MCQ 26: Pacemaker (36)

Q. A patient has been provided with a single chamber pacemaker recently for complete heart block. The pacing mode is set as VVIR. R in VVIR stands for?
A. Rate responsive
B. Rate controlled
C. Rate sensitive
D. Rate inhibition

Answer: A. Rate responsive

Explanation:

1st letter: Chamber paced
2nd letter: Chamber sensed
3rd letter: Action of the pacemaker after sensing a beat
4th letter: Rate responsiveness i.e. demand ventricular pacing is present with response to exercise

VVIR means: Ventricle is paced, ventricle is sensed, pacing is inhibited if beat is sensed and rate responsiveness is present in pacemaker i.e. rate of pacing is increased if a physiological need is there e.g. during exercise.

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ECG Spotter

What is the diagnosis? Click the button below to view answer: Show Answer

High heart rate

The patient contacts the doctor over phone with this report. Obviously anxious because of his high heart rate (199 beats per minute) as detected by ECG machine. Should he be worried about this and come to emergency department as soon as possible? Correct answer- ECG machine has calculated his heart rate incorrectly. Heart rate is around 100 beats per minute. Other findings in this ECG include ST segment elevation in anterior chest leads along with presence of Q waves, denoting old MI changes with possibly development of LV aneurysm. In such cases, ST segment elevation can persist for long periods. Now, should he come to emergency department? Not because of detection of high heart rate. But, if he is having symptoms such as shortness of breath or chest pain, he should visit emergency department. Otherwise, if he is asymptomatic, he can schedule a regular visit with his cardiologist.

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