EKG certification Certification Pacemakers & Cardiac Devices 1

Question 1

What EKG finding is the hallmark of pacemaker activity?

Accepted Answer

A pacemaker spike (pacer artifact) preceding the paced beat

Answer

A pacemaker spike is a sharp vertical deflection on the EKG that immediately precedes the paced P wave or QRS complex, confirming pacemaker activity.

Question 2

In the NBG pacemaker code, what does the FIRST letter represent?

Accepted Answer

The chamber paced

Answer

In the NBG (North American Society of Pacing and Electrophysiology/British Pacing Group) code, the first letter always indicates the chamber being paced (A=Atrium, V=Ventricle, D=Dual).

Question 3

What is 'failure to capture' in a pacemaker?

Accepted Answer

A pacemaker spike is present but no myocardial depolarization follows

Answer

Failure to capture occurs when a pacemaker spike is visible on the EKG but is not followed by a P wave or QRS complex, meaning the impulse did not depolarize the myocardium.

Question 4

Which EKG morphology is characteristically seen with right ventricular pacing?

Accepted Answer

Wide QRS complex with left bundle branch block (LBBB) morphology

Answer

Right ventricular pacing produces a wide QRS with LBBB morphology because the right ventricle is depolarized first via the pacing lead, causing abnormal left-to-right ventricular activation.

Question 5

What does a VVI pacemaker mode mean?

Accepted Answer

Ventricle paced, ventricle sensed, inhibited response

Answer

VVI means the ventricle is paced (first V), the ventricle is sensed (second V), and the pacemaker is inhibited (I) when it senses native ventricular activity.

EKG certification Practice Test

EKG certification Practice Test

EKG certification Certification Pacemakers & Cardiac Devices 1