CCDS IBHRE Exam Newest 2026 Complete
Questions | With 100% Correct Answers graded A+
Guaranteed Success!
Steroid used in electrodes
dexamethasone sodium phosphate in the silicone core(a
corticosteriod)
Steroid-Eluting Electrodes
1. The acute threshold is relatively flat compared to non-steroid
electrodes
2. The initial capture threshold is similar to non-steroid leads
Silicone Rubber lead insulation Pros
1. Can easily be repaired
2. Flexible
3. Proven performance history
4. Easy to make
,Silicone Rubber lead insulation cons
1. high friction coefficient
2. Absorbs lipids
3. More thrombogenic and fibrotic
4. Cuts easily
5. Tears easily if suture tied too tightly
6. Large diameter
Polyurethane 80A
BAD
Polyurethane 55D
GOOD
polyurethane lead insulation pros
1. relatively nonthrombogenic/fibrotic
2. thin walls
3. high tear friction
4. resists cutting
5. low friction coefficient
,polyurethane lead insulation cons
1. cannot be repaired
2. relatively stiff
3. hard to make
Pacemaker Syndrome Causes
1. Loss of AV synchrony
2. Sustained retrograde conduction
3. A single ventricular rate when rate modulation is required for
exercise
Approx 25% of patients only paced from the ventricle may have
some level of severity related to pacemaker syndrome
Pacemaker syndrome diagnosis
1. Observe fluctuation in the peripheral blood pressure
2. Cannon "A" wave in the neck
3. History alone
Pacemaker syndrome management
Restore AV synchrony
in ventricular only PM -->lower the pacing rate to minimize ventricular
only pacing
DO NOT increase the pacing rate
, Fallback
1. Decouples atrial & ventricular events at the upper rate limit
2. The ventricular inhibited pacing rate then gradually
decrements to a programmed lower or "fallback" rate over a
programmed duration
3. When the fallback rate is reached, atrial synchrony is restored
Rate smoothing
1. Eliminated large cycle to cycle variations by preventing paced
rate from changing more than a certain percentage (3%, 6%, 12%,
etc) from one V-V interval to the next
2. Eliminates large fluctuations in rate during fixed-ratio or
psuedo- Wenckebach block
FOUND IN GDT devices
Questions | With 100% Correct Answers graded A+
Guaranteed Success!
Steroid used in electrodes
dexamethasone sodium phosphate in the silicone core(a
corticosteriod)
Steroid-Eluting Electrodes
1. The acute threshold is relatively flat compared to non-steroid
electrodes
2. The initial capture threshold is similar to non-steroid leads
Silicone Rubber lead insulation Pros
1. Can easily be repaired
2. Flexible
3. Proven performance history
4. Easy to make
,Silicone Rubber lead insulation cons
1. high friction coefficient
2. Absorbs lipids
3. More thrombogenic and fibrotic
4. Cuts easily
5. Tears easily if suture tied too tightly
6. Large diameter
Polyurethane 80A
BAD
Polyurethane 55D
GOOD
polyurethane lead insulation pros
1. relatively nonthrombogenic/fibrotic
2. thin walls
3. high tear friction
4. resists cutting
5. low friction coefficient
,polyurethane lead insulation cons
1. cannot be repaired
2. relatively stiff
3. hard to make
Pacemaker Syndrome Causes
1. Loss of AV synchrony
2. Sustained retrograde conduction
3. A single ventricular rate when rate modulation is required for
exercise
Approx 25% of patients only paced from the ventricle may have
some level of severity related to pacemaker syndrome
Pacemaker syndrome diagnosis
1. Observe fluctuation in the peripheral blood pressure
2. Cannon "A" wave in the neck
3. History alone
Pacemaker syndrome management
Restore AV synchrony
in ventricular only PM -->lower the pacing rate to minimize ventricular
only pacing
DO NOT increase the pacing rate
, Fallback
1. Decouples atrial & ventricular events at the upper rate limit
2. The ventricular inhibited pacing rate then gradually
decrements to a programmed lower or "fallback" rate over a
programmed duration
3. When the fallback rate is reached, atrial synchrony is restored
Rate smoothing
1. Eliminated large cycle to cycle variations by preventing paced
rate from changing more than a certain percentage (3%, 6%, 12%,
etc) from one V-V interval to the next
2. Eliminates large fluctuations in rate during fixed-ratio or
psuedo- Wenckebach block
FOUND IN GDT devices
