CCI Pacemaker and Implantable Device Assessment 2

Question 1

Which ECG finding is most consistent with pacemaker failure to capture?

Accepted Answer

Pacing spike not followed by a P wave or QRS complex

Answer

Pacing spike followed by a QRS complex

Answer

Absent pacing spikes with no intrinsic rhythm

Answer

Prolonged PR interval after each pacing spike

Question 2

What is the most common cause of acute pacemaker failure to capture in the early post-implant period?

Accepted Answer

Lead dislodgement

Answer

Battery depletion

Answer

Electromagnetic interference

Answer

Insulation break

Question 3

T-wave oversensing in a VVI pacemaker most likely results in which pacemaker malfunction?

Accepted Answer

Inappropriate inhibition of pacing output

Answer

Failure to capture

Answer

Runaway pacemaker

Answer

Pacemaker-mediated tachycardia

Question 4

A pacing lead impedance measurement of 150 ohms is most consistent with which condition?

Accepted Answer

Lead insulation breach (short circuit)

Answer

Normal lead function

Answer

Lead fracture (open circuit)

Answer

Battery end-of-life

Question 5

On chest X-ray, which finding would most suggest right ventricular lead perforation?

Accepted Answer

Lead tip extending beyond the cardiac silhouette

Answer

Lead tip at the right ventricular apex

Answer

Bilateral pleural effusions

Answer

Mediastinal widening

Question 6

When a magnet is applied to a permanent pacemaker, what is the primary purpose of this maneuver in clinical assessment?

Accepted Answer

To assess battery status by inducing asynchronous pacing at a magnet rate

Answer

To permanently reprogram the pacing mode

Answer

To increase the pacing sensitivity

Answer

To deliver antitachycardia pacing

Question 7

Which pacemaker programming change is most appropriate to correct myopotential oversensing?

Accepted Answer

Decrease the sensitivity (raise the mV threshold)

Answer

Decrease the pacing output

Answer

Increase the sensitivity (lower the mV threshold)

Answer

Increase the pacing rate