approximately 300 EP procedures/ablations, 700-800 pacemaker insertions and 400 ICD/CRT-D insertions.
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