CMC Technology & Digital Tools 2 — Questions and Answers
Question 1: Which remote monitoring technology allows continuous ambulatory tracking of hemodynamic parameters in heart failure patients via an implanted pulmonary artery pressure sensor?
- CardioMEMS HF System (Correct answer)
- LifeVest wearable defibrillator
- Implantable loop recorder
- Zio patch monitor
Correct answer: CardioMEMS HF System
The CardioMEMS HF System is an implanted wireless sensor that measures pulmonary artery pressure to guide heart failure management remotely.
Question 2: When a cardiac catheterization laboratory's hemodynamic monitoring system displays a damped arterial waveform, the FIRST troubleshooting step should be:
- Flush the arterial line with heparinized saline (Correct answer)
- Recalibrate the pressure transducer to atmospheric pressure
- Replace the pressure transducer
- Administer a fluid bolus to the patient
Correct answer: Flush the arterial line with heparinized saline
A damped waveform typically indicates a clot or air bubble at the catheter tip, so flushing the line is the appropriate first step.
Question 3: In cardiac MRI, the term 'late gadolinium enhancement' (LGE) refers to:
- Myocardial fibrosis or scar tissue that retains contrast agent longer than normal tissue (Correct answer)
- Early hyperemia seen in acute myocarditis
- Gadolinium accumulation in healthy myocardium
- Pericardial effusion appearing bright on T2-weighted images
Correct answer: Myocardial fibrosis or scar tissue that retains contrast agent longer than normal tissue
LGE reflects areas where gadolinium is retained due to disrupted cell membranes or expanded extracellular space, indicating fibrosis or scar.
Question 4: A fractional flow reserve (FFR) value of 0.75 measured during coronary angiography indicates:
- Hemodynamically significant stenosis warranting revascularization (Correct answer)
- Non-significant stenosis that can be managed medically
- Borderline stenosis requiring optical coherence tomography
- Normal coronary flow with no pressure gradient
Correct answer: Hemodynamically significant stenosis warranting revascularization
An FFR ≤0.80 indicates hemodynamically significant ischemia; values ≤0.75 clearly indicate revascularization benefit.
Question 5: Which software algorithm used in modern ECG systems automatically measures the QT interval and flags prolongation?
- Glasgow algorithm (Correct answer)
- MARQUETTE algorithm
- Selvester scoring
- Duke treadmill score calculator
Correct answer: Glasgow algorithm
The Glasgow algorithm is a widely used automated ECG interpretation system that measures intervals including QTc and flags abnormalities.
Question 6: In electrophysiology, a 3D electroanatomic mapping system creates a cardiac chamber map using:
- Magnetic field sensors in the catheter tip correlated with fluoroscopic position (Correct answer)
- Ultrasound transducers built into the mapping catheter
- Infrared positioning sensors mounted on the patient
- Impedance measurements from multiple skin electrodes
Correct answer: Magnetic field sensors in the catheter tip correlated with fluoroscopic position
Systems like CARTO use magnetic field-based localization of catheter tip sensors to construct real-time 3D maps of cardiac chambers.
Question 7: Which technology is used in transcatheter aortic valve replacement (TAVR) planning to calculate annulus dimensions and optimal fluoroscopic angles?
- CT angiography with dedicated TAVR planning software (Correct answer)
- Transesophageal echocardiography alone
- Cardiac MRI with 4D flow sequences
- Intracardiac echocardiography
Correct answer: CT angiography with dedicated TAVR planning software
CT angiography with specialized planning software (e.g., 3Mensio, Vida) provides precise annulus sizing, calcium scoring, and coplanar angle calculation for TAVR.
CMC Technology & Digital Tools 2
Which remote monitoring technology allows continuous ambulatory tracking of hemodynamic parameters in heart failure patients via an implanted pulmonary artery pressure sensor?