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CCDS IBHRE questions and answers graded A+ 2025/2026
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CCDS IBHRE questions and answers graded A+ 2025/2026
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CCDS IBHRERheobase - ANSthe lowest factor on a electricity duration curve at an infinitely lengthy pulse
period
Chronaxie time - ANSthe pulse width at twice the rheobase cost. It approximates the most
green stimulation pulse duration
Charge (formulation) - ANSCharge= I(cutting-edge) x T(time)
Furman's components - ANSEnergy(microjoules)= I(present day)xV(voltage)xT(pulse width)
Ohms regulation system - ANSVoltage(electromotive force)= I(cutting-edge/float of
electrons) x R(resistance to contemporary waft in ohms)
Functional Refractory Period - ANSthe coupling interval which first consequences in a
measurable diploma of postpone in impulse conduction
Effective Refractory Period - ANSthe longest coupling c language to be related to block
Devices with NO interaction with pacers - ANS1. Microwave oven, 2. CT scan/Ultrasound 3.
X-rays (diagnostic)
Devices that reason transient or 1 beat inhibition - ANS1. EAS 2. Cellphones three. Arc
Welding four. Airport steel detector five. TENS 6. Electric appliances consisting of electric
blanket & power tools
Devices which could damage the pacemaker - ANS1. MRI 2. Defibrillator 3. Cardioversion
four. Cautery/RF Ablation five. Radiation Therapy
Resistance in Series - ANSSeries way the start of one resistance is hooked up to any other
Sum the resistances: R1+R2= general resistance. EX: A LEAD FRACTURE (fractures
INCREASE impedance)
Resistance in Parallel - ANSParallel way all the resistances are related to the same point.
(R1xR2)/(R1+R2)= general resistance
EX: LEAD INSULATION DEFECTS (insulation defects DECREASE impedance)
Permanent pacemakers are regular voltage or steady modern? - ANSALL everlasting
pacemakers are constant voltage gadgets.
,SOME temp pacemakers are consistent voltage, most are consistent contemporary.
LOAD - ANSLoad refers to impedance (or resistance) implemented to a circuit.
A gadget with a SMALL load (low impedance) applied to the circuit is said to be a steady
contemporary device
A device with LARGE load is said to be a regular voltage tool
Guidelines for Permanent Pacing - ANS1. Patient is symptomatic
2. The heart rate is less than forty bpm
3. Asystole of extra than 3 seconds is documented
NOTE: Pt may be asymptomatic with 2 or three
Slew Rate - ANSSlew fee = height slope of an electrogram
slew price= trade in voltage/ exchange in time
Normal slew price in atrium - ANS>.Three V/s
Normal slew rate in ventricle - ANS>.5V/s
Steroid utilized in electrodes - ANSdexamethasone sodium phosphate inside the silicone
center(a corticosteriod)
Steroid-Eluting Electrodes - ANS1. The acute threshold is exceedingly flat as compared to
non-steroid electrodes
2. The initial seize threshold is similar to non-steroid leads
Silicone Rubber lead insulation Pros - ANS1. Can easily be repaired
2. Flexible
three. Proven performance history
4. Easy to make
Silicone Rubber lead insulation cons - ANS1. Excessive friction coefficient
2. Absorbs lipids
three. More thrombogenic and fibrotic
four. Cuts effortlessly
5. Tears without difficulty if suture tied too tightly
6. Large diameter
Polyurethane 80A - ANSBAD
Polyurethane 55D - ANSGOOD
polyurethane lead insulation execs - ANS1. Notably nonthrombogenic/fibrotic
, 2. Thin walls
three. Excessive tear friction
4. Resists slicing
5. Low friction coefficient
polyurethane lead insulation cons - ANS1. Can not be repaired
2. Particularly stiff
3. Hard to make
Pacemaker Syndrome Causes - ANS1. Loss of AV synchrony
2. Sustained retrograde conduction
3. A single ventricular fee whilst charge modulation is required for exercising
Approx 25% of patients most effective paced from the ventricle can also have a few stage of
severity associated with pacemaker syndrome
Pacemaker syndrome prognosis - ANS1. Observe fluctuation inside the peripheral blood
strain
2. Cannon "A" wave in the neck
three. History alone
Pacemaker syndrome management - ANSRestore AV synchrony
in ventricular most effective PM -->decrease the pacing fee to minimize ventricular most
effective pacing
DO NOT boom the pacing price
Fallback - ANS1. Decouples atrial & ventricular activities on the top fee restriction
2. The ventricular inhibited pacing price then progressively decrements to a programmed
decrease or "fallback" price over a programmed length
three. When the fallback price is reached, atrial synchrony is restored
Rate smoothing - ANS1. Eliminated massive cycle to cycle versions by way of preventing
paced rate from converting extra than a sure percent (3%, 6%, 12%, and so forth) from one
V-V c programming language to the subsequent
2. Eliminates massive fluctuations in fee during constant-ratio or psuedo-Wenckebach block
FOUND IN GDT devices
sensor higher rate conduct - ANSif the sinus charge is quicker than the sensor indicated fee,
P synchronous pacing happens
if the sensor indicated rate is faster, AV pacing at the sensor indicated charge happens
blended scenario: when the device is sensor driven AV pacing for a few cycles and a sinus
rate unexpected emerges faster than the sensor indicated fee. The sensor driven atrial
output may be inhibited, a PR c programming language began, and a ventricular output will
arise at the stop of the sensor AV interval. That is, the ventricular price may be identical to
the sensor indicated fee, but the PV c language can be longer than expected
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