CET Holter Monitoring & Ambulatory ECG 4

Question 1

An implantable loop recorder (ILR) differs from a traditional Holter monitor in that the ILR:

Accepted Answer

Is subcutaneously implanted and can record for up to 3 years

Answer

ILRs are small subcutaneous devices implanted under the skin that can continuously monitor cardiac rhythm for up to 3 years, used for infrequent unexplained syncope.

Question 2

A Holter shows a heart rate that abruptly doubles from 75 to 150 bpm with a narrow QRS. The MOST likely mechanism is:

Accepted Answer

Paroxysmal supraventricular tachycardia (PSVT)

Answer

An abrupt doubling of rate with narrow QRS is the hallmark of PSVT, which begins and ends suddenly unlike the gradual rate change of sinus tachycardia.

Question 3

Which artifact pattern on a Holter recording mimics atrial fibrillation and is caused by patient movement?

Accepted Answer

Muscle (myopotential) artifact producing irregular rapid deflections

Answer

Myopotential artifact from muscle movement produces irregular, rapid, low-amplitude deflections that can mimic the chaotic baseline of atrial fibrillation.

Question 4

A patient with a pacemaker undergoes Holter monitoring. The technician notices pacemaker spikes not followed by QRS complexes. This finding indicates:

Accepted Answer

Pacemaker failure to capture

Answer

Pacemaker spikes not followed by a paced QRS indicate failure to capture, meaning the pacemaker stimulus did not depolarize the myocardium.

Question 5

During Holter application, the technician marks the recorder's event time using the patient's watch. At analysis, the technician discovers the recorder clock and the watch were 22 minutes apart. The correct action is to:

Accepted Answer

Add a notation to the report documenting the time discrepancy

Answer

Documenting the clock discrepancy allows the interpreting physician to correctly correlate diary entries with actual recording times when reviewing the report.

(CET) Certified Electrocardiogram Technician Practice Test

(CET) Certified Electrocardiogram Technician Practice Test

CET Holter Monitoring & Ambulatory ECG 4