CET Holter Monitoring & Ambulatory ECG 2

Question 1

A patient's Holter diary shows chest pain at 2:14 PM. The technician should first look for arrhythmias or ST changes in the recording at what time relative to the diary entry?

Accepted Answer

5 minutes before and after 2:14 PM

Answer

Reviewing a window around the symptom time (before and after) captures both precipitating arrhythmias and resulting changes.

Question 2

During Holter analysis, a technician notices the patient's heart rate drops to 28 bpm for 6 seconds during sleep. This finding is most consistent with:

Accepted Answer

Vagally mediated sinus pause, common during sleep

Answer

Brief nocturnal sinus pauses up to 2–3 seconds are a normal vagal phenomenon in athletes and during sleep; isolated pauses without symptoms are usually benign.

Question 3

Which electrode placement error most commonly produces a wandering baseline artifact on a Holter recording?

Accepted Answer

Inadequate skin preparation before electrode attachment

Answer

Poor skin prep leaves oils and dead cells that cause high-impedance connections, resulting in wandering baseline artifact.

Question 4

A 48-hour Holter report states 'total QRS complexes analyzed: 87,432 with 2.1% ventricular ectopy.' Approximately how many PVCs does this represent?

Accepted Answer

1,836

Answer

2.1% of 87,432 ≈ 1,836 PVCs over the 48-hour period.

Question 5

A patient returns a Holter recorder with only 18 hours of data on a prescribed 24-hour study. The BEST next step is to:

Accepted Answer

Note the incomplete recording and schedule a repeat study if clinically indicated

Answer

The technician should document the abbreviated recording duration and communicate with the ordering physician to determine whether a repeat study is needed.

(CET) Certified Electrocardiogram Technician Practice Test

(CET) Certified Electrocardiogram Technician Practice Test

CET Holter Monitoring & Ambulatory ECG 2