Practice Test Geeks(CET) Certified Electrocardiogram Technician Practice Test
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Holter Monitoring & Ambulatory ECG Flashcards

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  1. A Holter monitor uses a modified Mason-Likar lead system. Compared to standard 12-lead ECG limb leads, the limb electrodes are repositioned to:

    Answer: The torso to reduce motion artifact

    In the Mason-Likar system, limb electrodes are moved to the torso to minimize movement artifact during ambulatory monitoring.

  2. Which Holter finding is considered a class I indication for permanent pacemaker implantation?

    Answer: Symptomatic sinus pauses greater than 3 seconds while awake

    Symptomatic sinus node dysfunction with documented pauses causing symptoms meets class I criteria for permanent pacing per ACC/AHA guidelines.

  3. During ambulatory ECG monitoring, ST-segment depression that occurs without symptoms is termed:

    Answer: Silent myocardial ischemia

    Asymptomatic ST depression meeting ischemic criteria (≥1 mm, horizontal/downsloping, ≥1 min duration) is classified as silent myocardial ischemia.

  4. A patient wears a continuous-loop event monitor for 30 days. This device differs from a standard Holter monitor primarily because it:

    Answer: Continuously records but only retains data around patient-triggered events

    A continuous-loop event monitor constantly records but overwrites old data, retaining only the minutes before and after the patient presses the event button.

  5. A Holter report shows frequent couplets (pairs of PVCs). What is the minimum number of consecutive PVCs that defines ventricular tachycardia?

    Answer: 3

    By definition, three or more consecutive PVCs at a rate ≥100 bpm constitutes ventricular tachycardia.

  6. Which of the following best describes the '1x1x1 rule' used to identify significant ST changes on Holter monitoring?

    Answer: 1 mm depression or elevation, lasting at least 1 minute, in at least 1 lead

    The 1x1x1 rule defines significant ST change as ≥1 mm deviation lasting ≥1 minute in at least 1 lead, used to flag potential ischemia on Holter.

  7. When scanning Holter recordings using software, the technician's primary role is to:

    Answer: Verify, edit, and confirm computer auto-analysis for accuracy

    Holter technicians must critically review and correct automated beat classifications because software algorithms are imperfect and can misclassify artifact or arrhythmias.