Rces Review Part 1 Flashcards
Pacing leads consist of how many major components?
5
Electrodes Conductors Insulation Connector pin Fixation mechanism
A limitation of ultrasound ablation is that it is not relevant for which of the following?
Common left pulmonary veins
Common left atrial veins
Common right pulmonary veins
Common right atrial veins
Common left pulmonary veins
Ultrasound ablation is not relevant for common left pulmonary veins due to the bulky balloon size needed to engage a common ostium. The top most limitation of ultrasound balloon ablation systems is that they necessitate the ablation balloon to be aligned along the axis of a pulmonary vein. This can be difficult, principally for pulmonary veins with several early branches.
The most universal symptom of myocardial ischemia and infarction is:
Retrosternal chest discomfort, the patient may describe this discomfort more as pressure or tightness than genuine pain
The best example of measuring conduction velocity from intracardiac electrograms is given by which of the following electrograms?
Atrial
Ventricular
His bundle
All of the above
His bundle
The his bundle electrogram is the best example of measuring conduction velocity from intracardiac electrograms. The his bundle electrogram contains signals from all of the critical structures of the av conducting system that are needed to measure conduction velocity
When performing an ablation, which of the following tissue temperatures must be reached above before cell death will occur?
50 degrees c
40 degrees c
30 degrees c
20 degrees c
50 degrees c
When performing an ablation the tissue temperature has to be above 50 degrees c before or will cause cell death. Cell death is considered to be irreversible injury.
A coarctation of the aorta would be best described as which of the following?
A dilation of the descending aorta
An aortic aneurysm
A narrowing of the descending aorta
None of the above
A narrowing of the descending aorta
A coarctation of the aorta would be best described as narrowing of the descending aorta. This is a fairly common condition.
The anesthesiologist will assess the patient and assigns them to one of how many categories based on current health and the presence of diseases and disorders?
3
4
5
6
6
The physical status of a patient is ranked according to a classification system developed by the American society of anesthesiologists. The categories rank patients in a range from a totally healthy patient (P1 ranking) to a patient who is brain dead (P6 ranking). There are 6 total categories which are used to estimate potential risks during the procedure and patient outcomes.
With a cardiac ablation, if there is surface cooling, which of the following would occur?
A higher power
Decrease in size of the lesion
A lower power
A decrease in convection
A higher power
With a cardiac ablation, If surface cooling occurs, the following would occur:
A higher power
Greater lesion size
An approximation of blood flow velocity can be determined when comparing the frequency changes between the transmitted and __________ sound waves?
Pulsed
Shaped
Reflected
Received
Reflected
Comparing the frequency change between transmitted and reflected sound waves to approximate blood flow velocity is a method of Doppler imaging.
In cardiac ultrasound, Doppler imaging is employed in three ways:
Color flow mapping
Pulsed wave Doppler
Continuous wave Doppler
A phase 4 activity in which there is a leakage of ions across the cell membrane that causes a gradual positively directed change in transmembrane voltage is known as which of the following?
Resting phase
Refractory period
Automaticity
Threshold voltage
Automaticity
Spontaneous depolarization caused by the leaking of ions across the cell membrane is called automaticity. The leakage of ions causes a gradual increase in transmembrane potential. When the transmembrane potential reaches the threshold voltage, the appropriate channels are activated to cause the cells to depolarize.
“Negative delta wave in AVL and often lead I. Positive delta wave in inferior and precordial leads. Normal QRS axis.” These are characteristics of preexcited QRS in which tract location?
Posteroseptal
Anteroseptal
Right free wall
Left free wall
Left free wall
The left free wall location of a bypass tract shows the following characteristics of preexcited QRS:
Negative delta wave in AVL and often lead I
Positive delta wave in inferior and precordial leads
Normal QRS axis
Wellens syndrome
Proximal critical stenosis of the LAD, symmetrical deeply inverted T waves in v2-v3 with minimal ST elevation. Changes occur in pain free state and normalize when in pain
Brugada syndrome
Sodium channelopathy. 40% familial autosomal dominant RBBB with ST elevation in V1-3 Convex and concave ST variants SCN5A mutation
Wolff Parkinson white
Preexcitation syndrome
Reentrant bundle of AV tissue distant to AV node
Short PR
PROLONGED QRS
slurred upstroke of QRS complex (delta wave)
Lown ganong levine
LGL syndrome
Preexcitation syndrome
Reentrant bundle of AV tissue close to AV node
Accessory pathway is down James fibers
No delta wave as conduction is normal down bundle of his
Risk of AF being transmitted aberrantly causing VF or VT
requires ablation of pathway as WPW
