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RCES EXAM QUESTIONS AND ANSWERS
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RCES EXAM QUESTIONS AND ANSWERS
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RCES EXAM QUESTIONS AND ANSWERS40-50%
In patients with CHF and LBBB that are severely symptomatic, properly performed CRT-P (without defib) reduces sudden death and mortality by:
Stimulate LV in area of lowest threshold, stimulate LV in area of greatest asynchrony, prevent phrenic nerve stimulation by changing the LV pacing vector
Three reasons to use multipolar CS/LV leads in resynchronized therapy are:
Unipolar over the wire
Implanting the LV lead in small diameter coronary veins, which type of resynchronization lv lead design generally has the smallest diameter?
LBBB
A minority of patients treated with bi-v pacing do not improve clinically. Most of the following are characteristics of non responder patients. What characteristic will also suggest the patient is more likely to be a good responder to CRT?
A. Ischemic heart disease
B. LBBB (vs rbbb)
C. Transmural MI Scar
D. Enter your corner vein lead placement
Diaphragmatic stimulation
The most common problem associated with pacing from the LV from the coronary vein is:
CS lead
The only significant difference between implanting an ICD and a CRT-D device is a
Implantable defibrillator
Most patients that receive a BIV pacemaker also get a
Adequate pacing threshold & an absence of diaphragmatic pacing
In resynchronization therapy, after the LV lead is placed, it should be tested for:
The guider sheath is sliced and removed.
In resynchronization therapy, after the LV lead is properly placed and tested the next thing to do is:
Reduced end diastolic size and LV mass The main long-term benefit of CRT on the left ventricle is:
Pace 100% of the time
CRT pacemakers are usually programmed to:
CHF
BIV pacers/CRT devices are generally used to treat patients with:
Increased EF by 5-10%, reduced hospitalizations from CHF, improved quality of life.
What are the expected benefits of CRT implant in appropriately responding patients?
CRT
What type of pacemaker is shown in this X-ray
35%, 0.12 sec
ACC, AHA, HRS guidelines recommend CRT for patients who have CHF with functional
class III or IV on optimal medical therapy with an EF < _____and a QRS > _____
Implanting lead array
Prior to implanting an ICD on a 12 year old female patient with generic cardiomyopathy an initial EP study induced VT and VF. But, during the ICD implant procedure the implanted lead fails to provide an adequate DFT. What should be recommended?
SVC and RV
In two coil ICD's the shocking electrodes are usually configured to shock between the:
Defibrillating over the ICD may do damage to device, delay ACLS for up to one minute to allow the ICD detect and treat the VF, epicardial ICD patches may insulate the heart against anterior-lateral shocks, if your initial shock fails try a different paddle position. *** The incorrect answers to delay ACLS per up to one minute****
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