25
Cardiac Arrhythmias
JON W. ATKINSON
NOTE: This chapter corresponds to Chapter 31 in Fundamentals of Sleep Technology, 2nd edition.
1. According to the American Academy of Sleep Medicine (AASM) Scoring Manual, a sustained (30 seconds or longer) heart rate of 90 beats per minute or higher during sleep is called:
A. Atrial fibrillation
B. Left bundle branch block
C. Bradycardia
D. Tachycardia
2. According to the AASM Scoring Manual, a pause in the heart rate of 3 seconds or longer is called:
A. Asystole
B. Bradycardia
C. Prolonged QT interval
D. Premature ventricular contraction
3. The cardiac cycle begins with depolarization of the atria. This is caused by discharges originating from the:
A. Bundle of His
B. Sinoatrial node
C. Purkinje system
D. Cathode
4. The signal from the atrioventricular node passes through the atrioventricular bundle, the bundle of His, and the left and right bundles to cause contraction of the:
A. Mitral valve
B. Ventricles
C. Aorta
D. Atrium
5. In the ECG, the pause between the atrial depolarization and the ventricular depolarization in a normal sinus rhythm is the:
A. T wave
B. QRS complex
C. PR interval
D. Junction block
6. Each P wave in a normal sinus heart rhythm is associated with:
A. Two or more QRS complexes
B. A single QRS complex
C. A premature ventricular contraction
D. Sinus arrhythmia
7. Heartbeats that do originate in the atrium, atrioventricular node, or the ventricle, and not in the sinoatrial node, are not associated with a:
A. P wave
B. Ventricular contraction
C. Depolarization
D. Repolarization
8. Measuring P–P or R–R intervals allows the technologist to evaluate whether the heart rhythm is:
A. Associated with a widened QRS complex
B. Originating outside of the sinoatrial node
C. Regular or irregular
D. Resulting in adequate blood flow
9. A simple way for a sleep technologist to estimate heart rate is to count the number of QRS complexes in a 30-second epoch and:
A. Write down the number as the heart rate
B. Divide by 30
C. Multiply by 2
D. Determine the interval in millimeters
10. The QRS complex in a patient with sinus bradycardia is:
A. Widened
B. Present and each appears the same
C. Transformed into a QR–T complex due to the absence of the S wave
D. Not linked to a P wave
11. Sinus arrhythmia in a 5-year-old child is:
A. Normal
B. Potentially life threatening
C. Due to abnormal Purkinje bundle conduction
D. The most common reason for pacemaker implantation in children
12. During atrial flutter, P waves are:
A. Higher than normal amplitude
B. Locked to QRS waves on a 1:1 ratio
C. Replaced by sawtooth deflections
D. Replaced by K complexes
13. In some forms of junctional rhythm, the P wave may be:
A. Normal
B. Associated with multiple QRS complexes
C. Caused by mitral valve prolapse
D. Hidden within the QRS complex
14. First-degree atrioventricular (AV) block is characterized by:
A. Absence of P waves
B. Absence of QRS complexes
C. Markedly increased heart rate
D. Prolonged PR interval
15. In third-degree atrioventricular (AV) block, both the P–P interval and the R–R interval are regular but:
A. There is no QRS complex
B. The PR interval is shortened and regular
C. The rate is much higher than normal
D. The rates are dissociated and not the same
16. In bundle branch block, the QRS interval is:
A. Widened
B. Normal
C. Shortened
D. Unrelated to the P wave
17. Multifocal premature ventricular complexes (PVCs) can be identified because beats arising from different locations within the heart have:
A. Different morphologies
B. Different beat-to-beat intervals
C. Prominent notches at the top of the waveform
D. Couplets
18. The QRS complex in ventricular tachycardia is:
A. Normal
B. Absent
C. Wide and bizarre
D. Narrow and uniform
19. Ventricular fibrillation is:
A. Seen from time to time in normal patients
B. Always a medical emergency
C. Associated with normal blood flow from the heart
D. A regular sinus rhythm
20. AASM Sleep Manual guidelines recommend ECG recordings:
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