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RCES > RCES EXAM REVIEW QUESTIONS > Flashcards

RCES EXAM REVIEW QUESTIONS Flashcards

1
Q

What exits the patient during fluoroscopy to create a radiographic image?

A

Remnant beam

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2
Q

Which medication is commonly administered to facilitate AVNRT?

A

Isoproterenol

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3
Q

A properly RV pacing lead should produce what Morphology on the surface lead?

A

LBBB

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4
Q

A properly LV pacing lead should produce what morphology on the surface lead?

A

RBBB

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5
Q

What pacemaker adjustment would change the unit from the demand mode to the asynchronous mode?

A

Decreased sensitivity

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5
Q

What is the name of the ridge of tissue in front of the inferior vena cava?

A

Eustachian Ridge

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6
Q

Which of the following is the most important consideration when selecting the site for a peripheral IV in a patient undergoing a device implant?

A

the planned side of implant

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7
Q

Immediately following transeptal puncture, which medication should be given to a patient who is heparin- induced platelet aggregation (HIPA) positive?

A

Integrellin

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8
Q

What is the high/low pass filter for intracardia electrograms in Hertz?

A

30/500

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9
Q

What is the high/low pass filter for surface electrograms in Hertz?

A

.5/100

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10
Q

While assisting with a pacemaker generator change on a pacemaker dependent patient, the doctor attaches the new generator but nothing happens until it is placed back into the pocket why is this?

A

Its a unipolar generator

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11
Q

What functions are programmable in Both VVI and DDD pacemakers?

A

Sensitivity, Voltage output, rate smoothing

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12
Q

Prior to placing a left ventricular pacing lead, what should be preformed?

A

a coronary sinus venogram

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13
Q

The following prerequisites describe which type of tachycardia mechanism?

Two pathways (A&B) must be connected

One pathway must be conduct more slowly

The slower pathway must have a shorter effective refractory period

A

Re entry

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14
Q

The AV node is located at the base of the?

A

RA, at the apex of the triangle of Koch

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15
Q

Most coronary sinus pacemaker leads can accept a wire with a maximum diameter of?

A

0.035”

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16
Q

After correctly positioning the transeptal sheath for a transeptal puncture into the LA, which fluoroscopic position is ideal for viewing the intraatrial septum?

A

RAO

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17
Q

Which ventricular tachycardias are often provoked with exercise?

A

RVOT, idiopathic left posterior fascicular VT, VT associated with ARVC

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18
Q

What is the most common catheter position for preforming an initial VT Study?

A

HRA, HIS, RVOT, RVA

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19
Q

What filter adjustment minimizes signal overlap without adjusting voltage amplitude?

A

Clipping

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20
Q

Which cardiac structure is present during fetal development that may remain patent in adults?

A

Foramen Ovale

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21
Q

When removing a venous sheath, manual pressure should be held where?

A

on the puncture site

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22
Q

What are the benefits of a subcutaneous ICD?

A

Decreased risk of Pneumothorax, Decreased vascular complication, decreased post procedural patient discomfort

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23
Q

What is most likely to perforate the coronary venous vasculature?

A

Guide wires

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24
Q

Which blood test would be ordered prior to pulling a sheath?

A

ACT

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24
Q

What is the most important consideration when selecting a site for an IV in a patient undergoing a device implant? and why?

A

You want to take into consideration the side the device is going on. Usually the opposite of their dominant hand. This is due to wanting the IV to be on the same side to put contrast in to reduce risk of pneumothorax

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25
Q

What should the ACT level be before pulling a sheath?

A

<160

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26
Q

During a pacemaker implant, the sterile gloved hands of the scrub staff must be kept ______ at all times and not drop below_______.

A

In front of chest and, below the scrub staff waist

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26
Q

SVT has just been induced at a cycle length of 278. What is the heart rate and how do you get it?

A

HR= 216 bpm you take 60,000 and divide it bt 278

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26
Q

During an atrial fibrillation procedure, a physician preforms a transeptal puncture and proceeds to advance long wire into the left atrium. What would you expect to see on the screen?

A

The wire should enter the pulmonary veins

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27
Q

The patient begins to complain of shortness of breath after a venography, The patient is exhibiting signs of what?

A

They could be having an allergic reaction to the contrast

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28
Q

The corrected QT interval for a patient with an RR interval of 857 ms and a QT of 395 ms is what? How do you get that?

A

.43 You convert ms to s 857=.857 395=.395 you then do the QT in s divided by the square root of the RR in seconds

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29
Q

Peaked T waves on a 12 lead ECG is associated with what?

A

Hyperkalemia

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30
Q

The name of the ridge of tissue in front of the inferior vena cava

A

The eustachian ridge

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31
Q

Class IIa recommendation indicates that effective prevention and therapy are supported by what classification of recommendations?

A

IT is reasonable to preform (moderate)

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32
Q

Class 1 recommendations indicate that the procedure is what?

A

Useful and beneficial and effective (strong)

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33
Q

Class IIb recommendations indicate that the procedure is what?

A

Less favorable

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34
Q

Class III

A

The procedure is not useful or is harmful ( No benefit)

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35
Q

According to ACLS protocol for an adult patient, what would an acceptable respiration rate during a cardiac implant device procedure?

A

12-18

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36
Q

Focal arrhythmia are typically characterized by presystolic activation timing of a minimum of how many msec

A

200

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37
Q

The BCL is 850 and the SNRT is 1095 msec. What is the CSNRT and how do you get that

A

The CSNRT is SNRT-BCL(Cycle Length)

245 msec

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38
Q

Relative to the coronary sinus the IVC lies where?

A

Inferior and laterally

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39
Q

While advancing the RV catheter, the patient suddenly goes into complete heart block. What would be the most likely explanation for this?

A

The patient has an underlying LBBB

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40
Q

When handling sterile items, it is important to do what?

A

Keep them within the sterile field

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41
Q

Prior to scheduled idiopathic VT ablation, an acceptable pre procedural potassium (K) value is what?

A

3.5-5.4

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42
Q

The most common cause of non- cardiac syncope is what?

A

vasovagal

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43
Q

During ventricular entrainment pacing of an SVT, a post-pacing response of A-A-V is noted. This response is consistent with?

A

Atrial Tachycardia

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44
Q

While ablating near the osmium of coronary sinus, a sudden 60ohm increase in impedance is observed . What does this finding mean?

A

The catheter has fallen into the CS

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45
Q

According to the Joint Commission standards, the critical aspects for patient identification are what?

A

Verbal confirmation of two identifiers with patient

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46
Q

Prior to starting the case, and after explaining the procedure to the patients well as identifying risks and potential complications, permission is given to proceed with the study. This is known as what?

A

Informed Consent

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47
Q

One of the complications specific to PVI is

A

atrioesophageal fistula

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48
Q

For IV conscious sedation, a typical initial dose of fentanyl would be what?

A

25-50 mcg

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49
Q

What are the electrical properties of the cardiac cell?

A

Excitability, automaticity, conductivity

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50
Q

A patient is taken off Coumadin (warfarin) for one week prior to an RF ablation procedure. The INR yields a value of 4. What is the next logical step?

A

Send the patient home and repeat the INR at a later date

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51
Q

What is the normal range for INR for individuals on Coumadin?

A

2.0-3.0

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52
Q

What is the normal range for INR for individuals not on Coumadin?

A

0.9-1.2

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53
Q

Which technology, in addition to fluoroscopy, is most frequently used to identify anatomical landmarks prior to transeptal puncture?

A

TEE

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54
Q

What nerve lies over the right atrial appendage and affects diaphragmatic motion?

A

Phrenic Nerve

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55
Q

When preparing a patient for NIPS, what is the most important thing to have?

A

Back up defibrillator just incase the patient ICD doesn’t shock them out of the arrhythmia

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56
Q

What is the file format that allows healthcare systems to receive and transmit clinic images?

A

DICOM

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57
Q

During LAA Closure device insertion, it is recommended that the ACT is maintained at what?

A

250-350 / 300-400

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58
Q

The activation sequence of the Left Lateral pathway is characterized by what?

A

Distal CS Activating first

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59
Q

DFT may be preformed in what circumstances

A

failed therapy delivery, Congestive HF, Appropriate therapy delivery

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60
Q

At the time of device implant, the atrial sensing threshold should be at least?

A

1.5 mV

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61
Q

Lead conductor fracture usually leads to what

A

High impedance

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62
Q

A properly functioning RV catheter pacing should produce what kind of morphology?

A

LBBB

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63
Q

Give an example of when a pacemaker would be needed?

A

A symptomatic 1st degree AV block with the His Purkinje Disease

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63
Q

A properly functioning LV catheter pacing should produce what kind of morphology?

A

RBBB

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64
Q

What is likely to happen with lead maturation?

A

Electrode encapsulation

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65
Q

Which temporary pacemaker adjustment would change the unit of demand mode to asynchronous mode?

A

Decrease the sensitivity

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66
Q

The primary source of airborne bacteria is what?

A

The healthcare team

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67
Q

The physician orders ibutilide 1 mg IV. What aspect of the patients rhythm should be monitored?

A

The QT interval

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68
Q

Give an example of a class 1a antiarrythmic

A

Procainanmide

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69
Q

Give an example of a class IB AAD

A

Lidocaine

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70
Q

Give an example of a class Ic AAD

A

Flecainide and propafenone

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71
Q

Give an example of a Class II AAD

A

BB Metoprolol

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72
Q

Give an example Class III AAD

A

Amiodarone

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73
Q

Give an example Class IV AAD

A

Verapamil or Diltiazem

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74
Q

Give an example Class V AAD

A

Adenosine

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75
Q

During an open irrigated ablation, the pump alarms. What should you do?

A

Stop ablation and notify physician

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76
Q

Burst pacing protocol consists of what?

A

a fixed pacing sequence

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77
Q

Repetitive delivery of 8 atrial beats at the same cycle length followed by a 9th at a shorter cycle length describes what?

A

Decremental atrial pacing

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78
Q

Tachycardia has just been induced in a patient who did not have an VA block with adenosine. The tachycardia has a V-A of 180 ms. Suddenly, the patient develops a LBBB and the V-A increases to 220 ms. The patient most likely has what?

A

A left sided AP

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79
Q

What is retrograde conduction?

A

Backward conduction, example Ventricles to atria

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80
Q

What is the result of moving the ground patch closer to the site of RF energy?

A

Decreased impedance

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81
Q

During RF ablation, a high impedance reading continually shuts off the RF generator. The first trouble shooting attempt should be what?

A

check if the patient ground id secure

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82
Q

Prior to using the laser sheath for lead extraction a _____ should be used as first attempt.

A

Locking stylet

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83
Q

During monitoring of an RF ablation, you observe the catheter temp reach 80 degrees Celsius. What is the next action?

A

Alert the physician and stop the ablation delivery because of potential coagulum

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84
Q

What is the most common site for idiopathic VT?

A

RVOT

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85
Q

What is the normal range for pacemaker lead impedance?

A

300-1200 ohms

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86
Q

Following an EP/ ablation procedure, what instruction should be included on the post EP discharge education?

A

No heavy lifting

87
Q

What four structures outline the triangle go Koch?

A

Tendon of Todaro, Bundle of His, Septal leaflet of tricuspid annulus , CS os

88
Q

Hypoventilation causes what?

A

PCO2 to increase and pH to decrease

89
Q

Hyperventilation cause what?

A

PCO2 to decease and pH to increase

90
Q

resistance in measured in what unit?

A

Ohms

91
Q

What is the HR in beats for a tachycardia rate of 320 ms? how do you figure that out?

A

60,000/320= 188 bpm

92
Q

How would you measure a capture threshold testing for permanent pacemaker implant?

A

Starts at 5 mV, decrement voltage until capture is lost, the increase voltage until capture comes back and document that value

93
Q

A patient presents with an infected ICD pocket, to prepare for a laser lead extraction, the best source to find lead sizing information for a laser sheath would be where?

A

The SLS reference

94
Q

Hysteresis is used to do what?

A

Promote inartistic conduction

95
Q

What should be done prior to using a temporary pacemaker for pacing?

A

Check date of the last battery change

96
Q

The mA of the stimulator is conventionally set at what?

A

2x the diastolic threshold

97
Q

While providing patient education post-pacer implant, signs of pacemaker malfunction would include what?

A

Dizziness, dyspnea, angina, peripheral edema, return of previous symptoms

98
Q

What medication prolongs the action potential and hence refractoriness?

A

Amiodarone

99
Q

What should be done after a venous subclavian puncture and why?

A

Chest X-ray, due to the risk of a pneumothorax and to confirm correct placement of the catheter

100
Q

A delta wave is cause by what?

A

antegrade AP conduction pre-exciting the ventricular tissue

101
Q

Notification by the EP team to recovery room RN, post accessory pathway ablation, summarizing procedural activities is known as what?

A

Hand-off-report

102
Q

His bundle disease, or damage, is indicated by the prolongation of what?

A

The H-V interval

103
Q

During a cardiac resynchronizing therapy device implant, real-time pacing support, and device programming is achieved by which of the following?

A

Pacing system analyzer (PSA)

104
Q

Repetitive delivery of 8 atrial beats at the same cycle length followed by the 9th beat which is delivered with a progressively shorter cycle length?

A

Decremental atrial pacing

104
Q

What are two examples of pure class III AAD?

A

Dofetilide and ibutilide

104
Q

What is most appropriate action to take when you are unable to discern a pedal pulse on a palpitation?

A

You assess the pulse using a doppler and then make sure it it noted that you used a doppler

105
Q

ICD conductor fracture should be suspected when there is an impedance increase from the baseline of what value?

A

1500 Ohms

106
Q

The on face view of the tricuspid and mitral valve

A

LAO

107
Q

Differentiates atria from ventricles

A

RAO

108
Q

Differentiates Left and Right side of the heart

A

LAO

109
Q

What view helps locate the CS?

A

RAO

110
Q

To reduce radiation exposure the fluoroscopic frame rate should be set at how many frames per second?

A

15 on average, some can get down to 10

111
Q

What 12 lead ECG findings are commonly associated with Arrhythmogenic right ventricular cardiomyopathy/ dysplasia?

A

Epsilon Waves, and T wave inversion

112
Q

What is the most appropriate drug to treat WPW?

A

amiodarone

113
Q

Circulation distal to the femoral artery is best assessed by what pulse?

A

Dorsalis pedis pulse

114
Q

Cardiac signals that display a low and wide signal are described as what?

A

Far field

115
Q

Cardiac signals that display a sharp and narrow signal are described as what?

A

Near field

116
Q

A 12 lead ECG shows an atrial rate of 200ms with a negative saw tooth pattern in leads II,III, and aVF. What is the arrythmia?

A

Typical Counterclockwise flutter

117
Q

A 12 lead ECG shows an atrial rate of 200ms with a positive saw tooth pattern in leads II,III, and aVF. What is the arrythmia?

A

Typical clockwise flutter

118
Q

What is the best way to describe the threshold for a single chamber implantable pacemaker?

A

The minimum about of mA required to elicit a response from the chamber paced

119
Q

How is the left atrium activated simultaneously with the right atrium?

A

Via the Bachman’s bundle

120
Q

The imaging directional term meaning anatomically “Superior”

A

Cranial

121
Q

How is Wilson central terminal average calculated?

A

limb leads RA, LA, and LL

122
Q

A potential complication of VVI pacing is what?

A

Pacemaker syndrome

123
Q

Explain crosstalk when it comes to pacemakers

A

Cross talk is when a lead from one chamber is sensed by the lead in the other chamber. It can only happen in dual pacing

124
Q

Explain Pacemaker syndrome

A

since there is no atrial sensing lead to guide the ventricle, the ventricle contracts at the programmed rate regardless of the timing of atrial contraction. This leads to loss of AV synchrony

125
Q

Prior to the patient being put on the table for an implant, the procedure staff must do what

A
126
Q

What are the indications for a BI-V device insertion?

A

EF less than or equal to 30 and a QRS greater than 150

127
Q

What is the normal value for sodium?

A

135-145

128
Q

What is the normal value for calcium?

A

8.5-10

129
Q

What is the normal value for magnesium?

A

1.5-2

130
Q

What is the normal value for Chloride?

A

95-105

131
Q

What is normal glucose levels?

A

65-110

132
Q

What is normal Cholesterol levels

A

130-200

133
Q

What is the normal value for Aterial blood saturation (SaO2)

A

95-100%

134
Q

What is normal blood pressure?

A

120/80

135
Q

What is normal temperature?

A

97.8-99.1

136
Q

What is normal oxygen saturation?

A

greater than 95%

137
Q

What is normal PaCO2?

A

35-45

138
Q

What is normal PaO2

A

80-100

139
Q

What is normal bicarbonate (HCO3)

A

22-26

140
Q

What are normal troponin levels?

A

0.0-0.4

141
Q

Normal creatine kinase?

A

25-200

142
Q

GFR below 15 means? What do you want your GFR to be?

A

Kidney Failure, Above 90

143
Q

What is normal pH of the blood?

A

7.35-7.45

144
Q

What should be done with used needles?

A

They should be put in the sharps, no need to cap them

145
Q

If a patient is left handed what site would you prepare?

A

Normally you place a pace maker on the left side however, if someone is left handed you would prep the right side

146
Q

Prior to transferring a patient from the table to the bed what must you do?

A

Secure the femoral lines to avoid them being removed

147
Q

What must be done before the surgery?

A

A time out session where the staff verifies the patient, what procedure they are doing, and marking the correct site.

148
Q

When pacing from the CS measuring laterally, what activation time would likely indicate successful ablation of typical flutter?

A

200

149
Q

During open-irrigated ablation, the pump alarms. What should be done?

A

Stop ablation and notify physician

150
Q

During the monitoring of a radiofrequency ablation procedure, you observe the catheter temperature reach 80 degrees. What should you do next?

A

Alert the physician and stop the ablation delivery because of potential coagulum

151
Q

During RF ablation, a high impedance reading continually shuts off the RF generator. What should be your first line of trouble shooting?

A

Check if the patient ground is secure

152
Q

What should be placed in a biohazard bag?

A

All items saturated with blood or bodily fluid

153
Q

What does a low impedance mean during a follow up post pacemaker implant?

A

it means there’s is a possible lead insulation break

154
Q

What does it mean when impedance changes by more than 200 ohms

A

failure in the pacing system or an insulation break.

155
Q

What does it mean when impedance changes by more than 700 ohms?

A

Lead wire fracture

156
Q

If the impedance is greater than 1500 what does that mean?

A

Lead wire fracture

157
Q

What does it mean if impedance is less than 300?

A

Insulation break

158
Q

During an RF ablation of AVNRT, there is a loss of retrograde atrial conduction. What do you do next?

A

Stop RF application as the ablation is complete once there is not dual pathway present

159
Q

Tachycardia initiated by an impulse that blocks in the fast pathway and conducts through the slow pathway is described as what?

A

AVNRT

160
Q

Where is the tricuspid valve?

A

On the right side of the heart

161
Q

Where is the mitral valve?

A

On the left side of the heart

162
Q

When looking at the tricuspid and mitral valve from the superior portion where is the aortic valve and pulmonary valve?

A

The aortic valve in medial and slightly superior and then the pulmonary valve sits right above the aortic valve

163
Q

When draping a patient for a pacemaker implant what area do you drape?

A

You drape the area closest to you to continue to keep a sterile environment and avoid any on sterile items coming in contact with you.

164
Q

ICD conductor fracture should be suspected when there is an impedance from the baseline of what?

A

1500 Ohms (300-1200 is normal)

165
Q

alpha particles, beta particles, gamma rays, and X-rays (Fluoroscopy). These are all examples of what?

A

Ionizing radiation

166
Q

Ultra-Violet light, visible light, infrared, radio-frequency (EP ablation) and microwaves. These are examples of what?

A

Non- ionizing radiation

167
Q

With exception of the local stimulus of above normal strength, which of the following refractory periods describe the timing during depolarization in which the longest coupling interval of input into a tissue fails to produce capture?

A

Effective

168
Q

the time elapsed between the end of ERP to the beginning of phase 4 of the action potential.

A

relative

169
Q

is the shortest coupling interval between two successive conducted impulses, measuring both refractoriness and conduction velocity of the tissue of interest.

A

Functional

170
Q

Depolarization of the cell occurs at what phase and why?

A

Phase 0.This occurs because the sodium channels open allowing positively charge sodium ions to to rush into the cell

171
Q

Repolarization of the cell occurs at what phase and why?

A

Phase 0-3. this occurs because the sodium channels close ending the influx of sodium ions into the cell. Potassium ions begin to flow out of the cell starting the repolarization process. Next calcium channels will open allowing calcium ions to move into the cell. Finally calcium channels close but potassium keeps coming out of the cell. the sodium potassium pump pushes sodium out of the cell and pulls potassium back in. 3 sodium to 1 potassium

172
Q

Explain phase 0 action potential

A

Sodium channels open allowing sodium ions to rush into the cell

173
Q

Explain phase 2 action potential

A

calcium channels open allowing calcium ions into the cell known as the absolute refractory period where the cell cannot be depolarized.

174
Q

Explain phase 3 action potential

A

calcium channels close but potassium ions keep coming out of the cell. a sodium potassium pump pulls sodium ions out of the cell and pulls potassium ions back into the cell completing depolarization repolarization. This is the relative refractory period of a cardiac cell – during this time the cell will depolarize if given a strong enough stimulus.

175
Q

Explain phase 4 action potential

A

The distribution of sodium and potassium ions is restored, and the cell is available for depolarization.

176
Q

Explain phase 1 action potential

A

sodium channels close stopping sodium ions to come into the cell. Potassium ions begin flowing out of the cell

177
Q
A
178
Q

What are indications for single or dual chamber ICD implants?

A

Primary and secondary preventions, incessant VT

179
Q

After connecting the ablation catheter to the ablation cable, it is observed on the recording system that one of the bipolar is not displaying any information. What is the FIRST step to take?

A

Disconnect and reconnect the ablation cable

180
Q

During an ablation for atrial tachycardia near the bundle of His, a patient goes into complete heart block. The next logical step would be to?

A

Stop ablation and prepare for a pacemaker

181
Q

Defibrillation threshold testing (DFT) may be preformed in which circumstances?

A

Congestive Heart Failure, Post MI, failed therapy delivery

182
Q

During an electro-anatomical mapping procedure the system gives a patient movement warning. What is the next recommended step?

A

No action required

183
Q

During an RF ablation, the baseline impedance is 180 ohms as measure through the ablation catheter this can be corrected by what?

A

Adding a second grounding patch or moving the patch closer to the heart. The closest to the heart the lower the impedance, the further away from the heart the higher the impedance

184
Q

What is normal impedance for ablations?

A

90-120 ohms

185
Q

High impedance in ablations can cause what?

A

Char, or thrombus

186
Q

How do you know based on impedance if you have achieved a successful lesson formation?

A

There will be a 5-10 ohms drop

187
Q

What is normal temperature for ablation catheters?

A

50-70 degrees c

188
Q

Catheter temps above 70 can cause what?

A

Char and thrombus

189
Q

Catheter temps above 100 can cause what?

A

Steam pops

190
Q

What is the normal power for an ablation

A

20-60 watts

191
Q

Low power will do what?

A

ineffective lesion

192
Q

High power can cause what?

A

Promotes char, thrombus, steam pops

193
Q

What is the relationship between power and temperature

A

The higher the power the higher the temperature. The lower the power the lower the temperature

194
Q

A 300 pound patient is prepped for an RF ablation. Baseline impedance is 200 ohms. The next step would be to do what?

A
195
Q

Dextrocardia is what?

A

When the heart is on the right side of the body instead of the left

196
Q

What is transportation of the great vessels?

A

the aorta starts from the right ventricle and the pulmonary artery from the left ventricle. instead of normal position where the aorta starts from the Left ventricle and the pulmonary artery starts from the right ventricle

197
Q

What is persistent Left Superior vena cava?

A

A defect where the PLSVC runs between the left pulmonary veins and the left atrial appendage enlarging the coronary sinus as it enters the atrium.

198
Q

When preparing to transport a patient for a cardiac device implant, what documents must be updated and reviewed?

A

H&P, signed patient consent

199
Q

When ablating the osmium of the coronary sinus, a sudden 60 ohm drop occurs. What does this finding indicate?

A

Ablation catheter has fallen into the CS

200
Q

How can you tell the difference on an EGM of PVI entrance block vs exit block

A

Entrance block will occur in the proximal leads and fade as they get to the distal leads, an exit block will start at the distal leads and fade as it moves more proximal

201
Q

What is PMT in a pacemaker?

A

Pacemaker mediated tachycardia is a type of arrhythmia that happens in patients with dual-chamber pacemakers

202
Q

what is mode switching in a pacemaker?

A

the ability of a pacemaker to reprogram itself from tracking to non-tracking mode in response to atrial tachyarrhythmias, and to regain tracking mode as soon as the tachyarrhythmia terminates.

203
Q

What meds should be given to a patient with WPW who comes in with wide complex VT?

A

Amiodarone

204
Q

What pacing protocol are most likely to induce typical atrial flutter?

A

PES from the proximal cs and from the lateral RA

205
Q

carotid massage would be preformed on a patient with syncope and?

A

a negative EP study

206
Q

If a QRS is wide during AVRT what does that mean?

A

It means the AVRT is antidromic, or in a retrograde fashion

207
Q

If a QRS is narrow during AVRT what does that mean?

A

it means its orthodromic, in a normal fashion

208
Q

how do you decide if a AVRT is right or left sided?

A

If its right sided it then the ventricular deflection of the RVA proceeds the “V” deflection of the His EGM. If it is left sided. If ventricular deflection of the proximal CS precedes the “V” deflection of the His EGM

209
Q

(-) delta wave on V1 =

A

right sided

210
Q

(+) delta wave on V1=

A

left sided

211
Q

AVNRT is what kind of mechanism of activation?

A

Macro- reentry

212
Q

What is a normal AH interval?

A

50-120

213
Q

What is a normal HV interval?

A

35-55

214
Q

What is a normal QRS?

A

less an 120

215
Q

During tachycardia, if “A” and “V” signals are fused on the distal CS (1-2), the AP resides on

A

Left side

216
Q

f the “A” and “V” signals are fused on the proximal CS (9-10), the AP resides on the

A

right side

217
Q

Increase in V-A interval if RBBB develops

A

Right side

218
Q

Increase in V-A interval if LBBB develops

A

Left sided

219
Q

WPW is a form of what tachycardia?

A

Orthodromic AVRT

RCES (3 decks)

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