Final

Question 1

What is the name of the widely used classification system for anti arrhythmic drugs (ADD)

Answer 1

Vaughan Williams Classification

Question 2

True/false - antiarrhythmic drugs are generally considered potential cardiac toxins and must be used with caution

Answer 2

True

Question 3

Almost all antiarrhythmic drugs (AAD) have potentials for producing_____

Answer 3

Proarrhythmia

Question 4

What is “proarrhythmia”

Answer 4

The potential life threatening ventricular tachycardia or Ventricular fibrillation including torsades de pointes.”,

Question 5

Class I AAD is (a) sodium channel blocker (b) beta blocker (c) potassium channel blocker (d) calcium channel blocker (e) digitalis agent

Answer 5

(A) sodium channel blocker

Question 6

Class II AAD is

Answer 6

Beta blocker

Question 7

Class III AAD is

Answer 7

Potassium channel blocker

Question 8

Class IV AAD is

Answer 8

Calcium channel blocker

Question 9

Procaine mode is what class

Answer 9

Class Ia

Question 10

Lidocaine and Mexiletine are what class

Answer 10

Class Ib

Question 11

Propafenone & Flecanide are what class

Answer 11

Class Ic

Question 12

What AAD drug class is Amiodarone?

Answer 12

Class III - potassium channel blocker

Question 13

What drug class does Metoprolol, Labetelol, Atenolol & Nadolol belong to?

Answer 13

Class II - beta blockers

Question 14

AAD class Ib drug, lidocaine, only has an effect on ventricular tachyarrhythmias

Answer 14

True

Question 15

Antiarrhythmic drugs are better than ICDs in preventing sudden arrhythmic death (T/F)

Answer 15

False - ICDs are better

Question 16

The responsibility for the administration of IV drugs in the EP lab lies with the ________

Answer 16

Registered nurse

Question 17

The drug most regularly used in the EP lab as a heart stimulant is _______

Answer 17

Isoproterenol (isuprel)

Question 18

Infusion measurement of isoproterenol is given in _____

Answer 18

Micrograms/min

Question 19

Warfarin must be discontinued no fewer than ______ days prior to surgery/EP procedure.

Answer 19

Five (5)

Question 20

Name 4 elements of the patient medical chart that must be reviewed as part of the pre-procedure evaluation

Answer 20

1) H & P
2) EKG
3) blood lab values
4) informed consent

Question 21

Name two sedatives commonly used In the EP lab

Answer 21

1) versed (midazolam)

2) Valium (diazepam)

Question 22

Name 2 narcotics commonly used in the EP lab

Answer 22

Fentanyl
Morphine
Demerol

Question 23

What is the reversal drug for sedatives

Answer 23

Flumazenil (Romazicon)

Question 24

What is the reversal drug for narcotics

Answer 24

Naloxone (narcan)

Question 25

What are the elements of a joint commission mandated ‘time-out’ to be performed prior to procedure

Answer 25

1) where the patient has been prepped and draped 2) team pauses and confirms patient 3) right procedure 4) right site

Question 26

What was the first type of ablation performed?

Answer 26

DC shock, using 250 joules, 2000-4000 volts at the catheter tip

Question 27

What ablative energy is now widely used throughout the US?

Answer 27

Radio frequency

Question 28

Does radio frequency use DC or AC current?

Answer 28

AC current

Question 29

What temperatures in RF ablation cause irreversible tissue injury?

Answer 29

45-50 degrees Celsius

Question 30

What 2 mechanisms of hearing are employed at RF ablation?

Answer 30

1) resistive | 2) conductive

Question 31

Can you create lesion if you have no tissue contact?

Answer 31

No

Question 32

Where is the hottest spot during RF ablation?

Answer 32

Not at the interface between the tip and the tissue, however the hottest spot is 1-2 minting the tissue

Question 33

What value is a sensitive and specific indicator of contact and lesion quality

Answer 33

Impedance

Question 34

What is a steam pop?

Answer 34

Vaporization of water of cardiac tissues from high temperatures (inadequate cooling) and an explosion which can be audibly heard and physically felt

Question 35

Does a larger electrode size create a larger lesion radius?

Answer 35

Yes, according to 1990 study

Question 36

What is the benefit of irrigated catheter vs non-irrigated catheter

Answer 36

Better temperature management, blood convection, and constant irrigation carries heat away, cools electrode and tissue surface

Question 37

Which catheter will offer a deeper lesion, and more effective larger lesion, irrigated or non -irrigated

Answer 37

Irrigated

Question 38

Is a cryo ablation lesion bigger or smaller compared to RF ablation lesions?

Answer 38

Cryo produces smaller lesions

Question 39

What is the advantage of cryo ablation compared to RF ablation?

Answer 39

Cryo produces smaller lesions