CCDS ACTUAL EXAM QUESTIONS AND ANSWERS ALL CORRECT
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CCDS
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CCDS
CCDS ACTUAL EXAM QUESTIONS AND ANSWERS ALL CORRECT
What can effect P and R wave amplitudes? - Answer- MI, anti arrhythmic drugs, lead maturation
Auto threshold may be effected by - Answer- hydration, temp, sleep, electrolytes and meds
Evoked response algrith - Answer- utilizes a beat to bea...
CCDS ACTUAL EXAM QUESTIONS
AND ANSWERS ALL CORRECT
What can effect P and R wave amplitudes? - Answer- MI, anti arrhythmic drugs, lead
maturation
Auto threshold may be effected by - Answer- hydration, temp, sleep, electrolytes and
meds
Evoked response algrith - Answer- utilizes a beat to beat capture check with a back up
pulse in case of non-capture, allows output to be programmed just above threshold, set
to search for the threshold at a set time per day or at set intervals, capture is assessed
beat to beat, output is reduced until the evoked response signal is lost then a 5V
impulse is delivered to ensure capture.
V capture management - Answer- all mnufacturerers use evoked response. No all
algorithms are beat to beat. Medtronic used V capt. management: programmable
frequency of testing, permanent output 1.5 to 3 times greater than threshold, minimum
adaptive amplitude. VCM game 1.1 year increase in longevity and 1.9 with atrial on
Atrial Capture Management (ACM) - Answer- atrial pacing produces low amplitude
levels of evoked response -->resulting in rhythm suppression capture algorithm. ACM
will look for stable atrial or AV conduction. the device will insert AP pulses during SR to
see if this alters the timing of the next predicted AS event. If it does it assumes
captures; if not then the device will increase output and try again
AutoCapture assures capture through 4 basic steps - Answer- 1. Capture confirmation
2. Loss of capture recovery 3 Threshold search 4. Automatic output regulation
Post Mode-Switch Overdrive Pacing (PMOP) - Answer- 1. Paces DDIR mode after atrial
arrhythmia is terminated 2. A-A interval is shortened by 15 ms per cycle until reaching
the programmable overdrive rate 3. after overdrive period, AP rate is decreased, interval
is lengthened by 39 ms per cycle. 4 Device paces at LRL or SIR in the programmed
dual chamber mode (including MVP mode)
Overdrive pacing - Answer- only occurs in patients in sinus rhythm. In addition to
PMOP, overdrive pacing constantly delivers impulses at a rate faster than the
spontaneous rate of the atria to further reduce the burden of AF
Overdrive pacing cont. - Answer- Looks for the native sinus rate and then shortens the
P-P sensed interval to force atrial pacing, then paces at this new interval until a non
refractory atrial sense is detected
, Algorithms to prevent unnecessary RV pacing - Answer- AV hysteresis, reverse mode
switch, reduction of V pacing
DANISH II trial - Answer- showed L atrial size significantly increased by pacing in DDD
with either a short or long AVD and LV function was significantly reduced in the DDD
short AVD group. May under detect AF. AVD > 350 ms can be linked with increased
risks of PMT
MVP (medtronic) reverse mode switch for other company - Answer- AAI mode until non-
conduction DDD. MVP provides back up pacing from V channel at 80 ms post each
second P wave, 2 out of 4 non-conducted P waves, once confirmed --AAIR --> DDDR.
Periods of 1 min, 2 min, doubling to 16 hrs --> looks for intrinsic conduction to switch
back to AAIR
Patient with frequent mode switches or are symptomatic with dropped beats - Answer-
consider programming DDD
Rhythm IQ: BSC - Answer-
Rate response - Answer- Refractory period does not change but the sensing window
gets shorter
DDI mode : used with frequent atrial tachyarrhythmias such as afib (no tracking of atrial
events) - Answer- DDI mode: pacing in the ventricles only occurs at the end of the V-V
interval. AV synchronization w/a programmable AVD is only applied during atrial pacing
VDD: good with pacing with intact sinus function and high grade AV block - Answer-
TARP = AVD + PVARP - Answer- When intrinsic atrial rate exceeds TARP the
pacemaker will develop 2:1 block. 2:1 rate = 60,000/TARP
Auto sensing - Answer- functions beat to beat, dynamically making the system more
sensitive
rheobase - Answer- minimal intensity used with a long current duration that produces a
small muscle contraction aka smallest amplitude (voltage) that stimulates myocardium
Chronaxie (is the pulse duration at twice the rheobase) - Answer- testing procedure
used to measure amount of time required to produce a small muscle contraction at
twice the stimulus amplitude (rheobase voltage)
Voltage, current, pulse duration to stimulate energy is described by this formula -
Answer- E =V^2/R xt . R=total pacing impedance, T is pulse duration
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