CCI Pacemaker and Implantable Device Assessment 3

Question 1

What is the primary indication for an implantable cardioverter-defibrillator (ICD)?

Accepted Answer

Prevention of sudden cardiac death from ventricular arrhythmias

Answer

Sick sinus syndrome unresponsive to medications

Answer

Symptomatic complete heart block

Answer

Chronic atrial fibrillation with slow ventricular response

Question 2

Cardiac Resynchronization Therapy (CRT) is most beneficial for which patient population?

Accepted Answer

Heart failure with reduced EF, LBBB, and QRS ≥150 ms

Answer

Heart failure with preserved EF and narrow QRS

Answer

Atrial fibrillation with rapid ventricular response

Answer

Complete AV block with normal left ventricular function

Question 3

What minimum percentage of biventricular pacing is generally targeted to achieve optimal CRT benefit?

Accepted Answer

>98%

Answer

>50%

Answer

>70%

Answer

>85%

Question 4

During ICD device interrogation, a stored electrogram shows a fast, polymorphic ventricular rhythm followed by a shock that restored sinus rhythm. This most likely represents:

Accepted Answer

Appropriate ICD therapy for ventricular fibrillation

Answer

Inappropriate therapy due to T-wave oversensing

Answer

Pacemaker-mediated tachycardia with committed shock

Answer

Inappropriate therapy due to atrial fibrillation with RVR

Question 5

What is the typical heart rate threshold used to define the VF detection zone in an ICD?

Accepted Answer

>200 bpm

Answer

>120 bpm

Answer

>150 bpm

Answer

>280 bpm

Question 6

Which feature of a non-MR-conditional pacemaker or ICD is the primary concern when a patient requires MRI?

Accepted Answer

Electromagnetic interference causing oversensing or inappropriate pacing

Answer

Radiation emitted by MRI damaging the device circuitry

Answer

MRI contrast causing allergic reaction worsened by device presence

Answer

Ultrasound from MRI permanently reprogramming the device

Question 7

Anti-tachycardia pacing (ATP) in an ICD functions by delivering which type of therapy?

Accepted Answer

A series of rapid pacing stimuli to overdrive and terminate ventricular tachycardia

Answer

A high-energy shock to terminate ventricular fibrillation

Answer

Synchronized low-energy cardioversion for atrial fibrillation

Answer

Backup bradycardia pacing after spontaneous termination of VT