Ventricular arrhythmias and sudden cardiac death

1. Question

In accordance with clinical practice guidelines, what is recommended regarding public access defibrillation?

1. It is recommended that public access defibrillation be available at every public location.
2. It is recommended that public access defibrillation be available only in hospitals.
3. It is recommended that public access defibrillation be available at sites where cardiac arrest is more likely to occur.*
4. It is recommended that public access defibrillation be available only during large public events.
5. It is recommended that public access defibrillation be available only in residential areas.

2. Question

What is recommended for bystanders at an out-of-hospital cardiac arrest (OHCA)?

1. Administering medications
2. Performing prompt CPR*
3. Monitoring the patient until help arrives
4. Moving the patient to a hospital
5. Using an AED without performing CPR

3. Question

What is recommended to promote in the community to increase bystander CPR rate and AED use?

1. Advanced medical training
2. Community training in basic life support*
3. Reducing the cost of AED devices
4. Increased number of ambulances
5. Public awareness campaigns about heart disease

4. Question

In the context of public basic life support and access to AED, what is recommended regarding mobile phone-based alerting of basic life support-trained bystander volunteers?

1. It is not recommended under any circumstances.
2. It should be considered for assisting nearby OHCA victims. *
3. It is only recommended in hospital settings.
4. It is mandatory for all public places.
5. It should be avoided due to privacy concerns.

5. Question

What is recommended for the investigation of a sudden cardiac arrest (SCA) survivor without an obvious extra-cardiac cause?

1. It should be overseen by a single cardiologist.
2. It should be overseen by a neurologist.
3. It should be overseen by a multidisciplinary team.*
4. It should be overseen by a general practitioner.
5. It should be overseen by a cardiac surgeon.

6. Question

Which of the following is recommended for all sudden cardiac arrest (SCA) survivors?

1. Routine exercise programs
2. Dietary modifications
3. Retrieval of recordings from CIEDs and wearable monitors*
4. Immediate coronary angiography
5. Regular echocardiograms

7. Question

According to clinical practice guidelines, what should be made a public health priority in the investigation of unexpected sudden death (SD), especially in cases of suspected inherited disease?

1. Regular physical activity for all individuals
2. Investigation of unexpected sudden death (SD)*
3. Routine vaccination programs
4. Annual health check-ups
5. Dietary modifications for at-risk populations

8. Question

In the evaluation of SCA survivors, what is recommended following SADS in terms of genetic testing?

1. Genetic testing in the decedent should be avoided.
2. Post-mortem genetic testing in the decedent for additional genes may be considered.*
3. Genetic testing in the decedent is mandatory.
4. Genetic testing in the decedent should only be performed if there is a family history of SCA.
5. Post-mortem genetic testing in the decedent for additional genes is not recommended.

9. Question

According to clinical practice guidelines, what is recommended regarding hypothesis-free post-mortem genetic testing using exome or genome sequencing following Sudden Arrhythmic Death Syndrome (SADS)?

1. It is highly recommended.
2. It is moderately recommended.
3. It is recommended with caution.
4. It is not recommended.*
5. It is conditionally recommended.

10. Question

Based on the clinical practice guidelines, when is genetic testing recommended in the context of diagnosing a condition?

1. When a condition is diagnosed in an individual with no known genetic basis and low risk of VA and SCD.
2. Genetic testing is not recommended for any conditions.
3. When a condition is diagnosed in a living or deceased individual with a likely genetic basis and a risk of VA and SCD.*
4. Only when a condition is diagnosed in a living individual with no risk of VA and SCD.
5. Genetic testing should only be performed post-mortem.

11. Question

When a putative causative variant is first identified, what is recommended for evaluation of pathogenicity?

1. Evaluation using a nationally accepted framework
2. Evaluation using a locally accepted framework
3. Evaluation using an internationally accepted framework*
4. Evaluation using a regionally accepted framework
5. Evaluation using a hospital-specific framework

12. Question

When a Class IV or Class V variant has been identified in an individual with a condition that carries a risk of VA and SCD, who is recommended to undergo genetic testing?

1. Only the individual with the identified variant
2. All distant relatives of the individual
3. Only the deceased individual's relatives
4. First-degree and symptomatic relatives and obligate carriers*
5. Only symptomatic relatives

13. Question

According to clinical practice guidelines, who should undertake genetic testing and counselling on its potential consequences?

1. A single primary care physician.
2. A general cardiologist.
3. An expert multidisciplinary team.*
4. A medical student.
5. A laboratory technician.

14. Question

In the context of genetic testing, which of the following recommendations is correct for Class III and Class IV variants?

1. Class III and Class IV variants should be disregarded if they do not show immediate clinical significance.
2. Class III and Class IV variants should be evaluated for segregation in families where possible, and the variant re-evaluated periodically.*
3. Class III variants should be monitored annually, but Class IV variants do not require follow-up.
4. Only Class IV variants should be subjected to family segregation analysis, while Class III can be ignored.
5. Class III and Class IV variants should be evaluated solely based on initial genetic testing and not revisited.

15. Question

According to the clinical practice guidelines, what is recommended regarding genetic testing in index patients with insufficient evidence of a genetic disease?

1. Genetic testing should always be performed.
2. Genetic testing should be undertaken only if the patient requests it.
3. Genetic testing is recommended as a precautionary measure.
4. It is not recommended to undertake genetic testing.*
5. Genetic testing should be performed if there is any suspicion of a genetic disease.

16. Question

In the treatment of reversible conditions, what is recommended whenever drug-induced ventricular arrhythmias (VAs) are suspected?

1. Initiate new medication therapy.
2. Increase the dose of the current medication.
3. Perform cardiac surgery.
4. Withdrawal of offending agents.
5. Continue current medication regimen.

17. Question

What is recommended in patients with VA according to the clinical practice guidelines for treatment of reversible conditions?

1. Immediate surgical intervention
2. Long-term anticoagulant therapy
3. Investigation for reversible causes (e.g. electrolyte imbalances, ischaemia, hypoxaemia, fever)*
4. Permanent pacemaker implantation
5. Lifestyle modifications and exercise therapy

18. Question

When considering the implantation of an ICD in a patient with a possibly correctable cause for the presenting ventricular arrhythmia (VA), what factor should be evaluated?

1. The patient's age and general health
2. The cost of the ICD procedure
3. The patients personal preference
4. The risk of subsequent VA or sudden cardiac death (SCD)*
5. The availability of other treatment options

19. Question

Quiz Question: What is the recommended first-line treatment for the acute management of sustained ventricular tachycardia and electrical storm?

1. Beta-blockers
2. Calcium channel blockers
3. Amiodarone*
4. Digoxin
5. Lidocaine

20. Question

What is the recommended initial treatment for patients presenting with sustained ventricular tachycardia and electrical storm according to clinical practice guidelines?

1. Immediate administration of beta-blockers
2. Intravenous amiodarone as a first-line treatment*
3. Oral antiarrhythmic drugs
4. Elective cardioversion
5. Implantable cardioverter-defibrillator (ICD) therapy

21. Question

Which of the following is recommended for the acute management of sustained ventricular tachycardia and electrical storm?

1. Immediate defibrillation followed by amiodarone administration
2. Administration of lidocaine as the first line of treatment
3. Use of oral beta-blockers for initial stabilization
4. Intravenous amiodarone followed by catheter ablation*
5. Long-term anticoagulation therapy as the primary intervention

22. Question

In the acute management of sustained ventricular tachycardia and electrical storm, which of the following is a recommended approach?

1. Immediate initiation of statin therapy
2. Administration of intravenous amiodarone*
3. Use of oral beta-blockers as the first line of treatment
4. Prescription of long-term anticoagulation therapy
5. Implementation of lifestyle changes and diet modification

23. Question

Which of the following is recommended as the first-line treatment for the acute management of sustained ventricular tachycardia and electrical storm?

1. Beta-blockers
2. Calcium channel blockers
3. Intravenous amiodarone*
4. Oral flecainide
5. Magnesium sulfate

24. Question

Which of the following is the recommended acute management strategy for sustained ventricular tachycardia and electrical storm according to the clinical practice guidelines?

1. Immediate administration of beta-blockers
2. Intravenous amiodarone administration
3. Oral administration of antiarrhythmic drugs
4. Use of magnesium sulfate infusion
5. Cardioversion or defibrillation*

25. Question

Quiz Question: What is the recommended first-line treatment for the acute management of sustained ventricular tachycardia and electrical storm according to clinical practice guidelines?

1. Beta-blockers
2. Calcium channel blockers
3. Amiodarone*
4. Digoxin
5. Lidocaine

26. Question

**Question: According to the clinical practice guidelines, which of the following is recommended for the acute management of sustained ventricular tachycardia and electrical storm?**

1. Immediate administration of beta-blockers
2. Use of amiodarone or lidocaine*
3. Implementation of lifestyle changes
4. Long-term use of anticoagulants
5. Routine use of diuretics

27. Question

Given the topic of acute management of sustained ventricular tachycardia and electrical storm, which of the following is a recommended intervention for stabilizing a patient?

1. Immediate defibrillation
2. Administration of intravenous amiodarone*
3. Oral beta-blockers
4. Lifestyle modification
5. Use of diuretics

28. Question

**Quiz Question:**

What is the recommended first-line treatment for acute management of sustained ventricular tachycardia and electrical storm according to clinical practice guidelines?
1. Beta-blockers
2. Amiodarone*
3. Calcium channel blockers
4. Lidocaine

29. Question

What is the recommended first-line treatment for the acute management of sustained ventricular tachycardia and electrical storm according to clinical practice guidelines?

1. Beta-blockers
2. Calcium channel blockers
3. Amiodarone*
4. Lidocaine
5. Digoxin

30. Question

**Quiz Question:**

In the acute management of sustained ventricular tachycardia and electrical storm, which of the following is recommended as a first-line therapeutic intervention?
1. Beta-blockers
2. Lidocaine
3. Amiodarone
4. Electrical cardioversion*

31. Question

Guideline Topic: Recommendations for the acute management of sustained ventricular tachycardia and electrical storm

Which of the following is the recommended first-line antiarrhythmic drug for the acute management of sustained ventricular tachycardia in hemodynamically stable patients?
1. Amiodarone
2. Lidocaine
3. Procainamide*
4. Sotalol

32. Question

What is the recommended acute management strategy for sustained ventricular tachycardia and electrical storm?

1. Immediate defibrillation and administration of antiarrhythmic drugs
2. Administration of beta-blockers and calcium channel blockers
3. Use of anticoagulants and thrombolytics
4. Initiation of mechanical ventilation and sedation
5. Administration of diuretics and vasodilators

33. Question

What is the recommended first-line treatment for the acute management of sustained ventricular tachycardia and electrical storm according to the clinical practice guidelines?

1. Beta-blockers
2. Lidocaine
3. Amiodarone*
4. Magnesium sulfate
5. Verapamil

34. Question

**Quiz Question:**

What is the recommended initial treatment for patients presenting with sustained ventricular tachycardia in the context of an electrical storm according to clinical practice guidelines?
1. Immediate administration of a beta-blocker
2. Immediate administration of an antiarrhythmic drug*
3. Immediate catheter ablation
4. Administration of a calcium channel blocker

35. Question

What is the recommended first-line treatment for patients experiencing an electrical storm?

1. Beta-blockers
2. Calcium channel blockers
3. Amiodarone*
4. Digoxin
5. Lidocaine

36. Question

Quiz Question: According to clinical practice guidelines, what is the recommended initial treatment for patients experiencing sustained ventricular tachycardia or electrical storm?

1. Immediate administration of beta-blockers
2. Defibrillation or synchronized cardioversion*
3. Intravenous administration of amiodarone
4. Administration of calcium channel blockers
5. Observation and supportive care only

37. Question

What is the recommended first-line treatment for the acute management of sustained ventricular tachycardia and electrical storm according to clinical practice guidelines?

1. Amiodarone
2. Lidocaine
3. Procainamide*
4. Beta-blockers
5. Magnesium sulfate

38. Question

In the acute management of sustained ventricular tachycardia and electrical storm, what is the recommended first-line antiarrhythmic medication?

1. Lidocaine
2. Procainamide
3. Amiodarone*
4. Sotalol
5. Flecainide

39. Question

Which of the following is recommended for the acute management of sustained ventricular tachycardia and electrical storm?

1. Immediate defibrillation for hemodynamically unstable ventricular tachycardia*
2. Administration of oral beta-blockers as the first line of treatment
3. Delayed cardioversion until the patient is stabilized
4. Use of diuretics to manage electrical storm
5. Application of a cold compress to the chest

40. Question

What is the recommended first-line treatment for the acute management of sustained ventricular tachycardia and electrical storm according to clinical practice guidelines?

1. Beta-blockers
2. Calcium channel blockers
3. Amiodarone*
4. Lidocaine
5. Procainamide

41. Question

**Quiz Question:**

What is the recommended initial treatment for a patient presenting with sustained ventricular tachycardia and electrical storm?
1. Immediate administration of high-dose beta-blockers
2. Intravenous amiodarone or lidocaine*
3. Oral antiarrhythmic therapy
4. Immediate cardioversion without pharmacological intervention

42. Question

For the acute management of sustained ventricular tachycardia and electrical storm, which of the following is recommended?

1. Immediate administration of beta-blockers for all patients
2. Initiation of amiodarone infusion for hemodynamically stable patients
3. Use of synchronized cardioversion for hemodynamically unstable patients*
4. Administration of lidocaine as the first-line antiarrhythmic drug
5. Observation and monitoring without immediate intervention

43. Question

In the acute management of sustained ventricular tachycardia and electrical storm, what is the recommended first-line treatment for terminating the arrhythmia?

1. Amiodarone
2. Lidocaine
3. Sotalol
4. Electrical cardioversion*
5. Procainamide

44. Question

In the acute management of sustained ventricular tachycardia and electrical storm, which class of recommendation is associated with the use of intravenous amiodarone?

1. Class I
2. Class IIa
3. Class IIb*
4. Class III
5. Class IV

45. Question

What is the recommended first-line treatment for acute management of sustained ventricular tachycardia and electrical storm?

1. Amiodarone
2. Lidocaine
3. Beta-blockers
4. Procainamide*
5. Magnesium sulfate

46. Question

According to the clinical practice guidelines, what is the recommended first-line treatment for the acute management of sustained ventricular tachycardia and electrical storm?

1. Beta-blockers
2. Calcium channel blockers
3. Lidocaine
4. Amiodarone*
5. Magnesium sulfate

47. Question

In the acute management of sustained ventricular tachycardia and electrical storm, what is the recommended first-line treatment?

1. Beta-blockers
2. Lidocaine
3. Amiodarone*
4. Calcium channel blockers
5. Digoxin

48. Question

What is the recommended first-line treatment for the acute management of sustained ventricular tachycardia and electrical storm according to clinical practice guidelines?

1. Beta-blockers
2. Amiodarone*
3. Lidocaine
4. Magnesium sulfate
5. Calcium channel blockers

49. Question

What is the recommended first-line treatment for the acute management of sustained ventricular tachycardia and electrical storm according to clinical practice guidelines?

1. Amiodarone
2. Lidocaine
3. Beta-blockers*
4. Magnesium sulfate
5. Calcium channel blockers

50. Question

Under what condition is the implantation of a cardioverter-defibrillator recommended?

1. When patients have a history of heart failure
2. When patients have a history of myocardial infarction
3. When patients have a life expectancy of less than 6 months
4. When patients have an expectation of good quality survival > 1 year*
5. When patients are under the age of 60

51. Question

In patients with incessant ventricular arrhythmias (VAs), what is the recommendation regarding ICD implantation?

1. It is recommended to implant an ICD immediately.
2. It is recommended to implant an ICD only after the VA is controlled.*
3. It is recommended to implant an ICD regardless of VA control.
4. It is recommended to implant an ICD as a preventative measure.
5. It is recommended to implant an ICD only in cases of non-incessant VAs.

52. Question

In patients with documented ventricular fibrillation (VF) or haemodynamically not tolerated ventricular tachycardia (VT) in the absence of reversible causes, what is recommended?

1. Administration of antiarrhythmic drugs
2. Immediate cardioversion
3. ICD implantation*
4. Observation and monitoring
5. Thrombolytic therapy

53. Question

In patients with VT/VF, under what circumstances may amiodarone be considered when an ICD is not available, contraindicated for concurrent medical reasons, or declined by the patient?

1. When the patient has no history of arrhythmias
2. When the patient has a contraindication for amiodarone
3. When the patient has an indication for ICD and no contraindication for amiodarone*
4. When the patient prefers beta-blockers over amiodarone
5. When the patient is asymptomatic and stable

54. Question

In patients with SMVT or SPVT/VF triggered by a PVC with similar morphology and an indication for ICD, what alternative treatment may be considered when an ICD is not available, contraindicated for concurrent medical reasons, or declined by the patient?

1. Medication therapy
2. Lifestyle modification
3. Catheter ablation*
4. Surgery
5. Pacemaker implantation

55. Question

In which scenario should a subcutaneous defibrillator be considered as an alternative to a transvenous defibrillator in patients with an indication for an ICD?

1. When pacing therapy for bradycardia is needed
2. When cardiac resynchronization therapy is needed
3. When antitachycardia pacing (ATP) is required
4. When pacing therapy for bradycardia, cardiac resynchronization, or ATP is not needed*
5. When the patient has a history of ventricular fibrillation

56. Question

When an ICD is indicated, what is recommended to evaluate for the patient?

1. Whether the patient could benefit from CRT-pacemaker
2. Whether the patient could benefit from CRT-defibrillator*
3. Whether the patient could benefit from antiarrythmic drugs
4. Whether the patient could benefit from lifestyle modifications
5. Whether the patient could benefit from cholesterol-lowering therapy

57. Question

In which scenario should a wearable cardioverter defibrillator (WCD) be considered for adult patients?

1. For primary prevention of sudden cardiac arrest in patients with no history of heart disease
2. For secondary prevention of sudden cardiac arrest in patients who are temporarily not candidates for ICD implantation*
3. For patients who have an implanted pacemaker
4. For patients with stable angina and no history of arrhythmias
5. For patients who have undergone successful ICD implantation

58. Question

In the early phase after an MI, what device may be considered in selected patients according to the clinical practice guidelines?

1. Pacemaker
2. Implantable cardioverter-defibrillator (ICD)
3. Wearable cardioverter-defibrillator (WCD)*
4. Left ventricular assist device (LVAD)
5. Cardiac resynchronization therapy (CRT)

59. Question

What is the primary goal of optimizing ICD programming according to the clinical practice guidelines?

1. To increase the frequency of therapies
2. To reduce patient visits to the clinic
3. To avoid inappropriate and unnecessary therapies and reduce mortality*
4. To enhance battery life of the ICD device
5. To improve patient comfort and convenience

60. Question

In single- or dual-chamber ICD patients without bradycardia pacing indications, what is recommended regarding ventricular pacing?

1. It is recommended to maximize ventricular pacing.
2. It is recommended to minimize ventricular pacing. *
3. It is recommended to maintain ventricular pacing at a constant rate.
4. It is recommended to avoid ventricular pacing altogether.
5. It is recommended to alternate ventricular pacing with atrial pacing.

61. Question

What is the recommended duration criteria for programming prolonged detection settings in device optimization?

1. At least 36 sec or 20 intervals
2. At least 612 sec or 30 intervals*
3. At least 1218 sec or 40 intervals
4. At least 1520 sec or 50 intervals
5. At least 1824 sec or 60 intervals

62. Question

What is the recommended slowest tachycardia therapy zone limit for primary prevention ICD patients?

1. 150 bpm
2. 160 bpm
3. 170 bpm
4. 180 bpm
5. 188 bpm*

63. Question

In patients with SHD, which therapy is recommended to be programmed in all tachyarrhythmias zones?

1. Beta-blocker therapy
2. Anticoagulant therapy
3. ACE inhibitor therapy
4. Diuretic therapy
5. ATP therapy*

64. Question

What is recommended for programming algorithms to discriminate between supraventricular tachycardia (SVT) and ventricular tachycardia (VT) for tachycardias with rates up to 230 bpm?

1. It is recommended to program algorithms for SVT versus VT discrimination for tachycardias with rates up to 130 bpm.
2. It is recommended to program algorithms for SVT versus VT discrimination for tachycardias with rates up to 150 bpm.
3. It is recommended to program algorithms for SVT versus VT discrimination for tachycardias with rates up to 180 bpm.
4. It is recommended to program algorithms for SVT versus VT discrimination for tachycardias with rates up to 200 bpm.
5. It is recommended to program algorithms for SVT versus VT discrimination for tachycardias with rates up to 230 bpm.*

65. Question

In the context of device programming optimization, what is recommended?

1. It is recommended to deactivate lead failure alerts.
2. It is recommended to ignore lead failure alerts.
3. It is recommended to activate lead failure alerts.*
4. It is recommended to delay lead failure alerts.
5. It is recommended to reduce the sensitivity of lead failure alerts.

66. Question

According to clinical practice guidelines, what is recommended to reduce the incidence of inappropriate shocks?

1. Increased physical activity
2. Medication adjustment
3. Regular in-person check-ups
4. Remote monitoring*
5. Dietary changes

67. Question

In the guidelines for optimization of device programming, what is recommended as the first attempt in programming?

1. Ramp ATP
2. Synchronized cardioversion
3. Burst ATP*
4. Defibrillation
5. Antiarrhythmic medication

68. Question

For S-ICDs, what configuration is recommended for device programming, specifically in the lower conditional shock zone?

1. Single detection zone configuration without discrimination algorithm
2. Single detection zone configuration with discrimination algorithm
3. Dual detection zone configuration without discrimination algorithm
4. Triple detection zone configuration with discrimination algorithm
5. Dual detection zone configuration with activation of discrimination algorithm*

69. Question

For routine ICD programming, what action should be considered to optimize device performance?

1. Deactivation of all tachycardia detection zones.
2. Activation of a single tachycardia detection zone.
3. Activation of more than one tachycardia detection zone.*
4. Adjustment of tachycardia detection thresholds.
5. Disabling tachycardia detection entirely.

70. Question

Which of the following treatments is recommended for ICD patients with recurrent SVT resulting in inappropriate ICD therapies?

1. Beta-blockers
2. Catheter ablation*
3. Antiarrhythmic drugs
4. Pacemaker implantation
5. Lifestyle modification

71. Question

What is recommended for patients with AF-related inappropriate ICD therapies despite optimal ICD programming?

1. Lifestyle modification
2. Increased ICD monitoring
3. Pharmacological treatment or catheter ablation*
4. Surgical intervention
5. Dietary changes

72. Question

In patients with ICD implantation, what is recommended regarding psychological status and distress?

1. Routine follow-up appointments without specific psychological assessment
2. Assessment of psychological status and treatment of distress*
3. Only pharmacological treatment for distress
4. Assessment of psychological status only if the patient reports symptoms
5. No specific recommendations for psychological status and distress management

73. Question

What is recommended for addressing ICD-related concerns and discussing quality-of-life issues before ICD implantation and during disease progression?

1. Regular physical exercise
2. Dietary modifications
3. Communication between patient and physician/healthcare professional*
4. Surgical follow-up visits
5. Medication adjustments

74. Question

In patients with LVAD, under what condition is ICD implantation recommended?

1. In all LVAD recipients regardless of symptoms
2. Only in LVAD recipients without any ventricular arrhythmias
3. In LVAD recipients with symptomatic sustained VAs *
4. Only in LVAD recipients with a history of heart failure
5. In LVAD recipients after 5 years of device implantation

75. Question

Which type of ICD is recommended for primary prevention patients without current or expected indication for atrial or AV sequential pacing to reduce the risk of device-related complications?

1. Dual-chamber ICD
2. Subcutaneous ICD
3. Biventricular ICD
4. Single-chamber ICD*
5. Leadless pacemaker

76. Question

Which type of ICD lead should be considered due to a lower complication rate during transvenous lead extraction?

1. Triple-coil leads
2. Dual-coil leads
3. Single-coil leads*
4. Quadruple-coil leads
5. Hybrid-coil leads

77. Question

Informed discussion with patient and family about ICD deactivation options and shared decision-making is indicated at what times?

1. Only after implantation
2. Only in case of significant health status deterioration
3. Prior to implantation and in case of significant health status deterioration*
4. Only during routine follow-up visits
5. Only if the patient explicitly requests it

78. Question

In the context of end-of-life issues in ICD carriers, which type of ICD leads should be considered due to a lower complication rate during transvenous lead extraction?

1. Dual-coil leads
2. Bi-focal leads
3. Multi-coil leads
4. Single-coil leads*
5. Quad-coil leads

79. Question

In the context of recommendations for end-of-life issues in ICD carriers, which action is indicated prior to implantation and in case of significant health status deterioration?

1. Immediate deactivation of the ICD
2. Informed discussion with patient and family about ICD deactivation options and shared decision-making*
3. Routine physical examination
4. Adjustment of the ICD settings
5. Referral to a cardiologist for further testing

80. Question

In the treatment of ventricular arrhythmias (VAs) in acute coronary syndromes (ACS), which prophylactic treatment is not recommended?

1. Beta-blockers
2. Amiodarone
3. Lidocaine
4. Prophylactic treatment with antiarrhythmic drugs (AADs) other than beta-blockers
5. Calcium channel blockers

81. Question

In SCA survivors with coronary artery spasm, what intervention should be considered according to the guidelines?

1. Administration of thrombolytics
2. Use of beta-blockers
3. Implantation of an ICD*
4. Prescription of antiplatelet therapy
5. Lifestyle modification

82. Question

In patients with CAD, which prophylactic treatment is not recommended?

1. Beta-blockers
2. ACE inhibitors
3. Calcium channel blockers
4. Antiarrhythmic drugs (AADs) other than beta-blockers*
5. Statins

83. Question

In patients with an anomalous aortic origin of a coronary artery with an interarterial course, what additional diagnostic test is recommended to confirm or exclude myocardial ischaemia?

1. Echocardiography
2. Magnetic resonance imaging (MRI)
3. Cardiac stress imaging during physical exercise*
4. Computed tomography (CT) scan
5. Holter monitoring

84. Question

In patients with an anomalous aortic origin of a coronary artery and a history of aborted cardiac arrest (CA), what additional diagnostic evaluation is recommended after surgery?

1. Only cardiopulmonary exercise test
2. Only cardiac stress imaging during physical exercise
3. Cardiac stress imaging during physical exercise in addition to cardiopulmonary exercise test*
4. Cardiac MRI without exercise
5. Echocardiogram with pharmacologic stress

85. Question

In patients with coronary anomalies, under which conditions is surgery recommended?

1. Only in patients with angina
2. Only in patients with syncope
3. In patients with anomalous aortic origin of a coronary artery with CA, syncope suspected to be due to VAs, or angina when other causes have been excluded*
4. In patients with any form of coronary anomalies
5. Only in patients with syncope and angina

86. Question

Based on the clinical practice guidelines, what is the recommended treatment for asymptomatic patients with an anomalous aortic origin of a coronary artery and evidence of myocardial ischaemia or abnormal aortic origin of the left coronary artery with high-risk anatomy?

1. Regular monitoring without intervention
2. Pharmacological therapy only
3. Lifestyle changes and dietary modifications
4. Surgery should be considered*
5. Implantation of a coronary stent

87. Question

According to clinical practice guidelines, under what circumstances is catheter ablation recommended in children under 5 years of age or under 10 kg with idiopathic PVCs/VT?

1. When previous medical therapy fails or when VT is not haemodynamically tolerated.*
2. As a first-line treatment for all children under 5 years of age.
3. Only for children under 5 years of age with no previous medical therapy.
4. When VT is haemodynamically tolerated but persistent.
5. For all children under 10 kg regardless of medical history.

88. Question

According to clinical practice guidelines, what is the recommendation regarding the use of amiodarone as a first-line treatment in patients with idiopathic VTs/PVCs?

1. It is strongly recommended.
2. It is recommended with caution.
3. It is not recommended.*
4. It is recommended only in severe cases.
5. It is recommended for long-term management.

89. Question

In the management of idiopathic PVCs/VT in children, which of the following statements is accurate regarding the use of Verapamil?

1. Verapamil is recommended for children < 1 year of age with PVC/VT, regardless of heart failure signs or concurrent use of other AADs.
2. Verapamil is not recommended in children < 1 year of age with PVC/VT, especially if they have signs of heart failure or concurrent use of other AADs.*
3. Verapamil is recommended in children < 1 year of age with PVC/VT, particularly if they have signs of heart failure or concurrent use of other AADs.
4. Verapamil can be used in children < 1 year of age with PVC/VT only if they do not have signs of heart failure.
5. Verapamil is always safe to use in children < 1 year of age with PVC/VT.

90. Question

In patients with an unexplained reduced EF and a PVC burden of at least 10%, what should be considered?

1. Myocardial infarction
2. Heart failure with preserved ejection fraction
3. PVC-induced cardiomyopathy*
4. Atrial fibrillation
5. Valvular heart disease

91. Question

In non-responders to CRT with frequent, predominantly monomorphic PVCs limiting optimal biventricular pacing despite pharmacological therapy, what treatment option(s) should be considered?

1. Lifestyle modification
2. Surgical intervention
3. Implantable cardioverter-defibrillator (ICD)
4. Catheter ablation or antiarrhythmic drugs (AADs)*
5. Beta-blockers

92. Question

Which of the following recommendations is correct for individuals with DCM/HND-CM and an LMNA mutation?

1. Participation in low-intensity exercise including competitive sports is not recommended.
2. Participation in moderate-intensity exercise is not recommended.
3. Participation in high-intensity exercise including competitive sports is not recommended.*
4. Participation in any form of exercise is not recommended.
5. Participation in high-intensity exercise excluding competitive sports is not recommended.

93. Question

In patients with DCM/ HND-CM, what is recommended for those who survive SCA due to VT/ VF or experience haemodynamically not tolerated SMVT?

1. Administration of antiarrhythmic drugs
2. ICD implantation*
3. Use of beta-blockers
4. Lifestyle modification
5. Surgical ablation

94. Question

According to the clinical practice guidelines, what should be considered for patients with DCM/ HND-CM and recurrent, symptomatic SMVT or ICD shocks for SMVT, in whom AADs are ineffective, contraindicated, or not tolerated?

1. Immediate heart transplant
2. Lifestyle modification
3. Catheter ablation in specialized centres*
4. Increased dosage of AADs
5. Use of defibrillator vests

95. Question

In patients with DCM/HND-CM and an ICD who experience recurrent, symptomatic VA despite optimal device programming and beta-blocker treatment, which of the following should be considered?

1. Addition of oral amiodarone
2. Replacement of beta-blockers by sotalol
3. Addition of oral amiodarone or replacement of beta-blockers by sotalol*
4. Increasing the dosage of beta-blockers
5. Switching to a different class of antiarrhythmic drugs

96. Question

In patients with DCM/HND-CM and haemodynamically tolerated SMVT, what treatment should be considered?

1. Pacemaker implantation
2. ICD implantation*
3. Radiofrequency ablation
4. Beta-blocker therapy
5. Coronary artery bypass grafting

97. Question

In a first-degree relative of a DCM/HND-CM patient, when are an ECG and echocardiogram recommended?

1. If the index patient was diagnosed at any age and has no clinical features suggestive of an inherited cause.
2. If the index patient was diagnosed before 50 years of age or has clinical features suggestive of an inherited cause.*
3. If there is no family history of DCM/HND-CM.
4. If there is no family history of premature unexpected sudden death.
5. If the index patient was diagnosed after 50 years of age but has no clinical features suggestive of an inherited cause.

98. Question

In a first-degree relative of a patient with apparently sporadic DCM/HND-CM, what diagnostic tests may be considered?

1. MRI and stress test
2. ECG and echocardiogram*
3. Holter monitor and chest X-ray
4. Blood test and CT scan
5. Genetic testing and PET scan

99. Question

In patients with suspected ARVC, which diagnostic method is recommended?

1. Echocardiography
2. Cardiac CT
3. Nuclear imaging
4. Cardiac MRI (CMR)*
5. Electrocardiogram (ECG)

100. Question

In patients with a suspected or definite diagnosis of ARVC, what is indicated according to the clinical practice guidelines?

1. Lifestyle modification and regular exercise
2. Genetic counselling and testing*
3. Immediate surgical intervention
4. Routine blood tests and cholesterol monitoring
5. Long-term anticoagulation therapy

101. Question

Which of the following is recommended for patients with a definite diagnosis of ARVC according to clinical practice guidelines?

1. Participation in high-intensity exercise
2. Low-intensity exercise without restrictions
3. Moderate-intensity exercise with caution
4. Complete avoidance of any physical activity
5. Avoidance of high-intensity exercise*

102. Question

In the diagnostic evaluation and general recommendations for ARVC, what is suggested for carriers of ARVC-related pathogenic mutations who show no phenotype?

1. They should undergo surgery.
2. They should avoid high-intensity exercise.*
3. They should take daily medication.
4. They should have regular MRI scans.
5. They should follow a high-protein diet.

103. Question

In patients with a definite diagnosis of ARVC, what therapy may be considered?

1. Calcium channel blocker therapy
2. ACE inhibitor therapy
3. Beta-blocker therapy*
4. Diuretic therapy
5. Anticoagulant therapy

104. Question

According to clinical practice guidelines, in which situation should ICD implantation be considered for patients with definite ARVC?

1. Patients with definite ARVC and no symptoms.
2. Patients with definite ARVC and ventricular tachycardia without syncope.
3. Patients with definite ARVC and an arrhythmic syncope.*
4. Patients with suspected ARVC and stable angina.
5. Patients with definite ARVC and atrial fibrillation.

105. Question

In patients with definite ARVC and severe RV or LV systolic dysfunction, what intervention should be considered according to the clinical practice guidelines?

1. Beta-blocker therapy
2. ICD implantation*
3. Lifestyle modification
4. ACE inhibitor therapy
5. Cardiac transplant

106. Question

According to the clinical practice guidelines, in which patients with definite ARVC should ICD implantation be considered?

1. Asymptomatic patients with mild right ventricular dysfunction
2. Symptomatic patients with definite ARVC and severe biventricular dysfunction
3. Symptomatic patients with definite ARVC, moderate right or left ventricular dysfunction, and either NSVT or inducibility of SMVT at PES*
4. Patients with mild left ventricular dysfunction and no history of arrhythmias
5. Symptomatic patients with definite ARVC and no ventricular dysfunction

107. Question

In patients with ARVC and symptoms highly suspicious for VA, which test may be considered for risk stratification?

1. Echocardiogram
2. Exercise Stress Test
3. Holter Monitor
4. Genetic Testing
5. PES*

108. Question

What is recommended for ARVC patients with hemodynamically not tolerated VT or VF?

1. Antiarrhythmic drug therapy
2. Lifestyle modification
3. Radiofrequency ablation
4. ICD implantation*
5. Beta-blocker therapy

109. Question

In patients with ARVC and non-sustained or sustained VAs, which therapy is recommended?

1. Calcium channel blocker therapy
2. ACE inhibitor therapy
3. Beta-blocker therapy*
4. Diuretic therapy
5. Antiplatelet therapy

110. Question

In patients with ARVC and recurrent, symptomatic SMVT or ICD shocks for SMVT despite beta-blockers, what treatment should be considered?

1. Increase the dosage of beta-blockers
2. Referral for heart transplantation
3. Catheter ablation in specialized centres*
4. Implantation of a dual-chamber pacemaker
5. Administration of antiarrhythmic drugs

111. Question

In ARVC patients with indication for ICDs, which capability should be considered for the device?

1. Dual-chamber pacing
2. ATP programming for SMVT up to high rates*
3. Remote monitoring
4. Automatic threshold testing
5. CRT-D functionality

112. Question

According to clinical practice guidelines, what is recommended for ARVC patients with a haemodynamically tolerated SMVT?

1. ICD implantation should be avoided.
2. ICD implantation is not necessary.
3. ICD implantation should be considered.
4. ICD implantation is mandatory.
5. ICD implantation should be deferred.*

113. Question

In patients with ARVC and recurrent symptomatic VT despite beta-blockers, what treatment should be considered?

1. Lifestyle modification
2. Surgery
3. AAD treatment*
4. Anticoagulant therapy
5. Immunosuppressive therapy

114. Question

In a first-degree relative of a patient with ARVC, which of the following is recommended for management?

1. MRI and stress test
2. Blood pressure monitoring and lipid profile
3. ECG and echocardiogram*
4. Genetic testing and Holter monitoring
5. Cardiac catheterization and angiography

115. Question

In patients with hypertrophic cardiomyopathy (HCM), which diagnostic tool is recommended for diagnostic work-up?

1. Echocardiography
2. Exercise stress testing
3. Cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE)*
4. Holter monitoring
5. Genetic testing

116. Question

In patients with Hypertrophic Cardiomyopathy (HCM), what is recommended regarding genetic counselling and testing?

1. Genetic counselling and testing are not recommended in HCM patients.
2. Genetic counselling and testing are recommended only for symptomatic HCM patients.
3. Genetic counselling and testing are recommended in HCM patients.*
4. Genetic testing is recommended, but genetic counselling is not recommended in HCM patients.
5. Genetic counselling is recommended, but genetic testing is not recommended in HCM patients.

117. Question

Based on clinical practice guidelines, what may be considered for asymptomatic adult HCM patients without risk markers?

1. Avoidance of all physical exercise
2. Participation in high-intensity exercise*
3. Participation in low-intensity exercise only
4. Regular use of beta-blockers
5. Routine cardiac surgery

118. Question

In the context of risk stratification and primary prevention of SCD in patients with HCM, how often is it recommended that the 5-year risk of SCD be assessed after the initial evaluation?

1. Every 6 months
2. Every 13 years, or when there is a change in clinical status*
3. Every 5 years
4. Only at the initial evaluation
5. Only when there is a change in clinical status

119. Question

In patients aged 16 years or more with an estimated 5-year risk of sudden death (SD) 6%, what intervention should be considered?

1. Lifestyle modification
2. ICD implantation*
3. Beta-blocker therapy
4. Cardiac surgery
5. Regular exercise program

120. Question

In patients with hypertrophic cardiomyopathy (HCM) aged 16 years or more, under which conditions should ICD implantation be considered for primary prevention of sudden cardiac death (SCD) when the 5-year risk is intermediate ( 4 to < 6%)?

1. Significant late gadolinium enhancement (LGE) at CMR, usually 15% of LV mass.
2. Left ventricular ejection fraction (LVEF) < 50%.
3. Abnormal blood pressure response during exercise test.
4. Left ventricular apical aneurysm.
5. Presence of sarcomeric pathogenic mutation.

121. Question

In children less than 16 years of age with HCM and an estimated 5-year risk of SD 6% (based on HCM Risk-Kids score), what should be considered?

1. Regular exercise
2. ICD implantation*
3. Medication adjustment
4. Routine echocardiography
5. Dietary changes

122. Question

In patients aged 16 years or more with hypertrophic cardiomyopathy (HCM), at what estimated 5-year risk percentage of sudden cardiac death (SCD) may ICD implantation be considered?

1. 2 to < 4%
2. 3 to < 5%
3. 4 to < 6%*
4. 5 to < 7%
5. 6 to < 8%

123. Question

In HCM patients aged 16 years or more with a low estimated 5-year risk of SCD (< 4%), under which conditions may ICD implantation be considered?

1. Presence of significant LGE at CMR usually 15% of LV mass
2. LVEF < 50%
3. LV apical aneurysm
4. Any of the above*
5. None of the above

124. Question

According to clinical practice guidelines, in which of the following scenarios is ICD implantation recommended for HCM patients?

1. HCM patients with well-tolerated VT
2. HCM patients with asymptomatic arrhythmias
3. HCM patients with haemodynamically not-tolerated VT or VF*
4. HCM patients with mild palpitations
5. HCM patients with controlled hypertension

125. Question

In patients with hypertrophic cardiomyopathy (HCM) presenting with hemodynamically tolerated sustained monomorphic ventricular tachycardia (SMVT), what treatment should be considered?

1. Beta-blocker therapy
2. Ablation therapy
3. ICD implantation*
4. Amiodarone administration
5. Pacemaker implantation

126. Question

In patients with HCM and recurrent, symptomatic VA or recurrent ICD therapy, what treatment should be considered?

1. Anticoagulant therapy
2. Beta-blocker therapy
3. Calcium channel blocker therapy
4. AAD treatment*
5. Surgical intervention

127. Question

In patients with HCM and recurrent, symptomatic SMVT or ICD shocks for SMVT, under what conditions may catheter ablation in specialized centres be considered?

1. When patients have no access to other treatments.
2. When patients are intolerant to AAD.
3. When patients prefer non-invasive treatments.
4. When patients have asymptomatic HCM.
5. When patients have mild symptoms.

128. Question

In patients with neuromuscular disorders who have ventricular arrhythmias (VAs) or ventricular dysfunction, how should they be treated for arrhythmia?

1. Differently from patients without neuromuscular disorders
2. With a modified treatment plan specific to neuromuscular disorders
3. The same way as patients without neuromuscular disorders*
4. Only with medication
5. Only with lifestyle changes

129. Question

In patients with Limb-girdle type 1B or Emery-Dreifuss muscular dystrophies and indication for pacing, what intervention should be considered?

1. Pacemaker implantation
2. ICD implantation*
3. Cardiac resynchronization therapy
4. Medication therapy
5. Physical therapy

130. Question

In patients with Duchenne/Becker muscular dystrophy and significant LGE at CMR, what intervention may be considered?

1. Medication adjustment
2. Lifestyle changes
3. Physical therapy
4. Implantation of an ICD*
5. Surgical correction

131. Question

In myotonic dystrophy patients, when is serial electrophysiological evaluation of AV conduction and arrhythmia induction recommended?

1. Routinely at every check-up
2. Only when there is arrhythmia suspicion or progression of ECG conduction disorders*
3. Annually regardless of symptoms
4. Every five years as a preventive measure
5. Only in patients over 50 years old

132. Question

In patients with a LVNC cardiomyopathy phenotype based on CMR or echocardiography, what should be considered for primary prevention of SCD?

1. Implantation of a pacemaker
2. Lifestyle modifications
3. Medication management
4. Implantation of an ICD to follow DCM/HND-CM recommendations*
5. Surgical intervention

133. Question

In which patient group should an ICD be considered according to the guidelines on ICD implantation for light-chain amyloidosis or transthyretin-associated cardiac amyloidosis?

1. Patients with asymptomatic VT
2. Patients with tolerated VT
3. Patients with hemodynamically not-tolerated VT*
4. Patients with mild heart failure symptoms
5. Patients with only light-chain amyloidosis without VT

134. Question

In confirmed or clinically suspected acute myocarditis, what is recommended for patients who present with life-threatening ventricular arrhythmias (VAs)?

1. Immediate administration of high-dose corticosteroids.
2. Referral to a specialized centre.*
3. Initiation of anticoagulation therapy.
4. Performance of an immediate cardiac MRI.
5. Placement of an implantable cardioverter-defibrillator (ICD).

135. Question

In patients with hemodynamically not tolerated sustained monomorphic ventricular tachycardia (SMVT) occurring in the chronic phase of myocarditis, what is recommended?

1. Use of antiarrhythmic medication
2. Lifestyle modification and monitoring
3. ICD implantation*
4. Ablation therapy
5. No intervention

136. Question

In patients with haemodynamically not tolerated sustained VT or VF during the acute phase of myocarditis, what should be considered before hospital discharge?

1. Administration of beta-blockers
2. ICD implantation
3. Cardiac resynchronization therapy
4. Coronary artery bypass graft surgery
5. Heart transplant

137. Question

In patients with symptomatic non-sustained or sustained ventricular arrhythmias (VAs) during the acute phase of myocarditis, which antiarrhythmic drugs (AADs) should be considered?

1. Digoxin and calcium channel blockers
2. Amiodarone and beta-blockers*
3. Lidocaine and magnesium sulfate
4. Flecainide and sotalol
5. Procainamide and quinidine

138. Question

In post-myocarditis patients with recurrent, symptomatic VT, what treatment should be considered?

1. Surgical intervention
2. Lifestyle modification
3. Antithrombotic therapy
4. AAD treatment*
5. Immunosuppressive therapy

139. Question

In patients with post-myocarditis who experience recurrent, symptomatic sustained monomorphic ventricular tachycardia (SMVT) or implantable cardioverter-defibrillator (ICD) shocks for SMVT, and in whom antiarrhythmic drugs (AADs) are ineffective, not tolerated, or not desired, what treatment should be considered?

1. Cardiac transplantation
2. Coronary artery bypass grafting
3. Catheter ablation, performed in specialized centres*
4. Left ventricular assist device implantation
5. Lifestyle modifications and exercise therapy

140. Question

In patients with haemodynamically tolerated SMVT occurring in the chronic phase of myocarditis, what treatment should be considered?

1. Antiarrhythmic drug therapy
2. Ablation therapy
3. ICD implantation*
4. Lifestyle modification
5. Cardiac resynchronization therapy

141. Question

In patients with hemodynamically well-tolerated sustained monomorphic ventricular tachycardia (SMVT) occurring in the chronic phase of myocarditis, preserved left ventricular (LV) function, and a limited scar amenable to ablation, which treatment may be considered as an alternative to implantable cardioverter-defibrillator (ICD) therapy, after discussion with the patient and provided that established endpoints have been reached?

1. Beta-blocker therapy
2. Anticoagulation therapy
3. Catheter ablation*
4. Coronary artery bypass grafting
5. Lifestyle modification

142. Question

According to clinical practice guidelines, which medication should be considered to reduce arrhythmia burden in patients with Chagas cardiomyopathy who present with symptomatic PVCs or VT?

1. Metoprolol
2. Flecainide
3. Amiodarone*
4. Sotalol
5. Verapamil

143. Question

In patients with Chagas cardiomyopathy and recurrent, symptomatic SMVT or ICD shocks for SMVT in whom AADs are ineffective, contraindicated, or not tolerated, which treatment should be considered in specialized centres?

1. Beta-blockers
2. ACE inhibitors
3. Catheter ablation*
4. Anticoagulants
5. Coronary artery bypass surgery

144. Question

In patients with Chagas cardiomyopathy and symptomatic VT in whom AADs (amiodarone and beta-blockers) are ineffective or not tolerated, what treatment may be considered?

1. Ablation therapy
2. ICD implantation*
3. Pacemaker implantation
4. Surgical resection
5. Increased dosage of AADs

145. Question

In patients with aortic valve disease and SMVT, what is recommended to identify and ablate BBR-VT, especially if it occurs following a valve intervention?

1. PES with standby catheter ablation
2. Immediate surgical intervention
3. Long-term medical therapy
4. Routine echocardiography
5. Lifestyle modifications

146. Question

In patients with valvular heart disease and persistent LV dysfunction after surgical correction (if possible), what is recommended for primary prevention?

1. Immediate re-surgery
2. ICD implantation following DCM/HNDCM recommendations*
3. Medication adjustment
4. Lifestyle modification
5. Regular monitoring without intervention

147. Question

In adults with congenital heart disease (CHD) with biventricular physiology and a left systemic ventricle presenting with symptomatic heart failure (NYHA II/III) and an ejection fraction (EF) 35% despite 3 months of optimal medical therapy (OMT), what intervention is indicated?

1. Heart transplant
2. Left ventricular assist device (LVAD) implantation
3. Cardiac resynchronization therapy (CRT) implantation
4. Implantable cardioverter-defibrillator (ICD) implantation*
5. Coronary artery bypass grafting (CABG)

148. Question

In patients with CHD who have not tolerated VT or have had an aborted CA due to VF, what intervention is indicated after excluding reversible causes?

1. Beta-blocker therapy
2. Coronary artery bypass grafting (CABG)
3. Angioplasty
4. ICD implantation*
5. Lifestyle modifications

149. Question

In patients with CHD with presumed arrhythmogenic syncope and with either at least moderate ventricular dysfunction or inducible SMVT on PES, what intervention should be considered?

1. Medication management
2. Ablation therapy
3. Lifestyle modification
4. ICD implantation*
5. Pacemaker insertion

150. Question

In patients with advanced single ventricle or systemic RV dysfunction with additional risk factors, what intervention may be considered?

1. Heart transplant
2. ICD implantation*
3. Medication adjustment
4. Lifestyle modification
5. Cardiac resynchronization therapy

151. Question

In patients after repair of Tetralogy of Fallot (TOF) with arrhythmia symptoms and NSVT, what should be considered?

1. Cardiac catheterization
2. Electrocardiogram (ECG)
3. Electrophysiologic evaluation including PES*
4. Holter monitoring
5. Stress testing

152. Question

In patients after repair of TOF with arrhythmia symptoms and a positive PES, or a combination of other risk factors and a positive PES, what intervention should be considered?

1. Pacemaker implantation
2. Anti-arrhythmic medication
3. ICD implantation*
4. Catheter ablation
5. Beta-blocker therapy

153. Question

In patients after repair of Tetralogy of Fallot (TOF) without arrhythmia symptoms, but with a combination of other risk factors, what evaluation may be considered?

1. Electrophysiologic evaluation, including PES*
2. Routine echocardiography
3. Regular blood pressure monitoring
4. Annual stress tests
5. Holter monitoring

154. Question

In patients with repaired Tetralogy of Fallot (TOF) undergoing surgical or transcutaneous pulmonary valve replacement, what preoperative procedure may be considered?

1. Preoperative catheter mapping and transection of VT-related anatomical isthmuses
2. Routine echocardiography
3. Genetic testing
4. Full-body MRI scan
5. Blood pressure monitoring throughout the procedure

155. Question

In the management of patients with idiopathic ventricular fibrillation (VF), what is recommended for diagnosing idiopathic VF in a sudden cardiac arrest (SCA) survivor?

1. Diagnosing idiopathic VF without the need for documentation of VF.
2. Diagnosing idiopathic VF based on patient symptoms alone.
3. Diagnosing idiopathic VF after excluding structural, channelopathic, metabolic, or toxicological causes.*
4. Diagnosing idiopathic VF with only an ECG test.
5. Diagnosing idiopathic VF without excluding other potential etiologies.

156. Question

According to the clinical practice guidelines for the management of patients with idiopathic ventricular fibrillation (VF), what clinical testing may be considered for first-degree family members of idiopathic VF patients?

1. Genetic testing
2. History, ECG, high precardial lead ECGs, exercise test, and echocardiogram*
3. Cardiac MRI
4. Blood pressure monitoring
5. Holter monitoring

157. Question

In the management of long QT syndrome, what criteria are recommended for diagnosing LQTS?

1. QTc 460 ms in repeated 12-lead ECGs with or without symptoms
2. QTc 480 ms in repeated 12-lead ECGs with or without symptoms*
3. QTc 500 ms in a single 12-lead ECG with symptoms
4. LQTS diagnostic score > 5
5. QTc 470 ms in repeated 12-lead ECGs with or without symptoms

158. Question

In patients with clinically diagnosed LQTS, what is recommended for management?

1. Regular exercise and physical therapy
2. Genetic testing and genetic counselling*
3. Only pharmacological treatment
4. No specific management needed
5. Immediate surgical intervention

159. Question

In the management of long QT syndrome (LQTS), what is recommended for diagnosing LQTS?

1. It is recommended that LQTS is diagnosed only when QT duration exceeds normal limits.
2. It is recommended that LQTS is diagnosed in the presence of a pathogenic mutation, irrespective of the QT duration.*
3. It is recommended that LQTS is diagnosed based on clinical symptoms alone.
4. It is recommended that LQTS is diagnosed only in the presence of family history.
5. It is recommended that LQTS is diagnosed if the QT duration is normal and there is no mutation.

160. Question

In the management of long QT syndrome, under what condition should an LQTS diagnosis be considered according to the guidelines?

1. QTc 440 ms and < 460 ms in repeated 12-lead ECGs in patients with an arrhythmic syncope in the absence of secondary causes for QT prolongation.
2. QTc 450 ms and < 470 ms in repeated 12-lead ECGs in patients with an arrhythmic syncope in the absence of secondary causes for QT prolongation.
3. QTc 460 ms and < 480 ms in repeated 12-lead ECGs in patients with an arrhythmic syncope in the absence of secondary causes for QT prolongation.*
4. QTc 470 ms and < 490 ms in repeated 12-lead ECGs in patients with an arrhythmic syncope in the absence of secondary causes for QT prolongation.
5. QTc 480 ms and < 500 ms in repeated 12-lead ECGs in patients with an arrhythmic syncope in the absence of secondary causes for QT prolongation.

161. Question

In the management of long QT syndrome (LQTS), which of the following diagnostic tests is not recommended for routine use?

1. Electrocardiogram (ECG)
2. Genetic testing
3. Ambulatory Holter monitoring
4. Echocardiography
5. Epinephrine challenge*

162. Question

What is recommended regarding invasive electrophysiologic study in long QT syndrome (LQTS)?

1. It is strongly recommended for all patients with LQTS.
2. It is recommended only for high-risk patients with LQTS.
3. It is recommended for patients with a family history of sudden cardiac death.
4. It is not recommended in LQTS.*
5. It is recommended only for patients who have experienced syncope.

163. Question

In patients with suspected Andersen-Tawil syndrome, what is recommended for diagnosis?

1. MRI scan
2. Genetic testing*
3. Blood pressure monitoring
4. Echocardiogram
5. Exercise stress test

164. Question

Which of the following criteria should be considered when diagnosing Andersen-Tawil syndrome in patients without SHD?

1. Presence of prominent U waves with or without prolongation of the QT interval
2. Bidirectional and/or polymorphic PVCs/VT
3. Dysmorphic features
4. Periodic paralysis
5. KCNJ2 pathogenic loss-of-function mutation

165. Question

What is recommended for patients with Andersen-Tawil syndrome after aborted cardiac arrest (CA) or not tolerated sustained ventricular tachycardia (VT)?

1. Beta-blocker therapy
2. ICD implantation*
3. Lifestyle modification
4. Calcium channel blocker therapy
5. Surgical ablation

166. Question

According to clinical practice guidelines, which of the following treatment options should be considered in patients with Andersen-Tawil syndrome to treat ventricular arrhythmias (VA)?

1. Calcium channel blockers and/or flecainide with or without acetazolamide
2. Beta-blockers and/or amiodarone with or without acetazolamide
3. Beta-blockers and/or flecainide with or without acetazolamide*
4. ACE inhibitors and/or beta-blockers with or without acetazolamide
5. Beta-blockers and/or sotalol with or without acetazolamide

167. Question

In patients with Andersen-Tawil syndrome and unexplained syncope, what treatment option should be considered?

1. A pacemaker
2. An implantable cardioverter-defibrillator (ICD)
3. A wearable cardioverter-defibrillator (WCD)
4. An implantable loop recorder (ILR)*
5. A beta-blocker

168. Question

In patients with Andersen-Tawil syndrome, when may ICD implantation be considered?

1. When patients have a history of unexplained syncope or suffer from tolerated sustained VT.*
2. When patients experience frequent episodes of shortness of breath.
3. When patients have mild arrhythmias but no significant symptoms.
4. When patients are asymptomatic but have a family history of cardiac issues.
5. When patients show no signs of syncope or ventricular tachycardia (VT).

169. Question

In the diagnosis of Brugada syndrome, under what circumstances is BrS recommended to be diagnosed?

1. In patients with other heart diseases and a spontaneous type 2 Brugada ECG pattern.
2. In patients with no other heart disease and a spontaneous type 1 Brugada ECG pattern.*
3. In patients with no other heart disease and a drug-induced type 1 Brugada ECG pattern.
4. In patients with other heart diseases and a spontaneous type 1 Brugada ECG pattern.
5. In patients with no other heart disease and a spontaneous type 3 Brugada ECG pattern.

170. Question

Based on the guideline for the diagnosis of Brugada syndrome, in which patients is it recommended to diagnose BrS?

1. Patients with a history of hypertension and a type 1 Brugada ECG pattern
2. Patients with ischemic heart disease and a type 1 Brugada ECG pattern
3. Patients with no other heart disease who have survived a cardiac arrest due to ventricular fibrillation or polymorphic ventricular tachycardia and exhibit a type 1 Brugada ECG induced by sodium channel blocker challenge or during fever*
4. Patients with atrial fibrillation and a type 1 Brugada ECG pattern
5. Patients with a family history of Brugada syndrome and a type 2 Brugada ECG pattern

171. Question

What is recommended for probands with Brugada syndrome according to the clinical practice guidelines?

1. Routine echocardiography
2. Lifestyle modification
3. Genetic testing for SCN5A gene*
4. Regular exercise regimen
5. Dietary changes

172. Question

Based on the clinical practice guidelines, which of the following criteria would consider Brugada syndrome (BrS) in patients with no other heart disease and an induced type 1 Brugada pattern?

1. Arrhythmic syncope or nocturnal agonal respiration
2. Family history of BrS
3. Family history of sudden death (SD) (< 45 years old) with a negative autopsy and circumstance suspicious for BrS
4. All of the above*
5. None of the above

173. Question

In patients with no other heart disease, what may be considered as a diagnosis if they exhibit an induced type 1 Brugada ECG?

1. Long QT Syndrome
2. Brugada Syndrome*
3. Wolff-Parkinson-White Syndrome
4. Atrial Fibrillation
5. Ventricular Tachycardia

174. Question

In the diagnosis of Brugada syndrome, what is the recommendation regarding the use of a sodium channel blocker test in patients with a prior type I Brugada pattern?

1. It is highly recommended.
2. It is moderately recommended.
3. It is not recommended.*
4. It is optional.
5. It depends on the patient's symptoms.

175. Question

In the management of Brugada syndrome, which of the following patient scenarios may consider the use of PES?

1. Symptomatic patients with any type of BrS ECG
2. Asymptomatic patients with a spontaneous type I BrS ECG*
3. Patients with a family history of Brugada syndrome but no ECG abnormalities
4. Symptomatic patients with a drug-induced type I BrS ECG
5. Asymptomatic patients with a type II BrS ECG

176. Question

In the management of Brugada syndrome, which of the following is a recommendation for selected asymptomatic patients with inducible VF during PES using up to 2 extrastimuli?

1. Medication therapy
2. ICD implantation*
3. Lifestyle modification
4. Surgical ablation
5. Genetic counseling

177. Question

In the management of Brugada syndrome, what is the recommendation regarding catheter ablation in asymptomatic BrS patients?

1. It is recommended for all patients.
2. It is recommended for symptomatic patients only.
3. It is not recommended.
4. It is recommended for asymptomatic patients only.
5. It is recommended for patients with a family history of Brugada syndrome.

178. Question

What criteria are recommended for diagnosing early repolarization pattern (ERP) in an ECG?

1. J-point elevation of 2 mm in two adjacent inferior and/or lateral ECG leads
2. J-point elevation of 1 mm in three adjacent inferior and/or lateral ECG leads
3. J-point elevation of 0.5 mm in two adjacent inferior and/or lateral ECG leads
4. J-point elevation of 1 mm in two adjacent inferior and/or lateral ECG leads*
5. J-point elevation of 1 mm in any single ECG lead

179. Question

What is recommended for diagnosing ERS in a patient resuscitated from unexplained VF/PVT?

1. It is recommended that the ERS is diagnosed only in the presence of a concurrent heart attack.
2. It is recommended that the ERS is diagnosed in a patient resuscitated from unexplained VF/PVT in the presence of ERP.*
3. It is recommended that the ERS is diagnosed only after multiple episodes of VF/PVT.
4. It is recommended that the ERS is diagnosed in any patient with unexplained VF/PVT regardless of ERP presence.
5. It is recommended that the ERS is diagnosed only in the absence of ERP.

180. Question

In a sudden cardiac death (SCD) victim with a negative autopsy and medical chart review, and an antemortem ECG demonstrating the early repolarization pattern (ERP), what diagnosis should be considered?

1. Long QT syndrome
2. Brugada syndrome
3. Catecholaminergic polymorphic ventricular tachycardia (CPVT)
4. Early repolarization syndrome (ERS)*
5. Arrhythmogenic right ventricular cardiomyopathy (ARVC)

181. Question

In the management of ER pattern/syndrome, which group should be considered for clinical evaluation for ERP with additional high-risk features?

1. All patients with a history of syncope
2. Second-degree relatives of ERP patients
3. First-degree relatives of ERS patients*
4. Patients with hypertension
5. Individuals over 65 years old

182. Question

In the management of ER pattern/syndrome, what is recommended regarding genetic testing in ERS patients?

1. Genetic testing in ERS patients is mandatory.
2. Genetic testing in ERS patients is not recommended.
3. Genetic testing in ERS patients should be avoided.
4. Genetic testing in ERS patients may be considered.*
5. Genetic testing in ERS patients is highly recommended.

183. Question

In the management of ER pattern/syndrome, what is the recommendation for clinical evaluation in asymptomatic subjects with ERP?

1. Clinical evaluation should be performed regularly.
2. Clinical evaluation should be performed only if symptoms develop.
3. Clinical evaluation is recommended routinely for all subjects.
4. Clinical evaluation is not recommended routinely in asymptomatic subjects with ERP.*
5. Clinical evaluation should be performed annually.

184. Question

In the management of patients with CPVT, under what conditions is CPVT recommended to be diagnosed?

1. In the presence of a structurally normal heart, normal ECG, and exercise- or emotion-induced bidirectional or PVT.*
2. In the presence of a structurally abnormal heart, abnormal ECG, and exercise- or emotion-induced bidirectional or PVT.
3. In the presence of a structurally normal heart, abnormal ECG, and exercise- or emotion-induced unidirectional or PVT.
4. In the presence of a structurally abnormal heart, normal ECG, and rest-induced bidirectional or PVT.
5. In the presence of a structurally normal heart, normal ECG, and rest-induced bidirectional or PVT.

185. Question

In the management of patients with CPVT, which of the following is recommended for diagnosing CPVT?

1. Diagnosing CPVT based on clinical symptoms alone
2. Diagnosing CPVT in patients with a history of arrhythmias
3. Diagnosing CPVT in patients with a family history of cardiac events
4. Diagnosing CPVT in patients who are carriers of a mutation in disease-causing genes*
5. Diagnosing CPVT in patients with abnormal ECG findings

186. Question

In the management of patients with CPVT, what is recommended for patients with clinical suspicion or clinical diagnosis of CPVT?

1. Regular exercise and physical activity
2. Genetic testing and genetic counselling*
3. Surgical intervention
4. Immediate use of beta-blockers
5. Routine angiography

187. Question

In the management of patients with CPVT, which diagnostic method may be considered when an exercise test is not possible?

1. Holter monitoring
2. Epinephrine or isoproterenol challenge*
3. Cardiac MRI
4. Echocardiography
5. Coronary angiography

188. Question

In the management of patients with CPVT, which procedure is not recommended for stratification of SCD risk?

1. Genetic testing
2. Exercise stress testing
3. *PES
4. Holter monitoring
5. Echocardiography

189. Question

What are the criteria for diagnosing Short QT Syndrome (SQTS) according to the clinical practice guidelines?

1. A QTc 360 ms and a pathogenic mutation
2. A QTc 360 ms and a family history of SQTS
3. A QTc 360 ms and survival from a VT/VF episode in the absence of heart disease
4. A QTc 360 ms and one or more of the following: a pathogenic mutation, a family history of SQTS, or survival from a VT/VF episode in the absence of heart disease*
5. A QTc 360 ms and two or more of the following: a pathogenic mutation, a family history of SQTS, or survival from a VT/VF episode in the absence of heart disease

190. Question

In the management of short QT syndrome (SQTS), what is recommended for patients diagnosed with SQTS?

1. Regular exercise
2. Genetic testing*
3. Dietary modifications
4. Psychotherapy
5. Blood transfusions

191. Question

In the management of short QT syndrome, at what QTc interval should SQTS be considered?

1. 300 ms
2. 320 ms*
3. 340 ms
4. 360 ms
5. 380 ms

192. Question

In the management of short QT syndrome (SQTS), under what conditions should SQTS be considered?

1. In the presence of a QTc 370 ms and arrhythmogenic syncope
2. In the presence of a QTc 320 ms and 360 ms and arrhythmogenic syncope*
3. In the presence of a QTc 300 ms and arrhythmogenic syncope
4. In the presence of a QTc 310 ms and 350 ms without arrhythmogenic syncope
5. In the presence of a QTc 330 ms and 340 ms and arrhythmogenic syncope

193. Question

In the management of short QT syndrome, under which of the following conditions may SQTS be considered?

1. QTc > 360 ms and a family history of SD at age < 50 years
2. QTc 400 ms and a family history of SD at age < 60 years
3. QTc 320 ms and 360 ms and a family history of SD at age < 40 years*
4. QTc < 320 ms and no family history of SD
5. QTc > 360 ms and a family history of SD at age < 70 years

194. Question

For which patients with a diagnosis of SQTS is ICD implantation recommended?

1. Patients with a history of hypertension
2. Patients with a family history of SQTS
3. Patients who are survivors of an aborted CA and/or have documented spontaneous sustained VT*
4. Patients with mild arrhythmias managed by medication
5. Patients with no symptoms but with an abnormal ECG

195. Question

In the management of young patients with short QT syndrome (SQTS), what is recommended for risk stratification, SCD prevention, and treatment of VA?

1. Immediate ICD implantation
2. Beta-blocker therapy
3. Holter monitoring
4. ILR should be considered
5. Genetic testing

196. Question

In patients with short QT syndrome (SQTS), what management strategy should be considered for those experiencing arrhythmic syncope?

1. Pharmacological therapy with beta-blockers
2. Lifestyle modifications and regular monitoring
3. Ablation therapy
4. ICD implantation*
5. Anticoagulant therapy

197. Question

Quinidine may be considered in which of the following scenarios for SQTS patients?

1. Symptomatic SQTS patients without family history of SCD
2. Asymptomatic SQTS patients without family history of SCD
3. SQTS patients who have no contraindication to ICD and do not refuse it
4. SQTS patients who qualify for an ICD but present a contraindication to the ICD or refuse it*
5. SQTS patients with no history of arrhythmias

198. Question

In the management of short QT syndrome, what medication may be considered in emergency situations for patients with an electrical storm?

1. Amiodarone
2. Lidocaine
3. Magnesium sulfate
4. Isoproterenol *
5. Procainamide

199. Question

Which of the following is NOT recommended for SCD risk stratification in SQTS patients?

1. Genetic testing
2. Holter monitoring
3. Echocardiography
4. Invasive electrophysiological study (PES)*
5. Exercise stress testing

200. Question

During pregnancy, which intervention is recommended for sustained VT?

1. Administration of beta-blockers
2. Electrical cardioversion*
3. Use of antiarrhythmic drugs
4. Physical activity restriction
5. Magnesium sulfate therapy

201. Question

For the acute conversion of haemodynamically tolerated sustained monomorphic ventricular tachycardia (SMVT) during pregnancy, which of the following treatments should be considered?

1. Amiodarone
2. Flecainide*
3. Lidocaine
4. Quinidine
5. Magnesium sulfate

202. Question

If ICD implantation is indicated during pregnancy, what is recommended?

1. Implantation without any special precautions
2. Implantation with minimal anesthesia
3. Implantation with optimal radiation protection*
4. Implantation only after childbirth
5. Implantation with regular radiation exposure

203. Question

According to clinical practice guidelines, what is recommended during pregnancy and postpartum for women with LQTS or CPVT?

1. Discontinuation of beta-blockers
2. Initiation of calcium channel blockers
3. Use of ACE inhibitors
4. Continuation of beta-blockers*
5. Avoidance of all medications

204. Question

During pregnancy, what is the recommendation for women with ARVC regarding the continuation of beta-blockers?

1. Beta-blockers should be discontinued immediately.
2. Beta-blockers should be switched to another medication.
3. Beta-blockers should never be used under any circumstances.
4. Beta-blockers should be considered for continuation.*
5. Beta-blockers should only be used during the first trimester.

205. Question

Which oral medications should be considered for long-term management of idiopathic sustained VT during pregnancy?

1. Metoprolol, propranolol, or verapamil*
2. Atenolol, bisoprolol, or nifedipine
3. Metoprolol, atenolol, or amlodipine
4. Propranolol, bisoprolol, or diltiazem
5. Verapamil, nifedipine, or carvedilol

206. Question

In pregnant women with highly symptomatic recurrent SMVT refractory or intolerant to antiarrhythmic drugs (AADs), catheter ablation using non-fluoroscopic mapping systems should be considered during which period?

1. Before conception
2. During the first trimester
3. Preferably after the first trimester*
4. During the second trimester only
5. Only after delivery

207. Question

In patients awaiting heart transplantation, what should be considered for primary prevention?

1. Cardiac catheterization
2. Coronary artery bypass grafting
3. Echocardiography
4. ICD implantation*
5. Exercise stress testing

208. Question

In patients awaiting heart transplantation, what may be considered?

1. ICD
2. CRT-D
3. Medication adjustment
4. LVAD
5. WCD*

209. Question

In selected transplanted patients with cardiac allograft vasculopathy or treated rejection, what intervention may be considered according to the guidelines?

1. Antiarrhythmic drug therapy
2. Coronary artery bypass grafting (CABG)
3. ICD implantation*
4. Heart retransplantation
5. Angioplasty

210. Question

In athletes with positive medical history, abnormal physical examination, or ECG alterations, what further investigations are recommended to confirm (or exclude) an underlying disease?

1. MRI and stress test
2. CT scan and blood tests
3. Echocardiography and/or CMR*
4. Holter monitoring and angiography
5. PET scan and genetic testing

211. Question

According to the clinical practice guidelines, how should athletes diagnosed with a cardiovascular disease associated with SCD be managed?

1. Athletes should stop all physical activity immediately.
2. Athletes should follow a personalized training program.
3. Athletes should be managed according to current guidelines for sports eligibility.*
4. Athletes should undergo surgery to prevent SCD.
5. Athletes should only participate in low-intensity sports.

212. Question

According to clinical practice guidelines, what is recommended for staff at sporting facilities to help prevent sudden cardiac death (SCD) in athletes?

1. They should be trained in advanced cardiac life support (ACLS).
2. They should be trained in cardiopulmonary resuscitation (CPR) and in the use of automated external defibrillators (AED).*
3. They should be trained in basic first aid and emergency response.
4. They should be trained in the use of electrocardiograms (ECG).
5. They should be trained in injury prevention and management.

213. Question

According to clinical practice guidelines, what is recommended for the pre-participation cardiovascular evaluation of competitive athletes?

1. It is mandatory for all athletes.
2. It should be considered.*
3. It is not necessary unless symptoms are present.
4. It should only be done for professional athletes.
5. It is recommended to be done only once every five years.

214. Question

According to the clinical practice guidelines, what should be considered in the cardiovascular evaluation of young (< 35 years) competitive athletes?

1. History, physical examination, and echocardiogram.
2. History, physical examination, and stress test.
3. History, physical examination, and 12-lead ECG.*
4. History, physical examination, and MRI.
5. History, physical examination, and Holter monitoring.

215. Question

What should be evaluated in middle-aged and elderly individuals before they engage in strenuous sports, according to the guidelines for risk stratification and prevention of SCD in athletes?

1. Their nutritional status
2. Their cardiovascular risk through established scores such as the SCORE2 risk chart*
3. Their mental health status
4. Their bone density
5. Their hydration levels

216. Question

In elderly patients in whom a benefit from the defibrillator is not expected due to the patients age and comorbidities, what action may be considered regarding ICD implantation for primary prevention?

1. Mandatory ICD implantation
2. Optional ICD implantation
3. Omission of ICD implantation*
4. Delayed ICD implantation
5. Increased frequency of ICD implantation

Ventricular arrhythmias and sudden cardiac death

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