Shannon-Important Pacemaker/AICD Information

Question 1

Indications for insertion of pacemakers—___/___ node disease; long ___ syndrome; ___trophic obstructive cardiomyopathy; ___ cardiomyopathy

Answer 1

SA/AV node disease; long QT syndrome; hypertrophic obstructive cardiomyopathy; dilated cardiomyopathy

Question 2

Heart rhythm society pacemaker codes—position 1 = chamber ___; position 2 = chamber ___; position 3 = ___; position 4 = ___; position 5 = ___ pacing

Answer 2

Position 1 = chamber paced

Position 2 = chamber sensed

Position 3 = response to sensing

Position 4 = programmability

Position 5 = multisite pacing

Question 3

Pacemaker codes—position 4 programmability—rate modulation will ___ (increase/decrease) the pacer’s lower heart rate limit in response to activity that may require an ___ (increased/decreased) myocardial oxygen demand

Answer 3

Rate modulation will increase the pacer’s lower heart rate limit in response to activity that may require an increased myocardial oxygen demand

Question 4

Failure to ___ = when the pacemaker’s electrical output fails to cause myocardial depolarization

Answer 4

Failure to capture

Question 5

Failure to ___ = the pacemaker fails to recognize intrinsic cardiac electrical activity

Answer 5

Failure to sense

Question 6

Indications for ICD = ventricular ___/___; post MI with an EF < ___%; cardiomyopathy with an EF < ___%; ___trophic cardiomyopathy; awaiting a ___ transplant; long ___ syndrome

Answer 6

Ventricular tachycardia/fibrillation; post MI with an EF < 30%; cardiomyopathy with an EF < 35%; hypertrophic cardiomyopathy; awaiting a heart transplant; long QT syndrome

Question 7

Heart Rhythm Society ICD Codes—position 1 = ___ chambers; position 2 = anti-___ pacing chambers; position 3 = ___ detection; position 4 = anti-___ pacing chambers

Answer 7

Position 1 = shock chambers

Position 2 = anti-tachycardia pacing chambers

Position 3 = tachycardia detection

Position 4 = anti-bradycardia pacing chambers

Question 8

An ICD cardioverts V tach with ___-___ joules

Answer 8

1-30 joules

Question 9

An ICD defibrillates V fib with ___-___ joules; if an ICD acknowledges that a shock is needed, it will deliver ___ shocks

Answer 9

Defibrillates V fib with 10-30 joules

If an ICD acknowledges that a shock is needed, it will deliver 6 shocks

Question 10

What is the most prevalent source of electromagnetic interference in the OR?

Answer 10

Electrocautery

Question 11

___polar cautery has the anode and cathode at the tip of the device

Answer 11

Bipolar cautery

Question 12

There is less risk of EMI with ___polar cautery

Answer 12

Bipolar cautery

Question 13

Monopolar cautery requires a ___ pad to be placed elsewhere on the body

Answer 13

Grounding pad…why monopolar cautery has greater risk of EMI than bipolar

Question 14

Application of a magnet on a pacemaker—will set the pacemaker into the set ___ pacing rate; may disable any rate ___ that could be set with the pacemaker

Answer 14

Will set the pacemaker into the set asynchronous pacing rate (backup rate); may disable any rate modulation that could be set with the pacemaker

Question 15

Application of a magnet on an ICD—will disable the ability of ICD to ___

Answer 15

Shock VT or VF

Question 16

Application of a magnet on a dual pacemaker AND ICD—will only disable the ___ function

Answer 16

Shock function