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Basic EP Principles Flashcards

1
Q

electrical activity in a localized area of the heart, between 2 electrodes that lie near or come in contact with endocardial tissue

A

intracardiac electrograms

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2
Q

what action potential is recorded

A

rapid depolarization phase (phase 0)

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3
Q

egm records ___ phase of the action potential

A

rapid depolarization

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4
Q

most common dx catheter

A

quadripolar

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5
Q

quadripolar can record info at

A

2 sites

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6
Q

proximal electrode is used for

A

recording electrical activity

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7
Q

distal electrode is used for

A

deliver pacing stimuli

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8
Q

electrode sizing ranges from

A

2-8mm

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9
Q

electrode spacing ranges from

A

2mm to 10mm

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10
Q

electrode spacing that records the most detail

A

2mm

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11
Q

rate EP studies are displayed at

A

100 mm/second

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12
Q

higher resolution is provided by increasing the amplitude

A

gain

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13
Q

placed lateral all of right atrium near the junction of SVC as close to SA node as possible

A

High Right Atrial (HRA) catheter

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14
Q

placed across posterior aspect of triscupid valve close to HIS bundle

A

HIS bundle Catheter

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15
Q

HIS signals in 4 spots

A

low right atrium
av node
his bundle
portion of right ventricle

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16
Q

A spike represents depolarization in this area

A spike is usually few milliseconds later than

A

low right atrium

surface Pwave

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17
Q

H spike represents depolarization in this area

H spike is aligned to what interval

A

HIS bundle

PR interval

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18
Q

V spike represents depolarization in this area

v spike is aligned to what interval

A

Right ventricle

QRS complex

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19
Q

What catheter is placed in the coronary sinus, posterior and slightly inferior to the mitral valve

A

coronary sinus catheter

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20
Q

records activity from left side of heart

A

coronary sinus catheter

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21
Q

CS catheter -
proximal electrodes records
distal electrodes lie

A 
proximal = atrial
distal = between atrial and ventricles
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22
Q

CS EGM represents atrial and ventricular signals on what side of the heart

A

left

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23
Q

records right venticular activity

A

Right ventricular apex

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24
Q

RVA EGM represents the electrical activity of the right ___ and right ____

A

ventricle and bundle branch

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25
timed delivery of pacing stimuli to reproduce an arrhythmia under controlled condiitons
programmed electrical stimulatoin
26
drive train of electrical impulses delivered at fixed cycle lengths
incremental pacing
27
one or more premature impluses are delivered at progressively shorter intervals
extrastimulus pacing
28
interval between successive A waves measured from the HRA catheter
Basic Cycle Length
29
patient's intrinsic natural heart rate
Basic Cycle Length
30
faster heart rate, ___ the BCL
shorter
31
interval from the SA to the AV node
Intraatrial conduction time (IACT)
32
measured from beginning of surface P wave to the A spike on HIS EGM
Intraatrial conduction time (IACT)
33
normal values range from 25 - 55 ms
Intraatrial conduction time (IACT) | HV interval
34
reflects AV node conduction
AH interval
35
time it takes for an impulse to travel from the lower atrium through the AV node to the HIS bundle
AH interval
36
Normal values range from 45 to 140 ms
AH interval
37
reflects intraventricular conduction
HV interval
38
time it takes for an impulse to travel from the HIS bundle through the Purkinje system to the ventricles
HV interval
39
extrastimuli are used to measure
refractory period
40
3 EP-defined refractory periods
effective relative functional
41
longest coupling interval in which an extrastimulus fails to propagate through cardiac tissue
effective refractory period
42
cardiac cells cannot propagate during
effective refractory period
43
time between the last paced impulse and the extrastimulus
coupling interval
44
time from the end of the ERP to the beginning phase 4 of the action potential
relative refractory period
45
at the end of the relative refractory period, cardiac tissue is
fully recovered
46
narrowest interval between two successive conducted impulses
functional refractory period
47
TIme it takes for the SA node to recover from overdrive suppression of normal automaticity
Sinus node recovery time (SNRT)
48
how to suppress SA node automaticity
over drive pacing
49
technique pacing impulses delivered via HRA catheter at constant rate for 30 seconds then stopped
over drive pacing
50
longest pause between last paced beat and first intrinsic beat
Sinus node recovery time (SNRT)
51
SNRT considered abnormal > XXms
1500
52
CSNRT considered abnormal > XXms
525 ms
53
CSNRT formula
SNRT - BCL
54
SNRT Ratio
SNRT/BCL X 100%
55
time it takes for a sinus impulse to travel through perinodal atrial tissue
sinoatrial conduction time (SACT)
56
normal SACT
50-115 MS
57
prolonged SACT suggests
sinus exit block in which impulses form but are not conducted
58
two ways to measure SACT
Narula method | Straus method
59
short bursts of pacing pulses are delivered at a rate slightly faster than the sinus rate to minimize overdrive suppression
Narula method
60
decremental pacing is used to prevent overdrive suppression
Straus Method
61
SACT longer than __ is considered abornmal
115ms
62
basic EP tasks for EP study includes
measuring baseline conduction intervals | performing atrial and ventircular extrastimulus testing
63
baseline measurements 6
``` basic cycle length Intraatrial conduction time (IACT) AH HV QRS QT ```

EP 101 (6 decks)

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