ICD Flashcards
What is shock therapy?
Used to terminate fibrillation at a high output
What percentage of patients are non-responders?
30%
What is the most commonly recommended programming of first shock strength?
DFT + 10J
True or False
Fixed-gain sensing is not appropriate for ICDs.
True
What is the classification system for heart failure?
NYHA
What are the indications for NYHA class I?
There is evidence and general agreement that a given procedure or treatment is useful and effective
What are 3 functions of an ICD?
Pace
Sense
Shock
What is it called when after each delivered therapy, the ICD must determine whether the tachycardia was terminated?
re-confirm
What is another word for extended bipolar sensing?
integrated sensing
What is extended bipolar sensing?
tip to the RV shocking coil
What were the criteria for the MADIT II study?
previous MI wit an EF < 30%
Which drug is associated with increases in DFTs
Amiodarone
What is ATP?
Pacing technique that involves burst pacing to eliminate a tachycardia
Where is the CS located?
posterior septum of the RA
CRT is most beneficial to those with a QRS of _____ms or longer
> 120ms
Describe the difference between burst and ramp pacing in ATP
Burst - fixed
ramping - increase in rate
What do most ICD batteries consists of?
Lithium Anodes and Silver Vanadium
What is the nominal amount of intervals ?
12 intervals
When did the FDA approve the ICD?
1985
Who is the inventor of the ICD?
Michel Mirowski
What is true bipolar sensing?
recording the electrode tip to the proximal ring
What are canted leads?
hugs the vessel wall using torque and pressure
What is zone 1?
VF only
Current ICDs use high efficiency cardioversion and defibrillation. What is the most efficient shock waveform?
Biphasic
Which type of pacing produces a “no man’s land’ type of axis
Bi V
What is Zone 3?
VF, VT-1, VT-2
What is a non-responder?
don’t respond to therapy
Name 3 “first line” druge therapy for HF
loop
ace inhibitors
B blockers
ERI
Elective Replacement Indicator
Give the definition for DFT.
Defibrillation Threshold: Shock strength to give defibrillation
BOL
beginning of life
What is pacemaker syndrome caused by?
Non physiologic VVI pacing
What is regarded as the gold standard drug for HF?
ACE inhibitor
Where is critical LV lead placement required
lateral
anterolateral
posterolateral
What is zone 2?
VF and VT
What were the two pacing modes in the DAVID trial?
VVI + DDDR
What does ICD stand for?
implantable cardioverter defibrillator
What happens when the ICD is in the off zone?
no zones, but bradycardia pacing still works
EOL
End of Life
What is the effect of placing a magnet over on all models ICDs?
back up pacing
What is the most important intervention to revive patients in cardiac arrest?
Prompt Defibrillation
What does the ICD base its detection on?
rate
What are the 4 zones of detection of an ICD?
Zone 1, 2, 3 and off
How long is a typical ICD charge?
5-12 seconds
What are three mechanisms that cause rhythm disorders?
Enhanced automaticity
Triggered automaticity
Reentry
