2010 Paper

Question 1

Answer 1

C - yes and sinus bradycardia

Question 2

Answer 2

D - atrial and ventricular oversensing

Question 3

Answer 3

C - Rate Smoothing

Question 4

Answer 4

A - atrial output

Question 5

Answer 5

D - ventricular safety pacing

Question 6

Answer 6

B - appropriate A and V capture

Question 7

Answer 7

A increase upper tracking rate

Question 8

Answer 8

B - remove the telemetry wand

Question 9

Answer 9

D - inner conductor fracture

Question 10

Answer 10

D - apply pressure dressing

Question 11

Answer 11

D - start on Diltiazem 240mg and Coumadin

Diltiazam = Class 4 - calcium channel blockers - used if BB can’t be used

Coumadin = Warfarin

Question 12

Answer 12

D - polarity programming

Question 13

Answer 13

C - Pacemaker alternans

Question 14

Answer 14

A - outer insulation break

Question 15

Answer 15

D - DDD with rate drop response

Question 16

Answer 16

C - cardiovascular death or stroke

Question 17

Answer 17

C - atrial output should be increased

Question 18

Answer 18

B - development of pAF

Question 19

Answer 19

C - increase patient diuretics

Question 20

Answer 20

C - increase stimulation threshold post defib

Question 21

Answer 21

B - runaway pacing

Question 22

Answer 22

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

Question 23

Answer 23

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

Question 24

Answer 24

D - Fairfield sensing, pocket stimulation, double counting with some diagnostic and monitoring equipment

Question 25

Answer 25

C - 800ms

Question 26

Answer 26

B - inflammatory response at the lead tissue interface

Question 27

Answer 27

D - BR 100, dynamic PVARP and AV, high output

Question 28

Answer 28

B - replace device

Question 29

Answer 29

C - battery voltage reading

Question 30

Answer 30

D - increase PVAB or decrease atrial sensitivity

Question 31

Answer 31

C - atrial refractory PVC response Over-sensing makes the device think it’s a PVC

Question 32

Answer 32

D - back up pulse prevents asystole

Question 33

Answer 33

A. - atrial sensing

Question 34

Answer 34

A - Atrial output

Question 35

Answer 35

A - sinus rhythm

Question 36

Answer 36

D - Ventricular based timing

Question 37

Answer 37

C - extend AV Clock

Question 38

Answer 38

D

Question 39

Answer 39

A - electrocautery

Question 40

Answer 40

D - decrease PVARP

Question 41

Answer 41

C

Question 42

Answer 42

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)

Question 43

Answer 43

D - V insulation break

Question 44

Answer 44

D - cell impedance 3.7Kohms [3700ohms]

Question 45

Answer 45

D - RR AV Delay makes it possible

Question 46

Answer 46

C - Search AV hysteresis

Question 47

Answer 47

C - PMT

Question 48

Answer 48

D - replace device for surgery

Question 49

Answer 49

A - improved lead stability

Question 50

Answer 50

A - loose anodal screw

Question 51

Answer 51

A. - acute phase threshold rise

Question 52

Answer 52

245 - C - farfield oversensing 246 - B - decrease atrial sensitivity

Question 53

Answer 53

A - loss of V capture

Question 54

Answer 54

A - 1-1.5%

Question 55

Answer 55

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

Question 56

Answer 56

A - functional loss of of V sensing and capture Pseudo pseudo fusion not sensed due to P stim… no capture because PVC refractory

Question 57

Answer 57

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

Question 58

Answer 58

D - signal dropout (undersensing of signals) and high detection zone because markers are say VS even at fast rate

Question 59

Answer 59

A - device responded appropriately

Question 60

Answer 60

C - 3 x ATP then varied shocks | Although same Joules, the vector is different for the last 2

Question 61

Answer 61

C - 3 x ATP then varied shocks | Although same Joules, the vector is different for the last 2

Question 62

Answer 62

C - programmable vectors Can’t programme vectors with single coil lead - only one vector

Question 63

Answer 63

C - onset

Question 64

Answer 64

269 : A - induced VF terminated by 35J 270 : C - Test DFT again at 22J

Question 65

Answer 65

C - 35J and 10J

Question 66

Answer 66

C - inappropriate A and V association seen according to plot

Question 67

Answer 67

A - another ATP was added

Question 68

Answer 68

C - PMT

Question 69

Answer 69

C - DR ICD less adverse events compared to SR ICD DR allows discriminator beyond rate and morphology

Question 70

Answer 70

C - at leads infra electrode spacing too long

Question 71

Answer 71

D - 85J lower phase duration

Question 72

Answer 72

D - 85J lower phase duration

Question 73

Answer 73

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

Question 74

Answer 74

B - very distal RV coil position

Question 75

Answer 75

D - RV DEFIB