1. Telemetry Quiz February 11th, 2012 Dr. Irving Tiong Dr. Darren Kagal
Telemetry Quiz
February 11th, 2012
Dr. Irving Tiong
Dr. Darren Kagal 1

2. 2

3. A. Atrial fibrillation B. Atrial flutter C. Sinus tachycardia D. SVT
A. Atrial fibrillation
B. Atrial flutter
C. Sinus tachycardia
D. SVT c 3

4. A. Atrial fibrillation B. Atrial flutter C. Sinus tachycardia D. SVT
A. Atrial fibrillation
B. Atrial flutter
C. Sinus tachycardia
D. SVT c 4

5.
St elevation 5 5

6. What is the cause of chest pain?
What is the cause of chest pain?
A. Stomach acid
B. Acute coronary syndrome- call CODE STEMI
C. Psychological stress
D. Bad reaction to hospital food b 6

7. What is the cause of chest pain?
What is the cause of chest pain?
A. Stomach acid
B. Acute coronary syndrome- call CODE STEMI
C. Psychological stress
D. Bad reaction to hospital food b 7

8. 8

9. C. Ventricular tachycardia D. Looks pretty bad- call a “Code Blue”
A. Atrial fibrillation
B. Artifact
C. Ventricular tachycardia
D. Looks pretty bad- call a “Code Blue” d 9

10. C. Ventricular tachycardia D. Looks pretty bad- call a “Code Blue”
A. Atrial fibrillation
B. Artifact
C. Ventricular tachycardia
D. Looks pretty bad- call a “Code Blue” d 10

11. 11

12. D. Don’t know. Hope it won’t happen again
A. SVT
B. VT
C. Artifact
D. Don’t know. Hope it won’t happen again c 12

13. D. Don’t know. Hope it won’t happen again
A. SVT
B. VT
C. Artifact
D. Don’t know. Hope it won’t happen again c 13

14. 14

15. B. Second degree Mobitz I (Wenchebach) C. Second degree Mobiz II
A. Complete Heart block
B. Second degree Mobitz I (Wenchebach)
C. Second degree Mobiz II
D. Complete heart block b 15

16. B. Second degree Mobitz I (Wenchebach) C. Second degree Mobiz II
A. Complete Heart block
B. Second degree Mobitz I (Wenchebach)
C. Second degree Mobiz II
D. Complete heart block b 16

17. What is wrong with this strip?

18. Normal Atrial fibrilation First degree AV block Prolonged QT interval

19. Normal Atrial fibrilation First degree AV block Prolonged QT interval

20. 20

21. What Should You Do? A. Go back to sleep. Patient is likely on a walk
What Should You Do?
A. Go back to sleep. Patient is likely on a walk
B. Quickly assess patient. Ensure leads are properly on. Ensure gain is up. If no change call Code Blue
C. Start compressions
D. Call a CODE BROWN b 21

22. What Should You Do? A. Go back to sleep. Patient is likely on a walk
What Should You Do?
A. Go back to sleep. Patient is likely on a walk
B. Quickly assess patient. Ensure leads are properly on. Ensure gain is up. If no change call Code Blue
C. Start compressions
D. Call a CODE BROWN b 22

23. 23

24. D. Ventricular fibrillation
A. Atrial tachycardia
B. Atrial Flutter
C. Ventricular flutter
D. Ventricular fibrillation b 24

25. D. Ventricular fibrillation
A. Atrial tachycardia
B. Atrial Flutter
C. Ventricular flutter
D. Ventricular fibrillation b 25

26. 26

27. A. Ventricular fibrillation B. Atrial flutter C. Atrial fibrillation
A. Ventricular fibrillation
B. Atrial flutter
C. Atrial fibrillation
D. Sinus tachycardia c 27

28. A. Ventricular fibrillation B. Atrial flutter C. Atrial fibrillation
A. Ventricular fibrillation
B. Atrial flutter
C. Atrial fibrillation
D. Sinus tachycardia c 28

29. 29

30. C. Supraventricular tachycardia D. Subventricular tachycardia
A. Atrial flutter
B. Atrial fibrillation
C. Supraventricular tachycardia
D. Subventricular tachycardia c 30

31. C. Supraventricular tachycardia D. Subventricular tachycardia
A. Atrial flutter
B. Atrial fibrillation
C. Supraventricular tachycardia
D. Subventricular tachycardia c 31

32.
safeR 32 32

33. A. Poor ventricular sensing B. Poor ventricular capture
A. Poor ventricular sensing
B. Poor ventricular capture
C. Pacemaker mediated tachycardia
D. Pacemaker is working fine. Go back to sleep. d 33

34. A. Poor ventricular sensing B. Poor ventricular capture
A. Poor ventricular sensing
B. Poor ventricular capture
C. Pacemaker mediated tachycardia
D. Pacemaker is working fine. Go back to sleep. d 34

36. Ventricular tachycardia Artifact D. Ventricular bigeminy
Atrial bigeminy
Ventricular tachycardia
Artifact
D. Ventricular bigeminy D

37. Ventricular tachycardia Artifact D. Ventricular bigeminy
Atrial bigeminy
Ventricular tachycardia
Artifact
D. Ventricular bigeminy D

39.
A. Atrial Fibrillation B. Ventricular Fibrillation C. Sinus tachycardia D. Atrial tachycardia D

40.
A. Atrial Fibrillation B. Ventricular Fibrillation C. Sinus tachycardia D. Atrial tachycardia D

42.
A. Atrial fibrillation B. Sinus node disease (sinus pauses) C. Normal rhythm D. Ventricular fibrillation B

43.
A. Atrial fibrillation B. Sinus node disease (sinus pauses) C. Normal rhythm D. Ventricular fibrillation B

45.
A. First degree AV block B. PVCs C. Second degree AV block Mobitz II D. Wenchebach D

46.
A. First degree AV block B. PVCs C. Second degree AV block Mobitz II D. Wenchebach D

48. Premature atrial complex
Premature atrial complex
Premature ventricular complex with R on T phenomenon
Sinus tachycardia
D. Sinus pause B

49. Premature atrial complex
Premature atrial complex
Premature ventricular complex with R on T phenomenon
Sinus tachycardia
D. Sinus pause B

51.
A. Normal sinus rhythm B. Isorhythmic dissociation C. Complete heart block D. First degree heart block D

52.
A. Normal sinus rhythm B. Isorhythmic dissociation C. Complete heart block D. First degree heart block D

54.
A. Completely normal rhythm. B. Completed anterior myocardial infarction. C. Complete heart block. D. Completely challenging rhythm. B

55.
A. Completely normal rhythm. B. Completed anterior myocardial infarction. C. Complete heart block. D. Completely challenging rhythm. B

57.
A. Normal sinus rhythm B. VVI pacemaker. C. DDD pacemaker D. DDD pacemaker with atrial undersensing D

58.
A. Normal sinus rhythm B. VVI pacemaker. C. DDD pacemaker D. DDD pacemaker with atrial undersensing D

60.
A. Normal DDD pacemaker function B. Atrial undersensing C. Ventricular undersensing D. Can’t figure it out. Call EP!! A

61.
A. Normal DDD pacemaker function B. Atrial undersensing C. Ventricular undersensing D. Can’t figure it out. Call EP!! A

63. A. Normal sinus rhythm B. Loss of capture C. Oversensing D. ICD shock
A. Normal sinus rhythm B. Loss of capture C. Oversensing D. ICD shock B

64. A. Normal sinus rhythm B. Loss of capture C. Oversensing D. ICD shock
A. Normal sinus rhythm B. Loss of capture C. Oversensing D. ICD shock B

65.
Quiz Part 2 65

66. 66

67. D. Second degree, Mobitz I
A. Sinus tachycardia
B. Atrial flutter
C. Third Degree AV block
D. Second degree, Mobitz I d

68. D. Second degree, Mobitz I
A. Sinus tachycardia
B. Atrial flutter
C. Third Degree AV block
D. Second degree, Mobitz I d

69. 69

70. 70

71. Second degree AV block Mobitz I First degree AV block
Sinus bradycardia
Second degree AV block Mobitz I
First degree AV block
Third degree AV block

72.
Complete heart block 72

74. Multifocal atrial tachycardia Atrial tachycardia
Atrial Fibrillation
Sinus tachycardia
Multifocal atrial tachycardia
Atrial tachycardia

75. Multifocal atrial tachycardia Atrial tachycardia
Atrial Fibrillation
Sinus tachycardia
Multifocal atrial tachycardia
Atrial tachycardia

76. 76

77. Second degree AV block, Mobitz II Second degree AV block, Mobitz I
Complete AV block
Second degree AV block, Mobitz II
Second degree AV block, Mobitz I
Sinus bradycardia with junctional escape (Isorhythmic disassociation) a

78. Second degree AV block, Mobitz II Second degree AV block, Mobitz I
Complete AV block
Second degree AV block, Mobitz II
Second degree AV block, Mobitz I
Sinus bradycardia with junctional escape (Isorhythmic disassociation) a

79. 79

80. 80

81. Ventricular tachycardia Atrial fibrillation SVT with aberrancy
Ventricular tachycardia
Atrial fibrillation
SVT with aberrancy
Atrial tachycardia d

82. Ventricular tachycardia Atrial fibrillation SVT with aberrancy
Ventricular tachycardia
Atrial fibrillation
SVT with aberrancy
Atrial tachycardia d

84. Pacemaker oversensing Pacemaker undersensing
Pacemaker oversensing
Pacemaker undersensing
Pacemaker over and undersensing
Doctor connected the leads the wrong way during implant. d

85. Pacemaker oversensing Pacemaker undersensing
Pacemaker oversensing
Pacemaker undersensing
Pacemaker over and undersensing
Doctor connected the leads the wrong way during implant. d

86.
Dual chamber pacemaker with lead reversal (atrial lead connected to ventricular port and vice versa 86

87. 87

88. Supraventricular tachycardia with aberrancy First degree AV block
Supraventricular tachycardia with aberrancy
First degree AV block
Non sustained Ventricular tachycardia
Complete heart block with ventricular escape c

89. Supraventricular tachycardia with aberrancy First degree AV block
Supraventricular tachycardia with aberrancy
First degree AV block
Non sustained Ventricular tachycardia
Complete heart block with ventricular escape c

90. What are the blue arrows signifying?
Bonus Question
What are the blue arrows signifying? 90

91. Intermittent retrograde p waves (V-A conduction)
Artifact?
ST elevations?
Intermittent retrograde p waves (V-A conduction)
Atrial flutter with concomitant VT c

92. Intermittent retrograde p waves (V-A conduction)
Artifact?
ST elevations?
Intermittent retrograde p waves (V-A conduction)
Atrial flutter with concomitant VT c

93. 93

94. Second degree, Mobitz One Second degree, Mobitz Two
First degree AV block
Second degree, Mobitz One
Second degree, Mobitz Two
Third degree AV block

95. Second degree, Mobitz One Second degree, Mobitz Two
First degree AV block
Second degree, Mobitz One
Second degree, Mobitz Two
Third degree AV block

96. 96

97. Supraventricular tachycardia Sinus bradycardia Atrial flutter
Atrial fibrillation
Supraventricular tachycardia
Sinus bradycardia
Atrial flutter

98. Supraventricular tachycardia Sinus bradycardia Atrial flutter
Atrial fibrillation
Supraventricular tachycardia
Sinus bradycardia
Atrial flutter

99.
Bonus Question:
If Atrial Fibrillation, Why is there a regular rhythm (stable R-R)?

100. It is not atrial fibrillation?
It is actually irregular, but not irregular enough to be seen by the naked eye.
It is not atrial fibrillation?
Atrial fibrillation with complete AV block, and escape junctional rhythm
I do not know. I would call EP. c

101. It is not atrial fibrillation?
It is actually irregular, but not irregular enough to be seen by the naked eye.
It is not atrial fibrillation?
Atrial fibrillation with complete AV block, and escape junctional rhythm
I do not know. I would call EP. c

103. Ventricular fibrillation Atrial fibrillation Artifact
Torsade de Pointe
Ventricular fibrillation
Atrial fibrillation
Artifact d

104. Ventricular fibrillation Atrial fibrillation Artifact
Torsade de Pointe
Ventricular fibrillation
Atrial fibrillation
Artifact d

106. Ventricular fibrillation Atrial fibrillation Artifact
Torsade de Pointe
Ventricular fibrillation
Atrial fibrillation
Artifact a

107. Ventricular fibrillation Atrial fibrillation Artifact
Torsade de Pointe
Ventricular fibrillation
Atrial fibrillation
Artifact a

109. Second degree AV block, Mobitz II, and PVC PVC. Normal sinus rhythm
Normal sinus rhythm
Second degree AV block, Mobitz II, and PVC
PVC. Normal sinus rhythm
PVC and PAC, then initiating SVT. b

110. Second degree AV block, Mobitz II, and PVC PVC. Normal sinus rhythm
Normal sinus rhythm
Second degree AV block, Mobitz II, and PVC
PVC. Normal sinus rhythm
PVC and PAC, then initiating SVT. b

112. Atrial fibrillation and pause Junctional bradycardia
Sinus pause
Atrial fibrillation and pause
Junctional bradycardia
Ventricular bradycardia b

113. Atrial fibrillation and pause Junctional bradycardia
Sinus pause
Atrial fibrillation and pause
Junctional bradycardia
Ventricular bradycardia b

114.
Bonus Question:
How long is the pause?

115.
~2 seconds
~3 seconds
~4 seconds
~5 seconds d

116.
~2 seconds
~3 seconds
~4 seconds
~5 seconds d

117. Thank you for your attention!