RCES THE FINAL EXAM 2025 SOLUTION

In patients with CHF and LBBB that are severely symptomatic, properly performed CRT-P (without defib) reduces sudden death and mortality by: - 40-50% Three reasons to use multipolar CS/LV leads in resynchronized therapy are: - Stimulate LV in area of lowest threshold, stimulate LV in area of greatest asynchrony, prevent phrenic nerve stimulation by changing the LV pacing vector Implanting the LV lead in small diameter coronary veins, which type of resynchronization lv lead design generally has the smallest diameter? - Unipolar over the wire A minority of patients treated with bi-v pacing do not improve clinically. Most of the following are characteristics of non responder patients. What characteristic will also suggest the patient is more likely to be a good responder to CRT? A. Ischemic heart disease B. LBBB (vs rbbb) C. Transmural MI Scar D. Enter your corner vein lead placement - LBBB The most common problem associated with pacing from the LV from the coronary vein is: - Diaphragmatic stimulation The only significant difference between implanting an ICD and a CRT-D device is a - CS lead Most patients that receive a BIV pacemaker also get a - Implantable defibrillator In resynchronization therapy, after the LV lead is placed, it should be tested for: - Adequate pacing threshold & an absence of diaphragmatic pacing In resynchronization therapy, after the LV lead is properly placed and tested the next thing to do is: - The guider sheath is sliced and removed. The main long-term benefit of CRT on the left ventricle is: - Reduced end diastolic size and LV mass CRT pacemakers are usually programmed to: - Pace 100% of the time BIV pacers/CRT devices are generally used to treat patients with: - CHF What are the expected benefits of CRT implant in appropriately responding patients? - Increased EF by 5-10%, reduced hospitalizations from CHF, improved quality of life. What type of pacemaker is shown in this X-ray - CRT ACC, AHA, HRS guidelines recommend CRT for patients who have CHF with functional class III or IV on optimal medical therapy with an EF _____and a QRS _____ - 35%, 0.12 sec Prior to implanting an ICD on a 12 year old female patient with generic cardiomyopathy an initial EP study induced VT and VF. But, during the ICD implant procedure the implanted lead fails to provide an adequate DFT. What should be recommended? - Implanting lead array In two coil ICD's the shocking electrodes are usually configured to shock between the: - SVC and RV