RCES THE FINAL EXAM Questions with
Correct Verified Detailed Solutions
2025/2026
Introduction:
This document contains the full set of RCES (Registered Cardiac
Electrophysiology Specialist) final exam questions for the academic
year 2025/2026, along with correct, verified, and detailed
solutions. It covers essential topics such as pacemakers, ICDs, CRT
devices, electrophysiology studies, defibrillation, and
troubleshooting. This is a comprehensive preparation resource that
helps students and professionals understand both theory and
applied clinical scenarios.
,Exam Questions and Answers:
What are the main reasons patients with ICDs get inappropriate
shocks? Choose two of the following: lead over sensing, muscle
tremor, unrecognize SVT, ICD component failure, electromagnetic
in inference --- correct answer ---Lead over sensing and
unrecognized SVT
This patient with a DDD pacemaker occasionally feels very tired.
Judging from the each ECG strip with annotations what could be
wrong with the pacemaker? --- correct answer ---Occasional loss of
ventricular capture
Modern pacemaker switch modes based on need. In the diagram,
which of the ECGs could be from a patient with a DDDR pacemaker?
--- correct answer ---All of the rhythms are possible with a DDDR
pacemaker
If the acute sensed R of a patient peaks at 3 mV, where should the
pacemaker sensitivity be set to provide a 2 to 1 safety margin? ---
correct answer ---1.5 mV
Does ECG strip from a pacemaker interrogation shows: --- correct
answer ---Underpacing due to oversensing
, Following a recent PPI, a patient comes to clinic for pacemaker
interrogation. The following EGM event was retrieved as happening
one week ago. What should be the next step as the clinician? ---
correct answer ---Obtain relevant patient history possible EMI
An MI patient has an intrinsic rate of 60 to 80 bpm with a
stimulation threshold of 2 mA. With the external pacemaker shown,
when the switch is turned "on" with the setting shown, what will
occur? --- correct answer ---Fixed rate pacing at 75 bpm with
competition
A patient has just received a replacement VVI pacemaker generator.
What sensitivity measurement should be made with the pacemaker
system analyzer post implant? --- correct answer ---R-wave peak to
peak voltage and slew rate
Considering the entire history of a permanent pacemaker, from
implant to end of life, at what time is the highest stimulation
threshold usually measured? --- correct answer ---During acute
rejection phase of one month
What best reduces the acute rise in threshold within the first two
months after inital permanent pacer implant? --- correct answer ---
IV steroids or steroid eluding electrod tip
Correct Verified Detailed Solutions
2025/2026
Introduction:
This document contains the full set of RCES (Registered Cardiac
Electrophysiology Specialist) final exam questions for the academic
year 2025/2026, along with correct, verified, and detailed
solutions. It covers essential topics such as pacemakers, ICDs, CRT
devices, electrophysiology studies, defibrillation, and
troubleshooting. This is a comprehensive preparation resource that
helps students and professionals understand both theory and
applied clinical scenarios.
,Exam Questions and Answers:
What are the main reasons patients with ICDs get inappropriate
shocks? Choose two of the following: lead over sensing, muscle
tremor, unrecognize SVT, ICD component failure, electromagnetic
in inference --- correct answer ---Lead over sensing and
unrecognized SVT
This patient with a DDD pacemaker occasionally feels very tired.
Judging from the each ECG strip with annotations what could be
wrong with the pacemaker? --- correct answer ---Occasional loss of
ventricular capture
Modern pacemaker switch modes based on need. In the diagram,
which of the ECGs could be from a patient with a DDDR pacemaker?
--- correct answer ---All of the rhythms are possible with a DDDR
pacemaker
If the acute sensed R of a patient peaks at 3 mV, where should the
pacemaker sensitivity be set to provide a 2 to 1 safety margin? ---
correct answer ---1.5 mV
Does ECG strip from a pacemaker interrogation shows: --- correct
answer ---Underpacing due to oversensing
, Following a recent PPI, a patient comes to clinic for pacemaker
interrogation. The following EGM event was retrieved as happening
one week ago. What should be the next step as the clinician? ---
correct answer ---Obtain relevant patient history possible EMI
An MI patient has an intrinsic rate of 60 to 80 bpm with a
stimulation threshold of 2 mA. With the external pacemaker shown,
when the switch is turned "on" with the setting shown, what will
occur? --- correct answer ---Fixed rate pacing at 75 bpm with
competition
A patient has just received a replacement VVI pacemaker generator.
What sensitivity measurement should be made with the pacemaker
system analyzer post implant? --- correct answer ---R-wave peak to
peak voltage and slew rate
Considering the entire history of a permanent pacemaker, from
implant to end of life, at what time is the highest stimulation
threshold usually measured? --- correct answer ---During acute
rejection phase of one month
What best reduces the acute rise in threshold within the first two
months after inital permanent pacer implant? --- correct answer ---
IV steroids or steroid eluding electrod tip
