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EKG > pacemakers > Flashcards

pacemakers Flashcards

1
Q

codings system 5th letter

A

indicates multi site pacing

rarely used

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2
Q

what does an ICD do when it senses V-fib

A

defibrillate

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3
Q

good for people whose body cannot appropriately increase the HR during activity

A

rate responsive

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4
Q

___ requires shielding to prevent EMI

A

therapeutic radiation

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5
Q

___ system produces short pacemaker spikes

A

bipolar

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6
Q

temporary pacemaker are

A

transcutaneous

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7
Q

a series of small rapid electrical pacing pulses to interrupt V tach (by capturing the ventricle and breaking the re-entry circuit) and returning heart to the normal rhythm

A

anti-tachydysrhythmia pacing

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8
Q

sensors identify changes in the pt’s acitivity and adjust pacing to meet metabolic needs

A

rate responsive pacing

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9
Q

fast HR with a pacemaker spike preceding each QRS complex

A

pacemaker mediated tachycardia

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10
Q

sxs of bradycardia

A

syncope/ pre-syncope

dizzy

CHF

AMS

palpitations

SOB

exercise intolerance

relentless fatigue

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11
Q

50-60 Hz radio-frequency waves that interfere with pacemakers

A

electromagnetic interference

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12
Q

VVIR

A

ventricular inhibitory pacing with rate modulation

vent pacing

vent sensing

inhibits if vent activity sensed

rate mod active

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13
Q

types of pacing modes

which is most common

A

fixed rate

rate responsive

demand (most common)

lower/ upper rate limits

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14
Q

where do you look for atrial enlargement

A

V1 and lead 2

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15
Q

coding system 3rd letter

A

how the pacemaker responds to sensing

O = none

T= triggers pacing

I = inhibits pacing

D = dual (both triggers and inhibits)

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16
Q

coding system 2nd letter

A

the chamber being sensed by the pacemaker

0 = none

A = atrium

V = ventricle

D = dual

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17
Q

when is cardiac resynchronization therapy used

A

to resynchronize biventricular contraction

common in pts w/ HF

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18
Q

pacemaker spikes that fall where they should have been inhibited

A

failure to sense

the pacemaker doesn’t sense the intrinsic impulse and fires unnecessarily

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19
Q

which is more common, single chamber or dual chamber pacemakers

A

dual aka AV sequential chamber

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20
Q

3 indications for pacemakers

A

non-reversible

symptomatic

bradycardia

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21
Q

where should you first look for ischemia

A

precordial leads (V1-V6)- anterolateral heart

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22
Q

fires only when the pt’s intrinsic rate falls below a give threshold

A

demand pacing mode

23
Q

can you do RF ablation

A

defer to EP

24
Q

permanent pacemakers used to tx

A

symptomatic bradycardia

sick sinus syndrome

a-fib w/ bradycardia

3rd degree AV block

symptomatic 2nd degree type 2 AV block

AV block or BBB in pt w/ acute MI

resynchronization in heart failure

25
Q

AAI

A

atrial inhibitory pacing, no rate modulation

atrial pacing

atrial sensing

inhibits atrial pacing if atrial activity sensed

26
Q

where do you look for BBB

A

V6 and lead 1

27
Q

pacemaker spikes that are not followed by a P wave or broad QRS complex

A

failure to capture

28
Q

logic circuits

A

part of permanent pacemaker that detects cardiac electrical activity and determines the appropriate response

29
Q

only ICD permanent pacemakers are used in

A

V-fib

V-tach

(recurrent tachycardias)

30
Q

DDI

A

dual chamber pacing without atrial synchronous vent pacing

dual paced

dual sensed

inhibits vent pacing if vent activity sensed

31
Q

what does an ICD do when it senses asystole

A

pace only

32
Q

type of shocking that most pacemakers do

A

antibradycardia pacing

33
Q

low or high energy shock (up to 35 joules) which is timed to the R waves to terminate VT and return heart to normal rhythm

A

cardioversion

34
Q

coding system 1st letter

A

represents the heart chamber being paced

0 = none

A = atrium

V = ventricle

D = dual

35
Q

w/ a TENS units,

___ system is OK

___ system should be avoided

A

bipolar system is OK

unipolar system should be avoided

36
Q

___ system produces talll pacemakers spikes

A

unipolar

37
Q

ODO

A

pacemaker is off

no pacing

dual sensing

no response to sensing (b/c not pacing)

38
Q

what 3 things do ICDs do?

A

deliver paced beats

cardiovert

defibrillate

39
Q

Cardiac Resynchronization Therapy leads (3)

A
  • right atrium
  • right ventricle
  • coronary sinus (to pace the free wall of the L ventricle)
40
Q

pacemakers do what 4 things

A
  1. stimulate cardiac depolarization
  2. sense intrinsic cardiac fxn
  3. respond to increased metabolic demand by providing a rate responsive pacing
  4. store diagnostic info to diagnose atrial/ vent arrhythmias
41
Q

extracorporeal shock wave lithotripsy can cause EMI if

A

an abdominal device

42
Q

VOO

A

asynchronous ventricular pacing

ventricular pacing

no sensing

no response to sensing

43
Q

what does an ICD do when it senses V tach

A

anti tachcardia pacing

defibrillate

44
Q

electraocautery can cause EMI if

A

within 6 inches of heart

45
Q

high energy shock (up to 35 joules) to terminate ventricular fibrillation and return heart to normal rhythm

A

defibrillation

46
Q

coding system letters 1-4

(screw 5)

A
  1. chamber being paced
  2. chamber being sensed
  3. how pacemaker responds to sensing
  4. rate responsive?
47
Q

failure to pace is also called

A

oversensing

48
Q

do not withold ___ for fear of EMI

A

transthoracic defibrillation

49
Q

absence of pacemaker spikes when the HR that is slower than the rate set for the pacemaker

A

failure to pace

aka oversensing

50
Q

DDDr

A

dual chamber pacing

dual paced

dual sensed

dual response (inhibitory and triggered)

rate mod active

51
Q

can you do an MRI w/ a pacemaker

A

there are many compatible systems

52
Q

permanent pacemakers are

A

implanted

53
Q

where do you look for axis deviation

A

AVF and lead 1

54
Q

coding system 4th letter

A

whether rate responsive feature is activated

O = none

R = rate responsive

EKG (8 decks)

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