Pacemaker Monitoring and Function Flashcards
7 cards from real CMT practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Pacemaker Monitoring and Function flashcards as text
A patient with a biventricular pacemaker (cardiac resynchronization therapy, CRT) has two ventricular leads. What is the PRIMARY purpose of CRT?
Answer: To resynchronize left and right ventricular contraction in heart failure patients
CRT coordinates left and right ventricular contractions to improve cardiac output in patients with heart failure and ventricular dyssynchrony.
An ICD (Implantable Cardioverter Defibrillator) differs from a standard pacemaker in that it can:
Answer: Deliver high-energy shocks to terminate life-threatening arrhythmias
ICDs detect and treat life-threatening ventricular arrhythmias (VT/VF) by delivering high-energy defibrillation shocks or anti-tachycardia pacing.
When monitoring a patient with a pacemaker, what should a cardiac monitor technician do if the paced QRS morphology suddenly changes from the patient's established baseline?
Answer: Notify the nurse or physician immediately as this may indicate lead displacement or malfunction
A sudden change in paced QRS morphology can indicate lead displacement, dislodgement, or pacemaker malfunction requiring prompt evaluation by clinical staff.
Which of the following rhythms would be MOST concerning in a patient who is 100% pacemaker-dependent?
Answer: Pacemaker spikes without capture (failure to capture)
In a pacemaker-dependent patient, failure to capture means there is no effective cardiac pacing, which can be immediately life-threatening.
What is the significance of a 'pacemaker spike' artifact on an ECG?
Answer: It represents the electrical pulse delivered by the pacemaker generator
A pacemaker spike is the visible artifact caused by the electrical impulse delivered by the pacemaker generator to stimulate the myocardium.
A patient's pacemaker is programmed in VOO mode. What does this mean for monitoring purposes?
Answer: The pacemaker fires at a fixed rate regardless of the patient's intrinsic rhythm, with no sensing
VOO is an asynchronous ventricular pacing mode — the pacemaker fires at a fixed rate with no sensing, regardless of any intrinsic cardiac activity.
During telemetry monitoring, you notice a patient's pacemaker is firing at a rate of 65 bpm, but native QRS complexes appear at 72 bpm. The pacemaker spikes appear to compete with the patient's own beats without consistent capture. What is the MOST likely explanation?
Answer: The pacemaker is undersensing the patient's intrinsic rhythm
When pacemaker spikes appear in competition with intrinsic beats (rather than being inhibited by them), this indicates undersensing — the pacemaker is not detecting the patient's native beats.