Useful info

Question 1

Rate vs Rhythm control in AFFIRM study found what

Answer 1

No difference in major end points - Survival, mortality, bleeding etc

Question 2

Where do you see and what is a J-wave / Osborne-wave

Answer 2

After QRS, looks like Camels Hump - Hypothermia or Hypercalcemia

Question 3

Where do you see Brugarda on ECG

Answer 3

ST elevation in V1, V2, V3

Question 4

David and MOST studies found what

Answer 4

% of RV pacing associated with HF onset

Question 5

What did ADEPT find

Answer 5

That DDDR vs DDD increased HF hospitalisations

Question 6

Why does Rate Modulation increase HF hospitalisations

Answer 6

Because RR increases RV pacing %

Question 7

What did Olshansky find about ICD patients

Answer 7

That 10-19% RV paced is a sweet spot. Less or more pacing than that incurs more hospitalisations

Question 8

Where should your max track be?

Answer 8

130-150ppm

or 220-age

Question 9

Whats a normal PVARP

Answer 9

200-250ms

Question 10

What should be turned off in most patients

Answer 10

PMT termination and PVARP algorithms

Question 11

After AVN what should the base rate be set to and why

Answer 11

80-90ppm to avoid VT (Stevenson et al)

Question 12

Which drugs increase pacing thresholds

Answer 12

1A - Quinidine, Procainamide, Disopyramide

1C - Flecanide, Propafenone

3 - Amiodarone, Sotalol, Prapafenone

Question 13

Whats the energy equation to calculate output

Answer 13

E = V2 x T / R

Question 14

What is the range of inappropriate mode switching

Answer 14

9-38%

Question 15

What percentage of Vasovagal patients have mixed aetiology

Answer 15

ALWAYS a vasodilation component but up to 75% also cardioinhibitory

Question 16

What is pseudo-pseudofusion?

Answer 16

An atrial output pulse on an intrinsic R-wave or vice versa

Question 17

How to program PVARP to stop PMT

Answer 17

30-50ms longer than measured VA time

Question 18

Whats a fusion beat

Answer 18

Capture with intrinsic also - Altered morphology

Question 19

Whats a pseudo-fusion beat

Answer 19

Non-Capture with intrinsic - Intrinsic morphology

Question 20

What is the most common cause of false positive events

Answer 20

Far field sensing - 39%

Question 21

What percentage of patients can benefit from rate modulation

Answer 21

20-50%

Question 22

define open loop sensor

Answer 22

Only takes positive feedback

Question 23

define closed loop sensor

Answer 23

Both positive and negative feedback

Question 24

How to calculate Balanced endless loop Tachy (BELT)

Answer 24

Rate (ms) - SAV = VA

Question 25

After what period of time does perforation risk reduce

Answer 25

1 month

Question 26

Subclinical lead perforation occurs how often

Answer 26

15% of the time

Question 27

How many points does a TIA score for CHADS

Answer 27

2

Question 28

After what score of CHADS is warfarin indicated

Answer 28

2

Question 29

What is a recommended INR score

Answer 29

2-3

Higher = Bleed risk
Lower = Not anti-coagulated

Question 30

What does CHADS stand for

Answer 30

C = Congestive HF
H = Hypertension 
A = Age >75yr
D = Diabetes
S = Stroke - WORTH 2 POINTS

Question 31

What does CLS or Closed loop stimulation respond to that others don’t

Answer 31

Emotional stress

Question 32

Crosstalk is almost always triggered by a…..

Answer 32

R-wave

Question 33

Cures for Crosstalk

Answer 33

Reduce A-output
Reduce V sensitivity
Increase VBP