CRAT Pacemaker Rhythm Analysis 3

Question 1

What is pacemaker syndrome?

Accepted Answer

Symptoms from loss of AV synchrony in VVI pacing, causing retrograde atrial contraction against closed mitral valve

Answer

Pacemaker syndrome occurs with VVI pacing when retrograde (ventriculo-atrial) conduction causes atria to contract against closed AV valves, producing low cardiac output, hypotension, and symptoms of heart failure.

Question 2

Rate response (R) in pacemaker programming allows the device to do which of the following?

Accepted Answer

Increase pacing rate in response to physical activity by detecting body movement or minute ventilation

Answer

Rate-responsive pacemakers (VVIR, DDDR) use accelerometers or minute ventilation sensors to detect activity and increase pacing rate, simulating the normal sinus node chronotropic response to exercise.

Question 3

Which intervention should be attempted first for a pacemaker patient presenting with failure to capture?

Accepted Answer

Increase pacing output amplitude on the programmer or apply a magnet to evaluate threshold

Answer

The first step is to increase the pacing output (voltage or pulse width) via programming to overcome an elevated stimulation threshold, which may restore capture before considering invasive interventions.

Question 4

In a patient with a permanent pacemaker, a magnet applied over the pulse generator typically causes what pacemaker behavior?

Accepted Answer

Asynchronous pacing at a fixed rate (magnet rate), ignoring sensed cardiac activity

Answer

A magnet converts the pacemaker to asynchronous (DOO or VOO) mode, delivering pacing pulses at a fixed programmed magnet rate regardless of any sensed cardiac activity, which is useful for testing capture or overriding oversensing.

Question 5

Pacemaker-mediated tachycardia (PMT) can occur in dual-chamber pacemakers due to which mechanism?

Accepted Answer

Retrograde P waves are sensed by the atrial channel, triggering ventricular pacing, creating a reentrant loop

Answer

PMT occurs in DDD pacemakers when a premature ventricular beat conducts retrogradely to the atria; the resulting retrograde P wave is sensed by the atrial channel, which then triggers ventricular pacing, which again conducts retrogradely — creating a pacemaker-dependent reentrant loop.

CRAT - Certified Rhythm Analysis Technician Practice Test

CRAT - Certified Rhythm Analysis Technician Practice Test

CRAT Pacemaker Rhythm Analysis 3