CCT - Certified Cardiographic Technician Pacemaker Rhythm Interpretation Questions and Answers

Question 1

A CCT is reviewing an ECG strip that shows a regular vertical spike immediately preceding each P wave, followed by a normal QRS complex.
The patient's heart rate is 70 bpm.
Which of the following is the most accurate interpretation?

Accepted Answer

Atrial paced rhythm

Answer

Ventricular paced rhythm

Answer

Dual-chamber paced rhythm

Answer

Failure to capture

Question 2

An ECG rhythm strip from a patient with a pacemaker shows distinct pacing spikes that are not followed by any electrical activity (neither a P wave nor a QRS complex). This finding is best described as which type of pacemaker malfunction?

Accepted Answer

Failure to capture

Answer

Oversensing

Answer

Undersensing

Answer

Failure to pace

Question 3

Which of the following ECG findings is most characteristic of a ventricular-paced rhythm originating from a lead in the right ventricle?

Accepted Answer

A pacing spike followed by a wide QRS complex with a Left Bundle Branch Block (LBBB) morphology

Answer

A pacing spike followed by a narrow QRS complex (<0.12s)

Answer

A pacing spike followed by a P wave

Answer

Pacing spikes that occur randomly without relation to the QRS complex

Question 4

A technician observes a rhythm strip where pacemaker spikes appear at a fixed rate, including some that fall shortly after the patient's own native QRS complexes. This indicates that the pacemaker is not recognizing the patient's intrinsic beats. What is this malfunction called?

Accepted Answer

Undersensing

Answer

Failure to capture

Answer

Oversensing

Answer

Pacemaker-mediated tachycardia

Question 5

A patient's ECG shows two distinct pacing spikes. The first spike is followed by a P wave, and after a short, fixed delay, a second spike appears, followed by a wide QRS complex. This pattern is consistent with which pacing mode?

Accepted Answer

Dual-chamber AV sequential pacing (DDD)

Answer

Atrial pacing (AAI)

Answer

Ventricular pacing (VVI)

Answer

Biventricular pacing (CRT)

Question 6

A CCT is monitoring a patient whose pacemaker is programmed to a lower rate of 60 bpm. The patient's intrinsic heart rate drops to 50 bpm, but no pacing spikes appear on the ECG, resulting in a long pause. This scenario most likely represents which pacemaker malfunction?

Accepted Answer

Oversensing

Answer

Undersensing

Answer

Failure to capture

Answer

Normal pacemaker function