A patient is under permanent pacemaker support. The pacemaker is programmed in the VVIR mode according to the NG protocol What does the VVIR mode indicate?

Appeared in: NORCET-11 Prelims

Explanation

VVIR mode means the pacemaker paces and senses the ventricle only, not the atrium.
The 'R' in VVIR stands for rate-responsive, meaning the device increases heart rate with increased physical activity.
This mode is used for patients who need ventricular pacing and benefit from heart rate increase during activity.
Key differentiator: Only the ventricle is involved, and the device adapts rate to activity.

Option B: VVIR mode does not increase heart rate in response to heat; it responds to increased physical activity, not temperature.
Option C: VVIR mode does not maintain a stable heart rate at 80 beats per minute; it adjusts the rate based on activity.
Option D: This option omits the rate-responsive feature, which is a key part of VVIR mode.

Clinical Relevance

Nursing practice connection: Use the key finding related to Pacemaker programming codes and interpretation (VVIR mode) to guide bedside assessment, documentation, and the next nursing action.
Nurses must understand pacemaker modes to monitor patients and recognize device function or malfunction.
VVIR mode is commonly used in patients with atrial fibrillation and slow ventricular response or those with chronotropic incompetence.
What if? If the patient had intact atrial function, a dual-chamber mode (e.g., DDDR) might be preferred for better AV synchrony and physiologic pacing.

How to Approach the Question

Break down the pacemaker code: first letter (chamber paced), second letter (chamber sensed), third letter (response to sensing), fourth letter (rate response).
Recall that 'V' means ventricle, 'I' means inhibited, 'R' means rate-responsive.
Eliminate options that mention atrial involvement or incorrect triggers (like heat or fixed rate).
Focus on the rate-responsive feature and which chamber is involved.
Use process of elimination for distractors that do not match the code structure.

Concept Tested & Keywords

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E6 Medicine Davidson Principles Practice 24e p. 503-505

Practise the full NORCET-11 Prelims

Attempt every question from this paper in a timed mock, then review the full solution for each one.