CCT - Certified Cardiographic Technician Cardiac Medications and ECG Effects Questions and Answers Flashcards
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Which antiarrhythmic drug is most commonly used to chemically cardiovert atrial fibrillation with a rapid onset IV formulation in a hospital setting in the US?
Answer: Ibutilide
Ibutilide is an IV Class III agent approved for acute chemical cardioversion of atrial fibrillation and flutter, though it requires continuous ECG monitoring for QT prolongation.
A CCT notices a patient's rhythm changes from sinus tachycardia to a regular narrow-complex tachycardia at 160 bpm after IV adenosine. What has likely occurred?
Answer: Adenosine unmasked atrial flutter with 2:1 block
Adenosine can transiently block the AV node during atrial flutter, slowing ventricular response and revealing the characteristic flutter saw-tooth waves at ~300 bpm.
Which electrolyte abnormality is most likely responsible for a prolonged QT interval combined with U waves and muscle cramps?
Answer: Hypomagnesemia combined with hypokalemia
Concurrent hypomagnesemia and hypokalemia together commonly cause QT prolongation, prominent U waves, and skeletal muscle symptoms, and both must be corrected to stabilize the myocardium.
When monitoring a patient on quinidine therapy, a CCT should be most alert to which dangerous ECG change?
Answer: QT interval exceeding 500 ms
Quinidine prolongs the QT interval, and a QTc above 500 ms significantly increases the risk of quinidine syncope caused by torsades de pointes.
Atropine is used in bradycardia emergencies; what ECG effect does it produce?
Answer: Increases heart rate and shortens the PR interval by enhancing AV conduction
Atropine blocks vagal (parasympathetic) tone, increasing sinus rate and improving AV conduction, which speeds up the heart rate and may shorten the PR interval.
A patient undergoing a pharmacological stress test with dobutamine develops new horizontal ST depression in leads V4-V6. What does this finding indicate?
Answer: Myocardial ischemia in the lateral wall distribution
New horizontal or downsloping ST depression of ≥1 mm during dobutamine stress in lateral leads suggests inducible ischemia in the lateral wall, typically fed by the left circumflex artery.