CCDS IBHRE Questions And Answers 100% Guaranteed Success.
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Course
CCDS IBHRE
Institution
CCDS IBHRE
CCDS IBHRE Questions And Answers 100% Guaranteed Success.
Rheobase - correct answer. the lowest point on a strength duration curve at an infinitely long pulse duration
Chronaxie time - correct answer. the pulse width at twice the rheobase value. It approximates the most efficien...
CCDS IBHRE Questions And Answers
100% Guaranteed Success.
Rheobase - correct answer. the lowest point on a strength duration curve at an
infinitely long pulse duration
Chronaxie time - correct answer. the pulse width at twice the rheobase value. It
approximates the most efficient stimulation pulse duration
Charge (formula) - correct answer. Charge= I(current) x T(time)
Furman's formula - correct answer. Energy(microjoules)=
I(current)xV(voltage)xT(pulse width)
Ohms law formula - correct answer. Voltage(electromotive force)= I(current/flow of
electrons) x R(resistance to current flow in ohms)
Functional Refractory Period - correct answer. the coupling interval which first results
in a measurable degree of delay in impulse conduction
Effective Refractory Period - correct answer. the longest coupling interval to be
associated with block
Devices with NO interaction with pacers - correct answer. 1. microwave oven, 2. CT
scan/Ultrasound 3. X-rays (diagnostic)
Devices that cause transient or 1 beat inhibition - correct answer. 1. EAS 2.
Cellphones 3. Arc Welding 4. airport metal detector 5. TENS 6. Electric appliances such
as electric blanket & power tools
Devices that may damage the pacemaker - correct answer. 1. MRI 2. Defibrillator 3.
Cardioversion 4. Cautery/RF Ablation 5. Radiation Therapy
Resistance in Series - correct answer. Series means the beginning of one resistance
is connected to another
,Sum the resistances: R1+R2= total resistance. EX: A LEAD FRACTURE (fractures
INCREASE impedance)
Resistance in Parallel - correct answer. Parallel means all the resistances are
connected to the same point.
(R1xR2)/(R1+R2)= total resistance
EX: LEAD INSULATION DEFECTS (insulation defects DECREASE impedance)
Permanent pacemakers are constant voltage or constant current? - correct answer.
ALL permanent pacemakers are constant voltage devices.
SOME temp pacemakers are constant voltage, most are constant current.
LOAD - correct answer. Load refers to impedance (or resistance) applied to a circuit.
A system with a SMALL load (low impedance) applied to the circuit is said to be a
constant current device
A system with LARGE load is said to be a constant voltage device
Guidelines for Permanent Pacing - correct answer. 1. Patient is symptomatic
2. The heart rate is less than 40 bpm
3. Asystole of greater than 3 seconds is documented
NOTE: Pt may be asymptomatic with 2 or 3
Slew Rate - correct answer. Slew rate = peak slope of an electrogram
slew rate= change in voltage/ change in time
Normal slew rate in atrium - correct answer. >.3 V/s
Normal slew rate in ventricle - correct answer. >.5V/s
Steroid used in electrodes - correct answer. dexamethasone sodium phosphate in the
silicone core(a corticosteriod)
Steroid-Eluting Electrodes - correct answer. 1. The acute threshold is relatively flat
compared to non-steroid electrodes
2. The initial capture threshold is similar to non-steroid leads
Silicone Rubber lead insulation Pros - correct answer. 1. Can easily be repaired
2. Flexible
3. Proven performance history
, 4. Easy to make
Silicone Rubber lead insulation cons - correct answer. 1. high friction coefficient
2. Absorbs lipids
3. More thrombogenic and fibrotic
4. Cuts easily
5. Tears easily if suture tied too tightly
6. Large diameter
polyurethane lead insulation cons - correct answer. 1. cannot be repaired
2. relatively stiff
3. hard to make
Pacemaker Syndrome Causes - correct answer. 1. Loss of AV synchrony
2. Sustained retrograde conduction
3. A single ventricular rate when rate modulation is required for exercise
Approx 25% of patients only paced from the ventricle may have some level of severity
related to pacemaker syndrome
Pacemaker syndrome diagnosis - correct answer. 1. Observe fluctuation in the
peripheral blood pressure
2. Cannon "A" wave in the neck
3. History alone
Pacemaker syndrome management - correct answer. Restore AV synchrony
in ventricular only PM -->lower the pacing rate to minimize ventricular only pacing
DO NOT increase the pacing rate
Fallback - correct answer. 1. Decouples atrial & ventricular events at the upper rate
limit
2. The ventricular inhibited pacing rate then gradually decrements to a programmed
lower or "fallback" rate over a programmed duration
3. When the fallback rate is reached, atrial synchrony is restored
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