IBHRE- Pacing Indications- Questions
With Complete Solutions
Typical Symptoms correct answer: Chest pain
Nausea
Dizziness
Palpitations
Lightheadedness
Syncope
Shortness of breath
Exercise intolerance
Typical Signs correct answer: Jugular distension
Cardiac murmur
Low BP
ECG abnormalities
Pathological Causes of Abnormal Brady correct answer: SSS (inability to generate or transmit signal to atria)
Drug effects (digitalis glycosides, beta blockers, Ca-channel blockers, Class I AA's, amiodarone
SA block (impulses don't transmit to atria)
Other Causes of Abnormal Brady correct answer: Inf. wall MI
Toxic or environmental exposure
Electrolyte disorders
Sleep apnea
Hypoglycemia
Hypothyroidism Hypothermia
Intracranial pressure
Infection
Evaluating Symptoms- Hemodynamic Deficit Path correct answer: Looks at CO (CO = HR x SV)
Decreased perfusion causes symptoms
Evaluating Symptoms- AV Dyssynchrony Path correct answer: Loss of atrial kick, cannon P-waves, increased atrial pressure, atrial natriuretic peptide
Class I PM Indication for SND correct answer: SND with documented symptomatic brady or sinus pauses (LOE: C)
Symptomatic chronotropic incompetence (LOE: C)
SND as a result of essential long-term drug therapy of a type and
dose for which there are no acceptable alternatives (LOE: C)
Class IIa PM Indication for SND correct answer: Sinus brady with a HR of <40 when a clear symptom correlation has not been established with documented brady (LOE: C)
Syncope of unexplained origin when clinically significant abnormalities of SN function are detected or provoked during EP studies (LOE: C)
Class IIb PM Indication for SND correct answer: In minimally symptomatic patients with persistent brady with a HR <40 during awake hours (LOE: C)
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