SET 2026
◉ What is this ekg showing? Answer: Failure to sense
◉ Why would someone need a Bi-ventricular pacemaker? Answer:
To reestablish between the synchrony between the right ventricle
and left ventricle. (There is a slight pause between the two
ventricles. Going at the same time is a problem and waiting too long
is also a problem.)
◉ If you put in a bi-ventricular device where are the leads? Answer:
One in the right atrium, right ventricle, one in the coronary sinus to
pace the ventricle synchrony.
◉ If there is only one pacemaker lead in the atrium where is the
problem? Answer: The SA Node
◉ If there is only one pacemaker lead in the ventricle, where is the
problem? Answer: AV Conduction delay
◉ In an AV pacer, the first spike is responsible for what? Answer: AV
Contraction
,◉ Where are leads placed for a pacemaker, in the subclavian vein or
internal jugular? Answer: Subclavian
◉ Why do paced beats look like PVCs (upside down)? Answer: The
signal moves in a negative direction. The signal comes from the
perkinje fibers up to the SA Node
◉ Can you defibrillate a patient with a pacemaker? Answer: Yes but
do not put the paddle over the pacemaker
◉ Where are epicardial coronary arteries? Answer: Draped on the
heart, these are the ones that we fix.
◉ True or False: Epicardial coronary arteries dilate significantly
with exercise? Answer: False. The arterioles dialate.
◉ What vessels bring extra O2 to cardiac muscles when exercising?
Answer: arterioles
◉ When arterioles dilate to feed muscle fibers, what happens to the
pressure? Answer: The pressure goes down when the arterioles
dilate.
,◉ What happens to the blood flow to the muscle fibers if you have
an MI? Answer: The arterioles would not need to oxygenate dead
muscle so the impacted arterioles shut down, shrink and collapse.
◉ With FFR, where do you measure the pressure? Answer: The tip of
the transducer and the tip of the guide. The two pressures should be
the same.
◉ What does adenosine do in FFR? Answer: It dilates the arterioles
◉ True or False: An FFR greater than 0.8 is not significant and
should not be fixed. Answer: True
◉ What FFR score indicates that a lesion is significant and should be
repaired? Answer: less than .8
◉ True or False: When doing FFR if the arterioles do not dilate, do
not fix the lesion. Answer: True. The arterioles not dilating is a sign
that the muscle fibers are dead and there is nothing to deliver O2 to.
◉ What is IFR? Answer: It is similar to FFR without adenosine. IFR
wire is more sensitive than FFR wire, and gets more information
without requiring adenosine.
, ◉ When do coronary arteries perfuse? Answer: diastole
◉ Where do you place the IFR wire? Answer: As distal as possible to
the lesion
◉ In IFR what lesion calculation is too high to fix? Answer: 0.9 or
greater
◉ In IFR, what lesion calculation should you repair? Answer: 0.86
"Point 86 means you fix!"
◉ What type of catheter is used with impella? Answer: a pigtail
catheter
◉ What french size catheter an impella? Answer: 7 french
◉ T/F: The proximal end of the impella catheter is located in the
aorta. Answer: True
◉ Where is the distal end of an impella located? Answer: LV