Course Content
Disclaimer
This course is designed for educational purposes only. It focuses on the concepts and clinical understanding of shockwave lithotripsy. All energy settings, system limits, and device-specific protocols must be followed as per the manufacturer’s recommendations. Lithotripsy Academy does not replace hands-on training or clinical judgment. Users are responsible for applying their own expertise and adhering to local guidelines and safety standards.
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Disclaimer
01:11
Introduction: Understanding the Need for Cardiac Safety in ESWL
Managing patients with cardiac conditions during ESWL requires more than technical skill—it requires clear understanding, structured thinking, and clinical discipline. In this introductory section, we set the foundation for the entire course. You will explore why cardiac patients represent a unique challenge in shock wave lithotripsy, and why current practices across centers often vary widely—from unnecessary avoidance to unsafe execution
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Introduction:
00:53
Core Physics of Cardiac Interaction in ESWL
Understanding cardiac safety in ESWL begins with understanding physics—not protocol. In this section, we explore how shock waves interact with the human body, and more specifically, how they influence cardiac physiology and implanted cardiac devices. These interactions are not random—they follow predictable physical and biological principles that directly determine clinical risk. You will learn how shock waves can mechanically stimulate myocardial tissue, leading to transient arrhythmias, and how they can generate electromagnetic signals that interfere with pacemakers and ICDs.
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Core Physics of Cardiac Interaction in ESWL
02:14
ECG Gating
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ECG Gating
01:19
Core Physics
Pacemaker Management: Principles and Cooper Classification
Pacemaker Management: Principles and Cooper Classification Pacemakers are not a contraindication to ESWL—but they require a structured, device-specific approach. In this section, you will understand the key principle that safe treatment depends on how the device behaves under shock wave exposure, not simply its presence. The Cooper Classification provides a practical framework to categorize pacemakers into risk groups and guide appropriate management. You will learn when it is safe to proceed with monitoring alone, when reprogramming is required, and when additional precautions or alternative strategies must be considered.
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Pace maker management
00:14
Cooper classification
00:17
COOPER’S CLASSIFICATION – Class A
01:23
COOPER’S CLASSIFICATION – Class B
01:56
COOPER’S CLASSIFICATION – Class C
02:04
Coopers classification
Practical Application: Managing Pacemaker Modes During ESWL
Understanding pacemaker classifications is only the first step. Safe and effective ESWL requires translating that knowledge into real-time clinical decisions based on how each device behaves during treatment. In this section, we focus on the three most relevant pacing modes encountered in practice—VVI, DDD, and rate-responsive systems—and how each should be managed during ESWL.
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VVI Mode — The Stable Baseline
01:27
DDD Mode — Complexity with Risk
01:50
Rate-Responsive Mode — The Hidden Risk
01:58
EVIDENCE INSIGHTS
00:54
Practical Application: From Understanding to Action
01:28
Pacemaker quiz
00:15:00
ICD Management during ESWL
ICD Management: What You Will Learn Learn how to safely manage patients with implantable cardioverter defibrillators during ESWL, including device risks, mandatory deactivation protocols, and essential intraoperative precautions.
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ICCD Management during ESWL
01:17
ICD and complex devices
00:30:00
Arrhythmia Patients during ESWL
Arrhythmia Patients: What You Will Learn Learn how to safely manage patients with cardiac arrhythmias during ESWL, including atrial fibrillation, ventricular ectopy, and rhythm-related challenges with ECG gating.
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Arrhythmia Patients during ESWL
01:05
Protocol
Learn the complete pre-, intra-, and post-procedure protocol for safely performing ESWL in cardiac patients, including monitoring, device management, and sedation strategies.
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INTRAOPERATIVE PROTOCOL
01:08
Sedation and Physicology
00:19
Pre and Post Protocol
00:37
Decision frame work
00:40
Clinical Quiz
00:30:00
Thank you
Disclaimer: This course is intended for educational purposes only. The information presented reflects current knowledge, clinical experience, and available evidence in the field of ESWL and cardiac device management. However, it should not be considered a substitute for professional medical judgment, institutional protocols, or specialist consultation. Lithotripsy Academy and the course authors do not assume liability for clinical outcomes resulting from the application of this information.
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Thank you
00:49
ESWL in the Cardiac Patient
About Lesson

Managing patients with cardiac conditions during ESWL requires more than technical skill—it requires clear understanding, structured thinking, and clinical discipline.

In this introductory section, we set the foundation for the entire course.

You will explore why cardiac patients represent a unique challenge in shock wave lithotripsy, and why current practices across centers often vary widely—from unnecessary avoidance to unsafe execution.

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