Cardiac Implantable Devices

Question 1

NBG Code 1

Answer 1

Chamber paced

Question 2

NBG Code 2

Answer 2

Chamber sensed

Question 3

NBG Code 3

Answer 3

Mode of Response

Question 4

NBG Code 4

Answer 4

Rate Responsiveness

Question 5

NBG Code 5

Answer 5

Multisite pacing

Question 6

Lead impedance is lower than the last device check, what could this mean?

Answer 6

Lead insulation break

Question 7

Pacemaker was implanted and patient complains of dyspnea, facial swelling cough, and distorted vision

Answer 7

SVC Syndrome

Question 8

Patient receives an ICD because he was previously resuscitated from cardiac arrest this is primary or secondary?

Answer 8

Secondary prevention, this is to prevent a second incident

Question 9

What is EOL?

Answer 9

End of life; Pacemaker fails to function or dies

Question 10

What pacemaker is associated with pacemaker syndrome?

Answer 10

VVI

Question 11

Explain ACC/AHA Class I

Answer 11

There is supportive evidence that procedure is useful

Question 12

Explain ACC/AHA Class II

Answer 12

There is conflicting evidence about the usefulness of the procedure

Question 13

Explain ACC/AHA Class III

Answer 13

There is evidence about the procedure that is is not useful

Question 14

What is the advantage for a bipolar lead pacemaker?

Answer 14

Less suseptable to EMI noise

Question 15

Explain active fixation

Answer 15

Helical Screw

Question 16

Explain passive fixation

Answer 16

Winged

Question 17

What adjustment changes a pacemaker from demand Mose to asynchronous?

Answer 17

Decrease sensitivity

Question 18

Chronaxie is defined as?

Answer 18

2 x rheobase

Question 19

At what time is a PP’s stimulation threshold the lowest?

Answer 19

At the time of initial implant

Question 20

A patient receives and ICD with indications of only low EF and increased risk of SCD IS this primary or secondary?

Answer 20

Primary prevention

Question 21

What is it called when the pacemaker to ICD leads are twisted?

Answer 21

Twiddlers syndrome

Question 22

What are the benefits of SICDs?

Answer 22

No floor needed, Easy to explant, No risk for vascular injury

Question 23

People that receive a biventricular pacemaker usually get what else?

Answer 23

ICD

Question 24

What are hiccups suggestive of?

Answer 24

Phrenic nerve or diaphragm stimulation

Question 25

What is the most common reason for cardiac implanted lead removal?

Answer 25

Device infection

Question 26

What equipment is most important to have on hand when doing a lead wire extraction?

Answer 26

pericardiocentesis

Question 27

What kind of battery is a pacemaker?

Answer 27

Lithium iodine

Question 28

How long do the batteries last?

Answer 28

10-15 years

Question 29

What is normal impedance?

Answer 29

300-1500

Question 30

Ohms is greater than 1500

Answer 30

Lead wire fracture

Question 31

Change of 700 ohms

Answer 31

Lead wire fracture

Question 32

Ohms less than 300

Answer 32

Insulation break

Question 33

What is mA set to?

Answer 33

2x the diastolic threshold

Question 34

What is the safety margin set at?

Answer 34

2x the capture threshold to 1 mA above

Question 35

What kind of pacemaker is prone to cross talk issues?

Answer 35

Dual chamber

Question 36

What side is the pacemaker implanted?

Answer 36

Patients non dominant side

Question 37

What side is the IV placed on for PPI?

Answer 37

On the side on the device placement

Question 38

Placing a magnet over a pacemaker/ ICD will do what?

Answer 38

In pacemakers it will change to magnet mode and it will go asynchronous pacing. In ICD it will stop shocking.

Question 39

Which lead is placed first?

Answer 39

RV

Question 40

pacemaker signals are evaluated through what?

Answer 40

pacing system analyzer (PSA)

Question 41

What is the atrial sensing value?

Answer 41

1.5 mV

Question 42

What is the ventricular sensing value?

Answer 42

7 mV

Question 43

What is the atrial threshold value?

Answer 43

1 V

Question 44

What is the ventricular threshold value?

Answer 44

3 V

Question 45

How is the pocket sutured?

Answer 45

Fascia, Dermis, Epidermis

Question 46

What is done after a device placement?

Answer 46

Chest Xray to confirm lead placement, pneumothorax

Question 47

Signs of pacemaker malfunction

Answer 47

Syncope, Angina, SOB, Hyperventilation, Hiccoughs

Question 48

For an ICD what should the DFT be set to?

Answer 48

10 J higher

Question 49

The benefit of the intervention/ procedure far exceeds the risk (Recommended)

Answer 49

Class I

Question 50

The benefit of the intervention/ procedure moderately exceeds the risk (Moderate)

Answer 50

Class IIa

Question 51

The benefit of the intervention/ procedure may not exceed the risk (No benefit)

Answer 51

Class IIb

Question 52

The benefit of the intervention/ procedure is equivalent to or is exceeded by the risk (Harmful)

Answer 52

Class III