BCIT - Test 1 - Ambulatory ECG's - CARD
4201
Phase shift correct answersthe displacement of a waveform over time,
accurately showing the number of beats occurring in a given period of
time
Frequency modulation correct answersthe system's ability to accurately
display the various tall and short wave forms recorded from the ECG
source.
The greatest benefit of digital recording correct answersaccurate, high
fidelity and noise free recordings that allow for powerful, on-line analyzing
capacity.
baseline artefact correct answerscaused by body position, lead wire
movement, loose electrodes or perspiration.
The areas which have implications in digital recorder research are correct
answersheart rate variability (HRV), T wave alternans and spectral analysis
Signal Averaged ECG correct answersmeans of amplifying the recorded QRS
signal in order to detect abnormal electrical potentials in the form of late
potentials—those which occur during the repolarization portion of the ECG
waveform
Time-Domain QRS Averaging correct answersused to amplify, detect and
then analyze late potentials of microvolt amplitudes in the QRS complex.
Unwanted noise (such as myopotential) is suppressed.
Bipolar XYZ leads can be averaged, filtered and combined in a vector
recording called filtered QRS complex. The analysis will include: correct
answersfiltered QRS complex root mean square voltage in the terminal 40
ms of filtered QRS complex < 20 µv 9 duration of signal < 40 µV in terminal
QRS complex >38 ms
Frequency-Domain QRS Averaging correct answersFrequency analysis of
the QRS supplies information about the rate and synchronization of
depolarization of the ventricles. Three algorithms are used to obtain QRS
frequency data:
a continuous transform of a continuous signal (the signal averaged over
time) continuous transform of samples of the signal (measuring samples
taken at twice the highest frequency in the signal)
discrete transform of the samples (which samples the scaled continuous
transform)
,The most common application of signal averaging correct answersrisk
stratification for sustained ventricular arrhythmias, in patients in sinus
rhythm post MI
This method is not accurate when applied to a rhythm with a bundle
branch block.
Heart Rage Variability (HRV) correct answersAnalysis of beat-to-beat
variation in heart rate is clinically useful to evaluate the effects of
sympathetic-parasympathetic imbalances, the autonomic nervous
generation of arrhythmias.
Sympathetic nervous system (SNS) activation correct
answersControlled by norepinephrine production. This increases
the heart rate
parasympathetic nervous system (PNS) stimulation correct
answersControlled by acetylcholine production—slowing the heart rate
The inherent rate of the sinus node impulse without any nervous
influence is approximately correct answers100bpm
Sympathetic stimulation can increase HR from any value to over 100 bpm,
accelerating to correct answers200-300 bpm. Therefore, tachycardic heart
rates are only influenced by sympathetic effect.
Many other factors can affect HRV, including correct answersage, stress,
exercise, respiration, blood pressure regulation, and the circadian
rhythm.
The most commonly used intermittent recorders are called correct
answersevent recorders
record events which may occur over weeks to months
Loop recorders correct answersmonitor and record ECG continuously. Brief
periods are stored when activated: either by the patient pushing an event
marker button or arrhythmia detection algorithms within the recorder.
The most recent and effective weapon in the arsenal of arrhythmia
detection is the correct answersimplanted loop recorder (ILR)
An implanted recorder is usually reserved for cases of arrhythmia
which have a significant impact on the everyday life of the patient.
correct answerssyncope paroxysmal atrial fibrillation
supraventricular
tachycardia intermittent
heart block
sick sinus
syndrome
tachycardia
post MI arrhythmia such as ventricular
tachycardia eliminating arrhythmia as cause of
recurrent symptoms
, Implanted cardiac defibrillators have the capability of internally recording
arrhythmia episodes. The limitation is that the device must be
programmed to record specific findings: correct answersheart rate range
intervals measured in
msec onset of
arrhythmia
findings specific to either ventricle or
atrium rhythm irregularity
Acquisition Module correct answersthe device used to download the digital
data card or tape into the ambulatory analysis system.
Automated ECG analysis systems were designed mainly to detect
arrhythmias of correct answersventricular origin by defining the
characteristics of QRS timing and QRS morphology, or slope
The method in which a manufacturer designs an analyzer can be
categorized into two main approaches; correct answersdiscriminators and
categorizers.
Feature extraction correct answersused for examination of ST segment
change and pacemaker stimulus recognition. When the slope of Q onset or J
point increases beyond threshold the algorithm begins.
Each Canadian province publishes guidelines for allowable conditions
which will be reimbursed by public health care. correct answersBC-
symptoms of arrhythmia occurring 2 or more times in a 7 day period
syncope
BCMA protocol also includes patients whose cardiologist/specialist is
evaluating: pacemaker function
bradycardia
atrial
fibrillation
frequent, reproducible cardiac arrhythmias in patients who are using anti-
arrhythmic drugs and who need to undergo serial monitoring to assess
response or adverse reactions
BC will only cover 24hour holtor monitoring.
One of the most commonly seen arrhythmias is the: correct
answerspremature ventricular complex—PVC—also called VPB
(ventricular premature beat) or VE (ventricular ectopic)
commonly seen in patients with coronary disease
4201
Phase shift correct answersthe displacement of a waveform over time,
accurately showing the number of beats occurring in a given period of
time
Frequency modulation correct answersthe system's ability to accurately
display the various tall and short wave forms recorded from the ECG
source.
The greatest benefit of digital recording correct answersaccurate, high
fidelity and noise free recordings that allow for powerful, on-line analyzing
capacity.
baseline artefact correct answerscaused by body position, lead wire
movement, loose electrodes or perspiration.
The areas which have implications in digital recorder research are correct
answersheart rate variability (HRV), T wave alternans and spectral analysis
Signal Averaged ECG correct answersmeans of amplifying the recorded QRS
signal in order to detect abnormal electrical potentials in the form of late
potentials—those which occur during the repolarization portion of the ECG
waveform
Time-Domain QRS Averaging correct answersused to amplify, detect and
then analyze late potentials of microvolt amplitudes in the QRS complex.
Unwanted noise (such as myopotential) is suppressed.
Bipolar XYZ leads can be averaged, filtered and combined in a vector
recording called filtered QRS complex. The analysis will include: correct
answersfiltered QRS complex root mean square voltage in the terminal 40
ms of filtered QRS complex < 20 µv 9 duration of signal < 40 µV in terminal
QRS complex >38 ms
Frequency-Domain QRS Averaging correct answersFrequency analysis of
the QRS supplies information about the rate and synchronization of
depolarization of the ventricles. Three algorithms are used to obtain QRS
frequency data:
a continuous transform of a continuous signal (the signal averaged over
time) continuous transform of samples of the signal (measuring samples
taken at twice the highest frequency in the signal)
discrete transform of the samples (which samples the scaled continuous
transform)
,The most common application of signal averaging correct answersrisk
stratification for sustained ventricular arrhythmias, in patients in sinus
rhythm post MI
This method is not accurate when applied to a rhythm with a bundle
branch block.
Heart Rage Variability (HRV) correct answersAnalysis of beat-to-beat
variation in heart rate is clinically useful to evaluate the effects of
sympathetic-parasympathetic imbalances, the autonomic nervous
generation of arrhythmias.
Sympathetic nervous system (SNS) activation correct
answersControlled by norepinephrine production. This increases
the heart rate
parasympathetic nervous system (PNS) stimulation correct
answersControlled by acetylcholine production—slowing the heart rate
The inherent rate of the sinus node impulse without any nervous
influence is approximately correct answers100bpm
Sympathetic stimulation can increase HR from any value to over 100 bpm,
accelerating to correct answers200-300 bpm. Therefore, tachycardic heart
rates are only influenced by sympathetic effect.
Many other factors can affect HRV, including correct answersage, stress,
exercise, respiration, blood pressure regulation, and the circadian
rhythm.
The most commonly used intermittent recorders are called correct
answersevent recorders
record events which may occur over weeks to months
Loop recorders correct answersmonitor and record ECG continuously. Brief
periods are stored when activated: either by the patient pushing an event
marker button or arrhythmia detection algorithms within the recorder.
The most recent and effective weapon in the arsenal of arrhythmia
detection is the correct answersimplanted loop recorder (ILR)
An implanted recorder is usually reserved for cases of arrhythmia
which have a significant impact on the everyday life of the patient.
correct answerssyncope paroxysmal atrial fibrillation
supraventricular
tachycardia intermittent
heart block
sick sinus
syndrome
tachycardia
post MI arrhythmia such as ventricular
tachycardia eliminating arrhythmia as cause of
recurrent symptoms
, Implanted cardiac defibrillators have the capability of internally recording
arrhythmia episodes. The limitation is that the device must be
programmed to record specific findings: correct answersheart rate range
intervals measured in
msec onset of
arrhythmia
findings specific to either ventricle or
atrium rhythm irregularity
Acquisition Module correct answersthe device used to download the digital
data card or tape into the ambulatory analysis system.
Automated ECG analysis systems were designed mainly to detect
arrhythmias of correct answersventricular origin by defining the
characteristics of QRS timing and QRS morphology, or slope
The method in which a manufacturer designs an analyzer can be
categorized into two main approaches; correct answersdiscriminators and
categorizers.
Feature extraction correct answersused for examination of ST segment
change and pacemaker stimulus recognition. When the slope of Q onset or J
point increases beyond threshold the algorithm begins.
Each Canadian province publishes guidelines for allowable conditions
which will be reimbursed by public health care. correct answersBC-
symptoms of arrhythmia occurring 2 or more times in a 7 day period
syncope
BCMA protocol also includes patients whose cardiologist/specialist is
evaluating: pacemaker function
bradycardia
atrial
fibrillation
frequent, reproducible cardiac arrhythmias in patients who are using anti-
arrhythmic drugs and who need to undergo serial monitoring to assess
response or adverse reactions
BC will only cover 24hour holtor monitoring.
One of the most commonly seen arrhythmias is the: correct
answerspremature ventricular complex—PVC—also called VPB
(ventricular premature beat) or VE (ventricular ectopic)
commonly seen in patients with coronary disease
