Help Prepare For Ibhre Study

Front 1

Rheobase

Back 1

lowest point on a strength duration curve at an infinitely long pulse duration

Front 2

Two components of Minute Ventilation

Back 2

Respiratory Rate, Tidal Volume

Front 3

4 sensors currently used in pacemakers

Back 3

Accelerometer, QT, MV, CLS

Front 4

What are the basic parameters for programming rate response?

Back 4

LRL, MTR, MSR, Threshold, Slope, Reaction/Recovery

Front 5

If pacing in the A at a rapid rate above LRL first assumption should be?

Back 5

Rate Response, could also be preference pacing

Front 6

Most common for of SVT?

Back 6

AVNRT

Front 7

Characteristics of AVNRT

Back 7

HR 150-250, Neck Pounding, Palpitations, Narrow QRS, P wave is either buried within the QRS or just after QRS. Most common in women, Abrupt onset, most frequent after 20 years of age.

Front 8

What is Chronaxie?

Back 8

Pulse width at twice the rheobase value. This is the most efficient pulse duration.

Front 9

What is Function Refractory Period?

Back 9

Couping interval which first results in a measurable degree of delay in impulse conduction

Front 10

What is Effective Refractory period?

Back 10

The longest couping interval to be associated with block

Front 11

What is Resting (transmembrane) potential?

Back 11

Voltage difference between the inside and outside of the cell fiber

Front 12

Action potential- Phase 0

Back 12

Depolarization phase. Rapid sodium channels are stimulated to open causing the resting membrane potential to spike from -90 to 0 mv.

Front 13

Action Potential- Phase 1

Back 13

Early Repolarization

Front 14

Action Potential- Phase 2

Back 14

Plateau Phase. This phase mediated by the slow sodium channels, essentially disrupts and delays the repolarization started in phase 1 and prolongs the refractory period.

Front 15

Action Potential- Phase 3

Back 15

The end of repolarization.

Front 16

Action Potential - Phase 4

Back 16

Resting phase. During this phase in some cardiac cells, ions leak back and forth between membranes and cause a gradual incrase in the resting potential.

Front 17

What could incrased Atrial Naturetic Peptide (ANP) also known as Brain Naturetic Peptide (BNP) be associated with?

Back 17

Could be associated with dysnchrony, VVIR pacing, or loss of atrial capture.

Front 18

Calculate Slew Rate

Back 18

Slew Rate is dV/dt (voltage (mv) over time (ms)). This is the peak slope of an electrogram signal. Values of .3 v/s in the atria and .5 v/s in the ventricle are considered normal.

Front 19

What is the steroid used in steroid eluting electrodes?

Back 19

The corticosteroid dexamethason sodium phosphate

Front 20

What kind of polyurethane is considered reliable?

Back 20

55D

Front 21

What is a poor insulating polyurathane?

Back 21

80A

Front 22

What causes pacemaker syndrome?

Back 22

Loss of AV synchrony, Sustained Retrograde conduction, a single ventriculare rate when rate modulation is requred for exercise.

Front 23

Explain what Fallback is?

Back 23

Decouples the atrial and ventricular events at the upper rate limit, Ventricular inhibited pacing then gradually decrements to a programmed lower or fallback rate over a programmed duration. When the fallback rate is reached atrial synchrony is resumed

Front 24

Rate Smoothing is what?

Back 24

Eliminates large cycle to cycle variations by preventing the paced rate from changing more than a certain percentage from one V-V to the next. Eliminates large fluctuations in rate during fixed ration or psuedo Wenkebach

Front 25

How does K channel blocking effect of a drug demonstrate on the surface ECG?

Back 25

Lengthens QT interval

Front 26

Name some AA agents which have negative inotropy.

Back 26

disopyramide, propafenone, flecainide

Front 27

Name a class of drug which may have impotence depression and nightmares as a side effect

Back 27

betablockers

Front 28

A patient is in the CCU with recurrent and near incessant VT requring repeated cardioversion. Lidco and Amio have not been completely successful. What other drug might you suggest?

Back 28

Esmolol infusion

Front 29

Which drug has properties from all 4 Vauhan-Williams drug classifications?

Back 29

Amiodarone

Front 30

What type of monitoring should be done routinely on patients taking amio?

Back 30

Liver and thyroid studies. Amiodarone levels, annual eye exams and chest xray

Front 31

What is the most common serious side effect of Dofetilide (Tikosyn)?

Back 31

Long QT

Front 32

Bidirectional or alternating VT is a symptom of tox levels of what drug?

Back 32

Digoxin

Front 33

In what Class are the following drugs; Amiodarone, sotalol, Dofetilide?

Back 33

Class III

Front 34

What class drugs are verapamil and dilitiazem?

Back 34

Class IV

Front 35

A patient suddenly starts speaking in a very garbled voice after you admistered a drug intravenously. What did you just give?

Back 35

Lidocaine

Front 36

Name 2 contraindications for starting someone on sotalol

Back 36

Ashthma Prolonged QT

Front 37

What is an absolute contraindication for administering flecanide?

Back 37

Structural Heart Disease

Front 38

Does amio rais or lower pacing and defib thresholds?

Back 38

Raises

Front 39

Magnesium sulfate is primarily given to prevent recrrent torsades de pointes in patients with coronary artery disease. True or False.

Back 39

False it is given to prevent Torsades with patients with long QT not CAD

Front 40

The first anti-arrhythmic drug recomended to be given in a "code" pulseless VT situation is ___ and how is it administered?

Back 40

Amio 300 mg given IV push

Front 41

Drugs that can be administered via an ET tube are;

Back 41

NAVEL N (naloxone) A (atropine) V (vasopressin) E (epinephrine) L (lidocaine)

Front 42

Name AA drugs that increase pacing thresholds

Back 42

Quinidine, Procainamide, Disopyramide, Flecanide, Propafenone

Front 43

Name AA drugs that Increase Defibrillation Thresholds

Back 43

Quinidine, Lidocaine, Phenytoin, Flecanide, Amiodarone

Front 44

Name two drugs that lower DFTs

Back 44

Sotalol and Bretylium

Front 45

The premise of a proposed theory of defibrillation is that a shock need only eliminate the fibrillatory wavelets in a percentage of myocardium to extinguish the arrhythmia

Back 45

Critical Mass

Front 46

Factors that can affect whether a shock will succeed include:

Back 46

Fibrillation duration, potassium accumulation, and circulating pharmacologic agents

Front 47

Biphasic waveforms have been shown to result in higher implantation success rates due to...

Back 47

lower DFTs

Front 48

Prefered position for an external Defib pad placement in a patient with an implanted ICD is:

Back 48

Anterior-Posterior

Front 49

This feature is designed to avoid delayed when an arrhythmia straddles the VT and VF zones of an ICD

Back 49

Combined Count detection

Front 50

Guidant ICDs use which method to maintain appropriate sensing of QRS complexes and VF while avoiding oversensing T-waves?

Back 50

Automatic Gain Control

Front 51

This detection enhancement uses an abrupt change in rate to distinguish sinus tach from true VT

Back 51

Onset

Front 52

The Guidant Atrial View Detection enhancements adds which features to stability and onset?

Back 52

A Rate>V rate and A fib rate threshold

Front 53

ELAs PARAD Detection enhancement utilizes  what discriminators?

Back 53

Chamber of onset, AV association and interval stability

Front 54

What are the elements of PR logic?

Back 54

Rate Pattern Regularity AV Dissociation Far field R waves and AF Evidence

Front 55

What are the prevention/termination therapy options delivered by Medtronic's atrial defibrillators?

Back 55

Atrial rate stabilization, High-Rate Overdrive pacing, Atrial ATP, 50 Hz burst, Atrial Cardioversion

Front 56

What are the benefts of storing far-field egms for ICD analysis?

Back 56

More closely resembles surface ECG, can sometimes distinguish P waves, and easier to distinguish between sinus and VT morphologies.

Front 57

 Percentage of VT episodes that are asymptomatic?

Back 57

 60% of episodes