RCES Exam Flashcards
During RF ablation, a high impedance reading continually shuts off the RF generator. The first trouble shooting attempt should be to:
Check if the patient grounding pad is secure.
During monitoring of a radio frequency ablation procedures, you observe the catheter temperature reach 100 degrees C. What is the next action?
Alert the physician and stop the ablation delivery because of potential coagulum.
The technologist is assisting the physician with a PVI. Midway through a burn, micro-bubbles appear on the ICE image. The technologist should:
Tell the physician to stop burning.
What is the usual result of moving the ground patch closer to the heart for RF energy ablation?
A decrease in impedance.
One of the complications specific to PVI is:
Atrioesophageal fistula
An impulse that blocks in the fast pathway and conducts through the slow pathway describes what arrhythmia?
AVNRT
The mA of the stimulator is conventionally set at:
2x diastolic threshold
What is the appropriate high/low pass filters for the surface lead ECG in Hertz?
0.5/100
The formula for cSNRT is:
SNRT - Sinus Cycle Length = cSNRT
What mechanisms of tachycardia is the most common?
Reentry
The most common site of triggers for atrial fibrillation is/are the:
Pulmonary Veins
Burst pacing protocol consists of delivery what?
A fixed sequence pacing train
Following successful atrial flutter ablation, the stim to activation time as measured on the distal pole of the multi-pole catheter should measure at least what?
150 msec
While advancing the RV catheter, the patient suddenly goes into complete heart block. What old be the most likely explanation for this?
The patient has an existing LBBB
What is the most common site for idiopathic VT?
The right ventricular outflow tract
With the exception of a local stimulus of above normal strength, what refractory period describe the time during repolarization in which the longest coupling interval (s1, s2) of input into a tissue fails to produce capture?
Effective Refractory Period
What is the appropriate high/low pass filters for intracranial electro grams in Hertz?
30/500
During cryoablation for atrial fibrillation, what ensures avoidance of phrenic nerve damage?
High output pacing during ablation
What may be a sign of an embolism stroke immediately after a successful transeptal puncture?
Facial weakness and drooping on one side of the patient
What is the commonly used needle to obtain transeptal access?
Brokenbrough needle
What diagnostic catheter is used to drain the pericardial sac for a percardiocentesis?
Pigtail
In a typical bundle branch reentry ventricular tachycardia, the reentry signal initiates ante-grade down the right bundle branch (RBB) to what will complete the reentry circuit?
Retrograde up the left bundle branch (LBB)
What is the most appropriate for a 14-year old female patient who requires an ablation for AVNRT?
4mm cryoablation
What is monitored and documented during a typical tilt table test?
Blood pressure, ECG rhythm, and HR
To minimize the effects of signal artifact or environmental noise, how must all EP lab equipment be set up?
Isolate all EP equipment to a separate designed power circuit
If an atrial flutter cycle length is 280bpm, then what is the cycle length in milliseconds?
214ms
Ablating which section increases concern and risk for damaging the esophagus?
Posterior Left Atrium
During an Atrial Fibrillation using the pulmonary vein isolation (PVI) technique, pacing the coronary sinus (CS) will do what?
Check for entrance block
What is an upper acceptable value for a corrected SNRT?
540ms
What cryo-ablation temperatures cause effective tissue damage and lesion formation?
45 degrees C to 65 degrees C
Successful flutter ablation should show stimulus to activation conduction time measuring at least:
> 150ms
What verifies successful isthmus conduction block for a typical atrial flutter ablation?
> 150ms
For either one of the current mapping systems, what color setting is used to distinguish health tissue during vintage mapping?
Purple
During a tilt table test, the room should be:
Quiet with lights dimmed to establish a relaxing environment
If a tachycardia cycle length is 600 milliseconds, what is its rate in beats per minute?
100bpm
Activation mapping of 3D electro anatomical mapping system provides what?
Displays border region of earliest tissue activation, shows early-meets late patterns.
Which mechanism is defined by 1. Slow zone of conduction, 2. Unidirectional block in part of the tissue, and 3. Slow enough conduction allowing tissue to become refractory?
Reentry
Bradycardia is defined as a heart rhythm that is slow at a rate below:
60bpm
Failure of the SA node to adequately generate an appropriate number of intrinsic (native) electrical impulses define what term?
Failure of impulse generation
What are the three different mechanisms of activation that propagate tachycardias?
Reentry, triggered, and automaticity
Activity which propagates double activation of a cardiac cell from a single initial activation, resulting from the presence of upward deflections is known as what mechanism of activation?
Triggered activity
Delayed after depolarization (DAD) occur in which phase of the action potential of triggered activity?
Phase 4
Regarding tachycardias, what is the most common mechanism of activation?
Reentry
Baseline EGM measurements are generally performed at what recording speed?
200mm/sec.
Measuring the precise moment in time when the depolarization/activation wave front passes thought the mid-point between an electrode pair, manifested by the apex point of the EGM deflection is known as:
Zero-Cross over point approach
What is normal value for PA interval?
25ms - 55ms
What is normal value for AH interval?
55ms - 125ms
What is normal value for HV interval?
35ms - 55ms
What is normal value for HBE interval?
<30ms
PPI - TCL =
Circuit Distance
VA time <70ms =
AVNRT or AT
VA time >70ms =
AVRT
PPI - TCL = 115ms is what?
AVNRT or AT
PPI - TCL = <115ms is what?
AVRT
The wenckebach period is just a test of what?
The overall AV conductivity
Pseudo R prime in V1 is what?
Classic AVNRT
The esophagus is closest to which side of the pulmonary veins?
Left Pulmonary Veins
What interval measurement could indicate electrolyte disturbances like hypokalemia and hypocalcemia?
QT
Bradycardia is defined as:
A slow heart rhythm with rates below 60 and dizziness
Symptoms of bradycardia can include:
Syncope, dizziness, fatigue, SOB, confusion and diminished mental acuity
These can cause bradycardia:
Sick sinus syndrome, chronotropic incompetence, and sinus arrest
First degree AV block is defined by:
A PR interval of 200ms or greater
Second degree heart block (wenckebach) is characterized by:
Progressively lengthening PR interval followed by a dropped QRS
Third degree heart block is characterized by:
Dissociated (no relationship) P-waves to the QRS complex
The tests used to try and document bradycardia are:
Holter monitor, event recorder, and implantable event recorder
A corrected sinus node recovery time (CSNRT) is characterized by:
Subtraction the sinus cycle length from the time it takes a sinus beat to occur after rapid atrial pacing.
An EP study scheduled to diagnose causes of bradycardia would include:
HRA, His, and RV catheters
A junctional escape rhythm is characterized by:
A rate of 40-60, A narrow complex QRS rhythm, A proximal AV nodal block
Describe atrial tachycardia:
- An atrial focus other than the SA node. 2. An ectopic atrial pacemaker coming from structures near the atria. 3. An atrial focus coming from the pulmonary veins causing a tachycardia rate of 15 beats per minute.
Describe the symptoms of atrial tachycardia:
Dizziness, chest pain, palpitations
The common locations for atrial tachycardia:
The crystal terminalis, the pulmonary veins, the coronary sinus ostium
The following are classified as atrial tachycardias:
Focal atrial tachycardia, multi focal atrial tachycardia, intra-atrial re-entry tachycardia
Atrial tachycardia P-wave morphology will most likely resemble the sinus P-wave for which focus?
Superior Vena Cava (SVC)
Ventricular entrainment during atrial tachycardia with tachycardia continuing after pacing reveals:
V-A-A-V response
Intra-Atrial conduction time, time it takes for the electrical signal to travel from the SA node to the AV node.
PA interval
Trans-nodal conduction, or the time it takes for the electrical signal to travel through the AV node.
AH interval
Time through His Purkinje System, the time it takes for the electrical signal to travel from the His bundle to the ventricles.
HV interval
Corresponds to the total conduction time through the His Bundle
HBE interval
In Atrial Flutter: CS 1,2 PPI - TCL = <30ms
Left Sided A. Flutter
In Atrial Flutter: CS 1,2 PPI - TCL = >30ms
Right Sided A. Flutter
In Atrial Flutter: CS 9,10 PPI - TCL = <30ms
Right Sided A. Flutter
In Atrial Flutter: CS 9,10 PPI - TCL = >30ml
Left Sided A. Flutter
Flutter waves negative in II, III, aVF and positive in V1 =
Counter Clockwise Flutter
Flutter waves positive in II, III, aVF and negative in V1 =
Clockwise Flutter
On surface ECG, the P-waves are upright in V1 and have a sawtooth pattern in the inferior leads:
Typical A. Flutter
On surface ECG by notched, upright P=waves in the inferior leads and inverted P-waves in V1 =
Atypical Flutter
The largest vein in the heart. It drains over half of the deoxygenated blood from the heart muscle into the RA.
Coronary Sinus (CS)
What catheter is important for determining activation sequence in atrial tachycardia diagnosis?
Coronary Sinus Catheter
Multi focal atrial tachycardia refers to:
A tachycardia focus from more than one area of the atrium.
Patients with atrial flutter:
- Have a higher risk of developing atrial fibrillation, 2. Have a sawtooth appearance pattern on the 12-lead ECG, 3. Have a higher risk of stroke.
Typical flutter uses all of the following structures in its circuit:
Tricuspid annulus, lateral right atrial wall, atrial septum
The perpetuation (the continuation or preservation of a situation) of typical atrial flutter requires:
The SVC
Clock-wise flutter is characterized by all of the following:
- The flutter wave front traveling down the atrial septum, 2. Positive P-wave in the inferior leads, 3. The wave front traveling up the lateral anterior right atrial wall.
Atypical atrial flutter may be the result of:
Scarred atrial tissue, previous surgical intervention, previous ablative therapies.
These are elements of entrainment:
- Is a maneuver to assist in locating the structures in the flutter circuit. 2. Requires pacing the atrial tissue at a flutter to advance to the pacing cycle length while pacing.
Atrial fibrillation is noted for:
Chaotic atrial activity
Atrial fibrillation symptoms include these:
Weakness and fatigue, palpitations and chest pain, shortness of breath and confusion.
These are causes of atrial fibrillation:
- Sleep apnea, 2. Exposure to stimulants like caffeine, tobacco, or alcohol 3. High blood pressure
This structure is a suspect in clot formation i patients with atrial fibrillation:
Left atrial appendage
Progression of atrial fibrillation is defined:
Paroxysmal, Persistent, and Permanent
Complications of A. Fibrillation ablation:
- Atrial esophageal fistula and phrenic nerve damage, 2. Cardiac tamponade form cardiac perforation, 3. Stroke and fluid overload
Entrance and Exit block of the pulmonary veins refers to:
Pulmonary vein potentials not able to exit and enter the pulmonary vein
What catheters are commonly utilized for an A. Fib ablation?
ICE, Lasso, Ablation, and Coronary Sinus
The initiation of A. Fib most commonly originates from:
Pulmonary Veins
A conduction impulse that initially blocks down the fast pathway and slowly conducts over the slow pathway to initiate a reentry to rhythm describes which arrhythmia?
AVNRT
True or False, AVNRT is a micro-reentrant tachycardia:
True
When viewing a 12-Lead ECG of AVNRT, the P-wave may not be present, if present it will occur after the QRS or be a:
Retrograde P-wave
During AVNRT, ECG will display a tachycardia with a rate of:
150 -220 bpm
To terminate AVNRT pharmacologically, what will be the initial dose of adenosine?
6mg IV
In typical AVNRT, which pathway will a premature beat initially block and then what pathway will the impulse propagate down?
Initially block down the fast pathway (FP), then propagate down the slow pathway (SP).
Conduction occurring down the slow AV nodal pathway and up the fast AV nodal pathway is:
Typical AVNRT
What non-pharmaceutical technique can also terminate AVNRT?
Carotid Massage
True or False, A jump is defined during extra-stimulus pacing (S1, S2) in which decrements of 10ms on S2 demonstrates a jump in the A2H2 interval of >50ms, indicative of refractories in the fast AV nodal pathway:
True
In AVNRT, what pacing technique typically reveals the presence of a jump?
Programmed atrial stimulation (A1, A2).
True or False, Slow junctional rhythm can be a normal finding during a AVNRT ablation:
True
True or False, The slow pathway is routinely ablated for AVNRT:
True
Where is the fast pathway located?
Superior to the triangle of Koch
A beat that returns to its origin and is actually a single beat of reentrant tachycardia that failed to sustain AVNRT is:
An ECHO beat
What is the most common form of SVT?
AVNRT
AVNRT can be initiated with what pacing maneuver?
Premature atrial pacing, also called extra-stimulus pacing
In AVNRT, a delta wave is produced as a result of:
Ante-grade accessory pathway (AP) conduction which pre-excites atrial tissue.
What best describes a manifest accessory pathway?
Presence of a delta wave preceding the QRS complex surface ECG.
True or False, An accessory pathway with anti-grade conduction, displaying a pre-excited delta wave, is known as Wolff-Parkinson-White (WPW) syndrome:
True
Orthodromic tachycardia is defined as:
Tachycardia with normal conduction down the AV node and then up the accessory pathway.
Antidromic tachycardia is defined as:
Tachycardia is when the conduction travels down the accessory pathway and then up the AV node.
True or False, During manifest activation, the delta wave will become more prominent as more of the ventricle is activated via the accessory pathway during rapid atrial pacing (burst pacing):
True
AVRT is a:
Macro Reentry Circuit
True or False, A mahaim Fiber is a type of AP located similarly to the AV node on the tricuspid annulus and displays decremental properties, directly connecting to the fascicle of a bundle branch rather than the ventricle like the typical AV nodal accessory pathway:
True
In orthodromic AVRT, is the QRS complex narrow or wide?
Narrow
In antidromic AVRT, is the QRS complex narrow or wide?
Wide (pre-excited)
A patient in AVRT has a V-A time of 165ms. The patient then develops a left bundle branch block (LBBB) and the V-A times jumps >50ms, patient most likely has:
Left Sided accessory pathway
The most common catheter position and sites when performing a diagnostic EP study for VT are:
HRA, HIS, RVA, RVOT
Damaged cardiac tissue as a result of diminished or no blood supply describes which type of cardiac disease tissue?
Ischemic
This is the most common site for idiopathic VT is the:
RVOT
VT is considered sustained when it is maintained for:
30 sec.
If a patient has VT and is shocked at 22 sec. Because the patient is hemodynamically unstable, the VT is considered:
Sustained
This chamber is the most susceptible to ischemic, scar based VT’s:
Left Ventricle (VT)
Reentrant criteria for reentrant VT:
- Conduction around an in-excitable obstacle. 2. Zone of slow conduction, 3. Pathway of unidirectional block
The condition where fatty tissue infiltrates or fibrous tissue replaces normal myocardial tissue of the RV is known as:
Arrhythmogenic Right Ventricular Dysplasia (ARVD)
This is a genetic disorder that affects the ion channels (sodium, potassium) of cardiac cells can result in a arrhythmia called Torsade de Pointes:
Long QT Syndrome (LQTS)
These devices have been proven to reduce mortality of selected patients at risk for sudden cardiac death is:
Implantable Cardioverter Defibrillators (ICD)
True or False, Patients with Brugada Syndrome will usually present with a right bundle branch block (RBBB):
True
Patients with Brugada Syndrome will present with stable ST segment elevation in:
V1-V3
A drive train has a series of 6-8 paced beats at a fixed cycle length is considered known as:
S1
SNRT assessment is performed by:
Pacing the atrium for 30sec. And measuring last paced A to first intrinsic A
When evaluating the sinus node function, an abnormal CSNRT value would be:
575ms
The longest coupling interval of a premature stimulus which does not conduct through to the AV node is known as:
AVNERP
The longest coupling interval for a premature stimulus which does not conduct to depolarize ventricular tissue:
VERP
Normal H-V conduction interval is:
35 - 55ms
Electrical stimuli that causes depolarization of the chamber being stimulated is known as:
Capture
The minimum current needed to capture a chamber with pacing stimulus is known as:
Threshold
When incremental burst pacing (S1) faster until loss of 1:1 ratio in AV conduction is noted, the longest S1 coupling interval that fails to conduct 1:1 is known as what?
Wenchebach
Burst pacing is:
Pacing at a fixed cycle length
Introduction of one or more premature paced beats (extra-stimulus) at a shorter cycle length after the preceding pacing train which is a fixed cycle length (s1, s2), is which type of pacing?
Incremental
When burst pacing the RVA via a EP catheter, the pacing output should be set to a least:
1.0 mA more than threshold determination.
What condition may lead to CHB while advancing an EP catheter to the RVA?
Left Bundle Branch Block (LBBB)
RV pacing with proper capture produces an ECG morphology resembling:
Left Bundle Branch Block (LBBB)
When performing threshold determination, stimulus output is conventionally set to a minimum of at least 3 mA or:
2 x threshold minimum
A typical drive train consists of:
8 beats
Ventricular arrhythmia induction is assessed with:
Programmed Electrical Stimulation pacing (PES pacing)
Dual AV node physiology is assessed with:
Decremental pacing
Atrial tachycardias may be difficult to initiate, however to most effective pacing maneuver is:
Burst or decremental pacing
What should the next step be to trouble shooting when the ablation generator shuts off with a high impedance error message?
Ensure the grounding pad is properly applied to the patient
When performing an ablation with an open irrigated ablation catheter, what must be done when the irrigation pump alarms?
Stop the pump and notify the performing physician.
What is the primary cause of temperatures observed over 100 degrees Celsius during radio-frequency ablation?
Catheter tip coagulum and char
The common tip size for a cryoablation catheter tipis:
4mm
If bubbles are observed on intra-cardiac ultrasound (ICE) during left-sided ablation, the EP staff:
Stop the pump and notify the performing physician.
What is the next step if a patient’s rhythm changes to complete heart block during ablation near the His bundle?
Stop ablation and start ventricular pacing or prep for temporary pacing.
An effective lesion formation during radio frequency ablation is marked by:
Decrease in impedance, 5-10 ohms
Moving the grounding pad closer to the heart will likely result in:
Decrease in impedance (ohms)
A severe complication to left atrial ablation that is often monitored for is:
Esophageal
What situation should require the use of a 10mm tip and/or high-output 100 watt generator for ablation?
When a larger myocardial lesion is desired, i.e. thicker tissue like the isthmus and ventricular tissues.
What nerve should be considered when ablating the lateral regions of the right heart?
Phrenic Nerve
In a typical atrial flutter case, post ablation endpoint must prove:
Bi-directional block has occurred across the area where ablation was performed.
Which type of ultrasound can be done the same day without need for sedatives?
TTE (Transthoracic ECHO)
The functional part of an ultrasound probe is the referred to as the:
Transducer
Positioning the ICE catheter in the RA, just above the terminal end of the IVC, with the transducer printed with a leftward-anterior transducer face yields which of the following views?
Home view
After insertion of the ICE imaging for transseptal access?
Clockwise rotation from home view
Visual presentation of ultrasound in which the depth of echo is displayed along one axis and time is displayed along a second axis, recording motion of interfaces away and towards the transducer is known as:
M-Mode
The technology of ultrasound using the high frequency sound waves to image, measure and calculate blood flow is known as:
Doppler
Aspiration is a usual complication of which type of ultrasound modality?
TEE
3D electro-anatomical mapping systems display a variety of unique mapping techniques that include:
Voltage Mapping, Activation Mapping, Propagation Mapping
In voltage mapping, voltage values of <1.5mV is considered abnormal cardiac tissue, and values <0.5mV is considered:
Scar
On the CARTO mapping system, low voltage will be depicted in which color?
Red
The technique that utilizes a recorded ECG/EGM of a cardiac activation morphology green aged by an arrhythmia to be compared against paced activation morphologies in attempts to reproduce and match morphologies, which identifies the origin of the arrhythmia is known as:
Paced mapping
The mapping technique that requires the advancement of the tachycardia rate to that of the paced cycle length without altering the morphology of the tachycardia is:
Entrainment mapping
The leading cause of syncope is:
Vagal hypersensitive it’s syndrome
Rapid and temporary interruption of cerebral perfusion manifested by loss of consciousness, for a brief duration followed with spontaneous recovery is:
Syncope
The condition in which a nervous system response of sudden decrease in blood pressure, HR and CO, preceded by prodromal symptoms including, nausea, lightheaded nests, diaphoresis and feeling of warmth is:
Vasovagal
This is a condition in which a change from the supine position to an upright position causes an abnormally large increase in HR is:
POTS (Postural Orthostatic Tachycardia Syndrome
In addition to tilt table testing, syncope may also be evaluated by:
CT, MRI scans, EEG, trans-cranial Doppler, Metabolic testing
This is a portable, wearable device that records a patient’s ECG over a period of time, generally 24-48 hours:
Holter
What is utilized specifically to prove neuro-cardiogenic (vasovagal) syncope or to rule it out?
Tilt Table Test
Indication for use of a holter monitor includes:
Complaints of palpitations increasing in frequency
Which is the correct signal path from patient cardiac tissue to the EP recording system?
Patient cardiac tissue > Catheter > Cable > J Box > EP recording system
> = to next
True or false, Sequential powering up of EP equipment is essential for proper systems communication:
True
What takes all incoming cardiac patient signals and also functions as the gateway interface to the EP recording system, stimulator?
Amplifier
What device is used to deliver therapeutic energies to cardiac tissue?
Ablation Unit
What device used to interface the inter-cardiac EGM connection from the EP catheter?
Junction Box and Pin Box
What can affect signal quality and acquisition?
Signal pathway, circuits and grounding, proper connections
What are common high/low pass filter of a typical EP recording system?
0.5 - 100Hz
The filter setting that eliminates signal below a set frequency threshold or cut-off, allowing high frequencies to pass through the set cut off is what?
High band pass filter
The limiting of EGM signal amplitude (positive and negative), reducing signal overlapping of EGM’s is best achieved by what?
Clipping
What filter eliminates electric signal noise of 60Hz that is inherent in North American alternating current?
Notch Filter
Typical High Pass EP recording system filtering is generally set at what?
30 - 50Hz
Typical Low Pass EP recording system filtering is generally set at what?
300 - 500Hz
EGM signals recorded from localized tissue in contact between two catheter electrode pairs, displaying a narrow and sharp signal deflections is best described as what?
Near-Field
What is the corrected sinus node recovery time measured at 1395ms and a sinus cycle length measured at 775ms?
618ms
What is the formula to calculate corrected sinus node recovery time (cSNRT)?
SNRT - SCL
Ohms Law:
V = IR (voltage, current, resistance)
During open-irrigated ablation, the pump alarms beep. What should be done?
Turn off pump and notify the physician to turn flow off to patient.
The only cryoablation catheter to both map and ablate is:
4mm
During a cryoablation for atrial tachycardia near the bundle of His, a patient goes into complete heart block. The next logical step would be to :
Stop ablation and prepare for pacemaker.
A delta wave is caused by:
Antegrade accessory pathway conduction pre-exciting the ventricular tissue.
Carotid sinus massage would be performed on a patient presenting with syncope and:
A negative catheter study
When extracting fluid from the pericardial space, what catheter is normally used?
6F pigtail
Two pathways (A & B) must be connected. One pathway must conduct more slowly. The slow pathway must have a shorter effective refractory period is:
Re-entry
Tachycardia has just been induced in a patient who did not have V-A block with Adenosine. The tachycardia has a V-A of 180ms. Suddenly, the patient develops LBBB and the V-A increases to 220ms. The patient most likely has:
A left sided accessory pathway
Repetitive delivery of 8 atrial beats at the same cycle length followed by the 9th beat which is delivered with a progressively shorter coupling interval describes what pacing protocols?
Atrial extrastimulus
What are the most common catheter positions for performing an initial VT study?
HRA, HIS, RVOT, RVA
When performing stimulus testing for a typical atrial flutter procedure, which of the following differences between the PPI and TCL during entrainment mapping indicates that the pacing site is within the flutter circuit?
7ms (other choices were 33ms, 55ms, or 151ms)
What information in the patient’s medical history is contraindicated to proceed with a transeptal procedure?
History of stroke
The patient’s physician decides to perform an electric cardio version for atrial fibrillation with irregular ventricular rates after a CFAE atrial fibrillation (Complex Fractionated Atrial Electrograms). What is the most appropriate setting to cardiovert the patient from atrial fibrillation into normal sins rhythm?
150 joules synchronized
A technique to verify successful access to the pericardial space involves attaching an ECG lead to the access needle. Doing so will produce what ECG effect when making needle contact with the ventricle?
ST segment elevation
What is most important in ensuring optimal ECG and EGM signal acquisition?
Grounding the patient
For stimulation pacing induction, the mA on the stimulator should be set at least at:
2 times capture threshold
What type of pacing stimulation protocol is used to obtain Wenckebach (AV node cycle length)?
Decremental Pacing
What nerve drapes over the back of the right appendage and affects diaphragm motion?
Phrenic Nerve
Pacing the grounding pad closer to the ablation catheter tip will:
Decrease impedance
In pace-mapping, ideally you are looking for:
12/12
What is pacemapping mostly used for?
Ventricular Tachycardia morphology comparison
If a tilt table test is positive, the first thing you should do is:
Lay the table down flat, placing the patient in the patient in the supine position.
A patient states that he/she experienced a contrast allergy two years prior, which included a skin rash and hives. What is most appropriate for the patient to receive as a premedication?
Prednisone 60mg PO, Methylprednisolone (Solu-Medrol) 40mg IV, Hysrocortisone (Solu-Cortef) 200mg IV
The expression Psystolic - Pdiastolic is used to derive what?
Pulse Pressure
An epinephrine IV drip is ordered during an EP procedure in response to a quick drop of the patient’s blood pressure, which is critically low. What primary mechanism of action results in the blood pressure rise once epinephrine is infusing?
Vasoconstriction
What is the most appropriate fluoroscopy view in viewing the RV apex?
RAO
What is the most appropriate fluoroscopy view in imaging the distal coronary sinus for optimal bi-ventricular lead positioning?
LAO
What has an increased risk of occurring as a result of attempting a femoral artery puncture for vascular access above the inguinal ligament?
Retroperitoneal bleeding/hematoma
What brings oxygenated blood to the left atrium?
Pulmonary Veins
A 12-Lead EKG of VT with a positive QRS in Lead I and negative QRS in aVF usually indicates:
Left Axis Deviation
What is the name of the ridge of tissue in front of the inferior vena cava?
The Eustachian Ridge
What nerve drapes itself over the right atrial appendage and affects diaphragmatic motion?
Phrenic Nerve
The left atrium is activated simultaneously with the RA via:
Bachman’s Bundle
Tall peaked T-waves on a 12-lead ECG is associated with what?
Hyperkalemia
What medication markedly prolongs the action potential duration and hence refractories?
Amiodarone
Circulation distal to the femoral artery is best assessed by:
Dorsalis Pedis Pulses
When draping a patient for a pacemaker implant, the technologist drapes the area:
Closest to themselves first
Which value directly interferes with or obstructs access into the coronary sinus (CS)?
Thebesian Valve
