IBRHE EXAM BUNDLE 3 LATEST VERSIONS
(VERSION A,B AND C) NEWEST 2024-2025 ACTUAL
EXAM COMPLETE 400 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+||
IBRHE EXAM QUESTIONS VERSION A
LV pacing is most often associated with what? - ANSWER- LV
pacing is most often associated with a RBBB pattern since the
depolarization starts in the LV and arrives late in the RV.
Stimulation of the RV apex and RV free wall will have what
pattern? - ANSWER- Stimulation of the RV apex and RV free
wall will have a LBBB pattern.
The RVOT has an inferior axis and LBBB pattern.
Which leads on the ECG represent the septum? - ANSWER-
leads V1 and V2
What factors result in a positive CRT response? - ANSWER-
Wide QRS width (especially when combined with LBBB
morphology)
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Female Gender
Non ischemic cardiomyopathy as the underlying pathology of
heart failure.
Less consistently echo signs of dyssnychrony were found to
predict response.
What is associated with less favorable response to CRT? -
ANSWER- Coronary artery disease
Think presence of ischemic cardiomyopathy as the cause of
decreased LV function is clearly associated with a less favorable
response to CRT (especially regarding LV reverse remodeling).
This is likely due to irreversible myocardial scarring.
Which leads represent the lateral wall? - ANSWER- Lead 1,
AVL, V5 and V6 represent the lateral wall.
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Which study investigated the efficacy of a single burst of ATP
(8 pulses, 88% cycle length) in VT and fast VT? - ANSWER-
The PainFREE and the PainFREE II.
The success rate was 85% and 72%.
Acceleration of VT's by a burst of ATP were rarely observed.
Based on this data at least one burst of ATP before or during
charging should be programmed in virtually all patients.
Dependent patients - ANSWER- Switch to asynchronous pacing
in order to prevent oversensing from both electrocautery and
device manipulation.
Application of only short bursts of electrocautery or using a
bipolar cautery system will reduce the risk of over sensing.
Activity sensor should be turned off (for all patients) in order to
minimize inappropriate increases in heart rate due to device
manipulation.
Placement of transthoracic pacing pads.
Bipolar (NOT UNIPOLAR) pacing configurations should be
used when possible, as once the generator is out of the pocket
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there is no longer a pacing circuit and loss of capture resulting in
asystole in a pacemaker dependent patient.
Name a programming change LEAST likely to improve the
likelihood of the device going into mode switch? - ANSWER-
Decrease PVARP
(think shorten)
Decreasing PVARP will not increase the detection of atrial
fibrillation, as events occurring during PVARP are already
registered towards the mode switch count (although no AV
delay is started during this period).
What would shortening the PVAB do? - ANSWER- Shortening
the PVAB will potentially result in more atrial events not being
blanked, which are counted towards mode switch.
Making the atrial channel more sensitive will equally lead to
more atrial events being sensed.
Reducing the entry count and / or the mode switch rate will also
result in a higher likelihood for the device to go into mode
switch.
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