2010 Paper Flashcards
C - yes and sinus bradycardia
D - atrial and ventricular oversensing
C - Rate Smoothing
A - atrial output
D - ventricular safety pacing
B - appropriate A and V capture
A increase upper tracking rate
B - remove the telemetry wand
D - inner conductor fracture
D - apply pressure dressing
D - start on Diltiazem 240mg and Coumadin
Diltiazam = Class 4 - calcium channel blockers - used if BB can’t be used
Coumadin = Warfarin
D - polarity programming
C - Pacemaker alternans
A - outer insulation break
D - DDD with rate drop response
C - cardiovascular death or stroke
C - atrial output should be increased
B - development of pAF
C - increase patient diuretics
C - increase stimulation threshold post defib
B - runaway pacing
B - threshold
High - minimal movement quick response
Low - need to do a lot of movement to get response
Slope/gain= how much the pacing rate will be increased compared to the base rate depending on the level of activity sensed by the accelerometer - higher value = more important to raise rate
190: B - DDD, 60bpm, AV150ms, circadian rate 50bpm
191: A - DDD, 100bpm, 250ms AV, rate hysteresis 40bpm
192: C - DDDR, 60bpm, 125ms AV, MTR 150bpm, + PVARP off
D - Fairfield sensing, pocket stimulation, double counting with some diagnostic and monitoring equipment
C - 800ms
B - inflammatory response at the lead tissue interface
D - BR 100, dynamic PVARP and AV, high output
B - replace device
C - battery voltage reading
D - increase PVAB or decrease atrial sensitivity
C - atrial refractory PVC response
Over-sensing makes the device think it’s a PVC
D - back up pulse prevents asystole
A. - atrial sensing
A - Atrial output
A - sinus rhythm
D - Ventricular based timing
C - extend AV Clock
D
A - electrocautery
D - decrease PVARP
C
A - increased AP (base rate programmed up), less VP (AV extended), more sensor driven rate ( threshold programmed from low to very low - so will RR at even lower activity)
D - V insulation break
D - cell impedance 3.7Kohms [3700ohms]
D - RR AV Delay makes it possible
C - Search AV hysteresis
C - PMT
D - replace device for surgery
A - improved lead stability
A - loose anodal screw
A. - acute phase threshold rise
245 - C - farfield oversensing
246 - B - decrease atrial sensitivity
A - loss of V capture
A - 1-1.5%
A - CHB with VA conduction
First strip shows no A and V association - not 2:1 because 2nd P doesn’t associate with V consecutively
2nd strip shows VA conduction
A - functional loss of of V sensing and capture
Pseudo pseudo fusion not sensed due to P stim… no capture because PVC refractory
B - 65 and 225bpm
Scale = 5squares= half second.
A rate = 10 squares = 1 second x 1000 = 1000ms = ~65bpm
V rate = 3 squares - 1/2 sec =500ms/5 = 100ms x 3 = 300ms =~200bpm
D - signal dropout (undersensing of signals) and high detection zone because markers are say VS even at fast rate
A - device responded appropriately
C - 3 x ATP then varied shocks
Although same Joules, the vector is different for the last 2
C - 3 x ATP then varied shocks
Although same Joules, the vector is different for the last 2
C - programmable vectors
Can’t programme vectors with single coil lead - only one vector
C - onset
269 : A - induced VF terminated by 35J
270 : C - Test DFT again at 22J
C - 35J and 10J
C - inappropriate
A and V association seen according to plot
A - another ATP was added
C - PMT
C - DR ICD less adverse events compared to SR ICD
DR allows discriminator beyond rate and morphology
C - at leads infra electrode spacing too long
D - 85J lower phase duration
D - 85J lower phase duration
A - activate SVT discriminators
Ashmans phenomena = abberent V conduction usually seen with AF causing RBBB morphology and short V-V
Need SVT discriminators to distinguish because wavelet and rate not enough
B - very distal RV coil position
D - RV DEFIB
