Medtronic

Question 1

Over sensing causes ___

Answer 1

under pacing

Question 2

The magnet will pace asynchronously at ____

Answer 2

85 BPM

Question 3

Order of pacemaker identification code

Answer 3

PSSP or PaSeR (Paced, Sensed, Response)
Paced
Sensed
(response to) Sensed event
Programmability

Question 4

Indications for pacemakers

Answer 4

SA or AV node disease (symptomatic disease of impulse formation or conduction)
Long QT syndrome
Dilated CMP
HOCM
Syncope
Tachybrady syndrome
Post transplant
Post surgery

Question 5

Asynchronous pacing characteristics (DOO, VOO, AOO)

Answer 5

Delivers at a constant rate
There can be a competitive underlying rhythm
Can cause R on T

Question 6

Single chamber demand pacing characteristics (AAI, VVI)

Answer 6

Think of this as a “back up” mode
Only fires when native HR falls below predetermined HR

Question 7

Dual chamber AV sequential demand pacing (DDD) characteristics

Answer 7

Most common
Ensures atrium contrsact then the ventricles
Improves AV synchrony

Question 8

What can cause a pacemaker not to capture?

Answer 8

Hypothermia
Hypocarbia -> hypokalemia
Hyperkalemia
MI
Antiarrhythmics
Fibrotic tissue around pacing leads

Question 9

What does a magnet do to a pacemaker?

Answer 9

Converts pacemaker to asynchronous mode (usually)

Question 10

What does a magnet do to ICD?

Answer 10

Suspends ICD and shock

Question 11

What does a magnet do to a pacemaker + ICD?

Answer 11

Suspends ICD shock
No effect on pacemaker function
Might need to be reprogrammed by manufacturer

Question 12

Failure to sense can cause ___

Answer 12

R on T -> v fib
Asynchronous pacing

Question 13

A monopolar cautery causes ___ EMI than bipolar

Answer 13

More

Question 14

The risk of EMI is highest when the electrocautery tip is within ____ CMs

Answer 14

15

Question 15

Indications for ICD

Answer 15

Vtac
Vfib
EF <30%
CMP EF <35%
H CMP
Awaiting heart transplant
Long QT syndrome
Structural or congenital heart disease

Question 16

ICD codes

Answer 16

1- Shock chambers
2- Anti-tachycardia pacing chambers
3- Tachycardia detection
4- Anti-brady pacing chambers

Question 17

An ICD cardioverts V tach with ___, and V fib with ____

Answer 17

Vtac 1-30 J
V fib 10-30 J

Question 18

What is the most prevalent source of EMI in the OR?

Answer 18

Electrocautery
2- MRI

Question 19

___ cautery has LESS chance of EMI

Answer 19

Bipolar

Question 20

___ cautery requires a grounding pad

Answer 20

Monopolar

Question 21

Magnet on a pacer will ___
Magnet on an ICD will ___
Magnet on a dual pacer/ ICD will ___

Answer 21

asynchronous pacing
Disable Shock
Only disables shock

Question 22

Disadvantages of magnet (compared to reprogramming)

Answer 22

Does not produce asynchronous pacing for medtronic pacer/ICD patients
May not be possible due to obesity or position
No continuous audible (only for ten seconds)
No physician order needed

Question 23

Disadvantages of reprogramming

Answer 23

Drains battery life
Programmer is not readily available
Human error may lead to an error in programming
Charges to insurance

Question 24

When electrocautery is used, the __ setting causes more EMI than the ___ setting

Answer 24

coagulation
cutting

Question 25

If the surgeon insists on using monopolar, then you insist that he use ___bursts

Answer 25

Short <0.5 seconds

Question 26

What are the contraindications of a patient with a pace maker?

Answer 26

MRI
Thats all