CRM HF/CRT Week 9 UPDATED
ACTUAL Questions and CORRECT
Answers
What additional steps are required when conducting a CRT follow-up (3-leads) compared to an
ICD follow-up (2-leads)? (select all that apply)
Evaluate patients AV conduction to determine if MVP would be appropriate
Evaluate LV lead performance for impedance and threshold
Evaluate Wavelet template since Auto-Collection is inactive
Assess CRT pacing: if less than 90% investigate more
Evaluate Cardiac Compass/trend information - CORRECT ANSWER - Evaluate LV lead
performance for impedance and threshold
Evaluate Wavelet template since Auto-Collection is inactive
Assess CRT pacing: if less than 90% investigate more
The first "P" in PBL-STOP reminds you to check: (select the best answer)
Presenting rhythm, previous episodes and P-waves
Presenting rhythm, rate and percent pacing
Previous episodes, P-waves and percent pacing
,Previous episodes, P-waves and rate - CORRECT ANSWER - Presenting rhythm, rate and
percent pacing
AdaptivCRT is a dynamic, physiologic pacing algorithm which enhances CRT by adjusting CRT
parameters automatically to changes in the patient's activity and conduction. It can be
programmed to provide pacing by 1 of 3 different options: (choose all that apply)
Adaptive BiV & LV
Adaptive BiV
CardioSync
Non-Adaptive CRT
QuickOpt - CORRECT ANSWER - Adaptive BiV & LV
Adaptive BiV
Non-Adaptive CRT
Which of these LV pace polarity options would maximize device longevity without Phrenic
Nerve stimulation:(LV Pace Polarity; Threshold; Phrenic Nerve Stimulation (PNS); Impedance)
LV Ring to LV Tip; 2.0V @ 0.4ms; Yes PNS; 1000 ohms
LV Tip to RV Coil; 1.0V @ 0.4ms; No PNS; 325 ohms
, LV Tip to LV Ring; 1.5V @ 0.4ms; No PNS; 825 ohms - CORRECT ANSWER - LV Tip
to LV Ring; 1.5V @ 0.4ms; No PNS; 825 ohms
Acute HF decompensations can result from precipitating events that make the clinical status of
the patients less stable, or from insidious hemodynamic deterioration resulting from the
progression of the disease itself. Hemodynamic alterations contribute to chamber dilatation and
increase endogenous protease activity, leading to sub-endocardial ischemia and myocyte necrosis
and loss. As a result, each hospitalization for heart failure contributes to the progression of LV
dysfunction, which in turn will increase the risk for a future hospitalization. Thus, not only does
the process perpetuate itself, but the time period between hospitalizations also becomes shorter
and shorter. Treatment goals should include not only managing the current episode but also
managing to anticipate any foreseeable problems.
True
False - CORRECT ANSWER - True
This graph is depicting an Optivol Fluid Index level that is trending upward and Thoracic
Impedance that is trending downward which is suggestive of what: (select the best answer)
Gradually deteriorating cardiac condition
Gradually improving cardiac condition
Severe HF decompensation due to volume overload
This graph represents a well-known error in the Optivol algorithm. - CORRECT
ANSWER - Severe HF decompensation due to volume overload
A night heart rate of >85 bpm is suggestive of:
Poor physical conditioning and needs exercise
ACTUAL Questions and CORRECT
Answers
What additional steps are required when conducting a CRT follow-up (3-leads) compared to an
ICD follow-up (2-leads)? (select all that apply)
Evaluate patients AV conduction to determine if MVP would be appropriate
Evaluate LV lead performance for impedance and threshold
Evaluate Wavelet template since Auto-Collection is inactive
Assess CRT pacing: if less than 90% investigate more
Evaluate Cardiac Compass/trend information - CORRECT ANSWER - Evaluate LV lead
performance for impedance and threshold
Evaluate Wavelet template since Auto-Collection is inactive
Assess CRT pacing: if less than 90% investigate more
The first "P" in PBL-STOP reminds you to check: (select the best answer)
Presenting rhythm, previous episodes and P-waves
Presenting rhythm, rate and percent pacing
Previous episodes, P-waves and percent pacing
,Previous episodes, P-waves and rate - CORRECT ANSWER - Presenting rhythm, rate and
percent pacing
AdaptivCRT is a dynamic, physiologic pacing algorithm which enhances CRT by adjusting CRT
parameters automatically to changes in the patient's activity and conduction. It can be
programmed to provide pacing by 1 of 3 different options: (choose all that apply)
Adaptive BiV & LV
Adaptive BiV
CardioSync
Non-Adaptive CRT
QuickOpt - CORRECT ANSWER - Adaptive BiV & LV
Adaptive BiV
Non-Adaptive CRT
Which of these LV pace polarity options would maximize device longevity without Phrenic
Nerve stimulation:(LV Pace Polarity; Threshold; Phrenic Nerve Stimulation (PNS); Impedance)
LV Ring to LV Tip; 2.0V @ 0.4ms; Yes PNS; 1000 ohms
LV Tip to RV Coil; 1.0V @ 0.4ms; No PNS; 325 ohms
, LV Tip to LV Ring; 1.5V @ 0.4ms; No PNS; 825 ohms - CORRECT ANSWER - LV Tip
to LV Ring; 1.5V @ 0.4ms; No PNS; 825 ohms
Acute HF decompensations can result from precipitating events that make the clinical status of
the patients less stable, or from insidious hemodynamic deterioration resulting from the
progression of the disease itself. Hemodynamic alterations contribute to chamber dilatation and
increase endogenous protease activity, leading to sub-endocardial ischemia and myocyte necrosis
and loss. As a result, each hospitalization for heart failure contributes to the progression of LV
dysfunction, which in turn will increase the risk for a future hospitalization. Thus, not only does
the process perpetuate itself, but the time period between hospitalizations also becomes shorter
and shorter. Treatment goals should include not only managing the current episode but also
managing to anticipate any foreseeable problems.
True
False - CORRECT ANSWER - True
This graph is depicting an Optivol Fluid Index level that is trending upward and Thoracic
Impedance that is trending downward which is suggestive of what: (select the best answer)
Gradually deteriorating cardiac condition
Gradually improving cardiac condition
Severe HF decompensation due to volume overload
This graph represents a well-known error in the Optivol algorithm. - CORRECT
ANSWER - Severe HF decompensation due to volume overload
A night heart rate of >85 bpm is suggestive of:
Poor physical conditioning and needs exercise
