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IBHRE® > Indications > Flashcards

Indications Flashcards

Highlights current AHA indications for Brady, Tachy and CRT therapy. Currently weighted 9% in the CCDS exam.

1
Q

List the 3 class I indications for SND.

A
  1. Symptomatic documented brady / pauses
  2. Symptomatic chronotropic incompetence
  3. SND resultant of drug therapy of which there are no alternatives
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2
Q

List the 5 class I indications for AV Block.

A
  1. 3rd or 2nd degree AVB + Symptomatic bradycardia
  2. Pauses >3s or HR <40bpm
  3. AF pauses >5s
  4. Post AVN ablation
  5. Surgical LV dysfunction
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3
Q

What is the one Class IIb indication for SND?

A

Minimally symptomatic with HR <40bpm during awake hours.

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4
Q

List the 2 class IIb indications for AV Block.

A
  1. Neuromuscular diseases
  2. AV block during drug use where block is recurrent
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5
Q

List the 3 class I indications for bifasicular block.

A
  1. Advanced 2nd or intermittent 3rd degree block
  2. Mobitz II
  3. Alternating BBB
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6
Q

Which pacing indication class is the following?

‘Asymptomatic CHB with HR >40bpm’.

A

Class IIa.

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7
Q

What 4 things are typically present in class I ICD indications?

A
  1. Survivor of VF or VT
  2. LVEF <40% due to prior MI
  3. Recorded or inducible VF/VT
  4. NYHA class I, II or III

Not necessarily all at the same time.

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8
Q

The phrase ‘‘It is reasonable’’ typically relates to what indication class?

A

Class IIa.

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9
Q

The phrase ‘‘may be considered’’ typically relates to what indication class?

A

Class IIb.

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10
Q

List the only class I indication for reflex syncope.

A

Recurrent 3 second pauses with syncope from CS stimulation.

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11
Q

Yes / No

Does asymptomatic Mobitz II indicate pacing?

A

Yes.

Has a high risk of progression vs. Mobitz I which is lower risk.

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12
Q

Yes / No

If symptoms are due to AV block, should we permanently pace?

A

Yes - Class I indication.

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13
Q

True / False

Which class applies?

‘A-pacing is recommended over V-pacing for sypmtomatic patients with SND’.

A

True - Class I indication.

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14
Q

Which class applies with respect to permanent PPM insertion?

‘SND, Symptomatic, Intact AV conduction, no evidence of conduction abnormality’.

A

Class I indication.

Either DR or SR pacing is recommended at class I in this instance.

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15
Q

Yes / No

Should this device be programmed to minimise RV pacing (list indication class)?

‘SND, Symptomatic, DR pacemaker in-situ and intact AV conduction’.

A

Yes - Class IIa indication.

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16
Q

Yes / No

Should a device be implanted in this patient (list indication class)?

‘SND, Symptomatic, Frequent Vp is not expected or patient has significant co-morbidities that are likely to determine survival’.

A

Yes - Class IIa indication.

SR permanent pacing is reasonable for this patient.

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17
Q

Which class applies?

‘Reversible, transient causes of AVB such as lyme carditis should have medical therapy including temporary pacing if required before determination of a permanent pacing system’.

A

Class I indication.

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18
Q

Which class applies with respect to permanent PPM insertion?

‘Second or third degree AVB, chronically stable doses of necessary anti arrhythmic medication’.

A

Class IIa indication.

It is reasonable to proceed with a permanent system without observation of washout.

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19
Q

Which class applies with respect to device insertion?

‘Second or third degree AVB associated with cardiac sarcoidosis and survival >1yr’.

A

Class IIa indication.

Permanent PPM or ICD (if required).

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20
Q

Which class applies with respect to permanent PPM insertion?

‘Second or third degree AVB associated with thyroid abnormalities without myxedema’.

A

Class IIb indication.

Permanent pacing without further observation for reversibility may be considered.

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21
Q

Which class applies with respect to temporary transvenous pacing?

‘Symptomatic, Second or third degree AVB that is refractory to medical therapy’.

A

Class IIa indication.

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22
Q

Which class applies?

‘Opt for an externalised active fixation lead over a passive fixation temporary lead’.

For patients who require prolonged temporary pacing.

A

Class IIa indication.

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23
Q

Which class applies with respect to temporary transcutaneous pacing?

Second or third degree AVB with haemodynamic compromise refractory to antibradycardic medication’.

A

Class IIb indication.

Temporary transcutaneous pacing may be considered until a temporary transvenous or permanent pacemaker is placed.

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24
Q

Yes / No

Should a permanent pacing system be implanted in this patient (list class)?

‘1st degree AVB or Mobitz I or 2:1 block at the level of the AV node with symptoms that do not always correlated to the block’.

A

No - Class III indication.

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25
Q

Yes / No

Should a permanent pacing system be implanted in this patient (list class)?

‘Asymptomatic, 1st degree AVB or Mobitz I or 2:1 block at the level of the AV node’.

A

No - Class III indication.

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26
Q

Yes / No

Should a permanent pacing system be implanted in this patient (list class)?

‘Symptomatic AVB with reversible cause, however AVB persists despite optimal treatment of underlying cause’.

A

Yes - Class I indication.

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27
Q

Should a permanent pacing system be implanted in this patient (list class)?

‘Symptomatic AVB with reversible cause, AVB resolves and does not return following optimal treatment of underlying cause’.

A

No - Class III indication.

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28
Q

Yes / No

Should a permanent pacing system be implanted in this patient (list class)?

‘Patient has vagally mediated AVB without symptoms’.

A

No - Class III indication.

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29
Q

Which class applies with respect to PPM insertion?

‘Acquired Mobitz II, high grade AVB or 3rd degree AVB without reversible cause’.

A

Class I indication.

Irrespective of symptoms a device should be implanted.

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30
Q

Which class applies?

‘Neruomuscular disease and associated conduction disease with evidence of 2nd or 3rd degree AVB, Survival >1yr’.

A

Class I indication.

Irrespective of symptoms a device should be implanted.

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31
Q

True / False

The following is a Class I indication for permanent pacing.

‘Patient has AF with symptomatic bradycardia’.

A

True.

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32
Q

True / False

The following is a Class IIa indication for pacing.

‘Patient develops AVB as a result of guideline directed therapy for which there is no alternative and continued treatment is necessary’.

A

False - Class I.

Pacing is recommended to increase HR and improve symptoms.

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33
Q

Which class applies with respect to permanent pacing?

‘Infiltrative cardiomyopathy and Mobitz II or CBH with a survival >1yr’.

A

Class IIa indication.

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34
Q

True / False

The following is a class IIb indication for permanent pacing.

‘Patients with gene mutations and a PR interval >240ms and LBBB with survival >1yr’.

A

False - Class IIa indication.

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35
Q

True / False

The following is a class I indication for permanent pacing.

‘Marked 1st degree or Mobitz I with symptoms clearly attributable to the AVB’.

A

False - Class IIa indication.

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36
Q

Which class applies with respect to permanent pacing?

‘Neuromuscular disease, PR >240ms, QRS >120ms or fascicular block, survivability >1yr’.

A

Class IIb indication.

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37
Q

Is DR pacing recommended over SR pacing - if so, which class?

‘Patient has SND and AVB’.

A

DR pacing is recommended over SR - Class I indication.

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38
Q

Which class applies?

‘AVB patient who requires permanent pacing but is not expected to Vp frequently or has significant comorbidities likely to dictate clinical outcome and that may limit benefit of a DR system, SR ventricular pacing is effective’.

A

Class I indication.

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39
Q

Is revising to a DR system is recommended, if so - which class?

‘Patient in sinus rhythm with a SR system whom develops pacemaker syndrome’.

A

Class I indication.

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40
Q

Is it reasonable to choose systems that maintain physiologic ventricular activation such as CRT or HIS bundle over RV pacing in patients such as these, if so - which class?

‘AVB patients indicated for permanent pacing, EF between 36-50%, Vp >40%’.

A

Yes - Class IIa indication.

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41
Q

True / False

The following is a class IIa indication.

‘AVB at the level of AV node & indicated for permanent pacing, HIS bundle may be considered to maintain physiological activation’.

A

False - Class IIb indication.

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42
Q

Yes / No

Should an atrial lead be implanted in the following patient - what class?

‘Patients with permanent or persistent AF in whom rhythm control is not planned’.

A

No - Class III indication.

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43
Q

Yes / No

Should a permanent pacing system be implanted in this patient - what class?

‘1:1 AV conduction, normal PR, exhibits syncope and BBB with HV >70ms or evidence of infranodal block’.

A

Yes - Class I indication.

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44
Q

Yes / No

Should a permanent pacing system be implanted in this patient - what class?

‘1:1 AV conduction with normal PR - Patient exhibits alternating BBB’.

A

Yes - Class I indication.

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45
Q

Yes / No

Should a permanent pacing system be implanted in this patient - what class?

‘1:1 AV conduction, normal PR, diagnosed Kearns-Sayre syndrome and conduction disorders, expected survivability >1yr’.

A

Yes - Class IIa indication.

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46
Q

Yes / No

Should a permanent pacing system be implanted in this patient - which class?

‘1:1 AV conduction, normal PR, diagnosed Anderson-Fabry disease, QRS >110ms, expected survivability >1yr’.

A

Yes - Class IIb indication.

Class IIb is debatable due to weaker evidence.

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47
Q

Yes / No

Should a CRT permanent pacing system be implanted in this patient - which class?

‘1:1 AV conduction, normal PR, HF, reduced LVEF (36-50%), LBBB, QRS >150ms’.

A

Yes - Class IIb indication.

Class IIb is debatable due to weaker evidence.

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48
Q

Yes / No

Should a permanent pacing system be implanted in this patient - which class?

‘1:1 AV conduction, normal PR, isolated conduction disease and asymptomatic’.

A

No - Class III indication.

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49
Q

Which class applies with respect to placement of transcutaneous pacing pads?

‘High risk of development of intraoperative or periprocedural bradycardia’.

A

Class IIa indication.

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50
Q

Yes / No

Should prophylactic temporary transvenous pacing be performed - which class?

‘Patients who have LBBB and require PA catheterisation for intraoperative monitoring’.

A

No - Class III indication.

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51
Q

Yes / No

Should a permanent pacing system be implanted in this patient - which class?

‘Postoperative SND or AVB associated with symptoms or haemodynamic instability that does not resolve after coronary artery bypass surgery’.

A

Yes - Class I indication.

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52
Q

Yes / No

Should there be routine placement of temporary epicardial pacing wires - which class?

‘Patients undergoing coronary artery bypass surgery’.

A

Yes - Class IIa indication.

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53
Q

Yes / No

Should you place a permanent epicardial LV lead intraoperatively - which class?

‘Patients undergoing coronary artery bypass surgery that likely need future CRT or Vp’.

A

Yes - Class IIb indication.

Class IIb is debateable due to weaker evidence.

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54
Q

Yes / No

Should you place temporary epicardial pacing wires - which class?

‘Patients undergoing surgery for AF’.

A

Yes - Class I indication.

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55
Q

Yes / No

Should a permanent pacing system be implanted in this patient?

‘New postoperative SND or AVB with associated symptoms or haemodynamic instability that does not resolve after AF surgery’.

A

Yes - Class I indication.

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56
Q

Should you intraoperatively place a permanent epicardial LV lead - which class?

‘Patients undergoing AF surgery that likely need future CRT or Vp’.

A

Class IIb indication.

Class IIb is debateable due to weaker evidence.

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57
Q

Yes / No

Should you place temporary epicardial pacing wires - which class?

‘Patients undergoing surgical aortic valve replacement/repair’.

A

Class I indication.

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58
Q

True / False

The following is a class IIa indication for permanent pacing.

‘Postoperative SND or AVB associated with symptoms or haemodynamic instability that does not resolve after aortic valve surgery’.

A

False - Class I indication.

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59
Q

Yes / No

Should you intraoperatively place a permanent epicardial LV lead - which class?

‘Patients undergoing aortic valve surgery who will likely need future CRT or Vp’.

A

Yes - Class IIb indication.

Class IIb is debateable due to weaker evidence.

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60
Q

True / False

The following is class I indication for permanent pacing.

‘New postoperative SND or AVB with associated symptoms or haemodynamic instability that does not resolve after mitral valve surgery’.

A

True - Class I indication.

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61
Q

Yes / No

Should you intraoperatively place a permanent epicardial LV lead - which class?

‘Patients undergoing mitral valve surgery who will likely need future CRT or Vp’.

A

Yes - Class IIa indication.

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62
Q

Yes / No

Should you intraoperatively place a permanent epicardial LV lead?

‘Patients undergoing aortic valve surgery who will likely need future CRT or Vp’.

A

Yes - Class IIb indication.

Class IIb is debateable due to weaker evidence.

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63
Q

Yes / No

Should you place temporary epicardial wires - which class?

‘Patients undergoing tricuspid valve surgery’.

A

Yes - Class I indication.

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64
Q

Which class applies for permanent pacing?

‘New postoperative SND or AVB with associated symptoms or haemodynamic instability that does not resolve after tricuspid valve surgery’.

A

Class I indication.

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65
Q

Yes / No

Should you intraoperatively place permanent epicardial leads at the time of surgery - which class?

‘Patients undergoing mitral valve surgery & high risk of postop high degree AVB’.

A

Yes - Class IIa indication.

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66
Q

Yes / No

Should a permanent pacing system be implanted in this patient - which class?

‘New AVB following transcatheter aortic valve replacement with associated symptoms or haemodynamic instability that does not resolve’.

A

Yes - Class I indication.

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67
Q

Yes / No

Should a permanent pacing system be implanted in this patient?

‘Has new persistent LBBB following transcatheter aortic valve replacement’.

A

Yes - Class IIb indication.

Class IIb is debateable due to weaker evidence.

68
Q

Yes / No

Should a permanent pacing system be implanted in this patient - which class?

‘Develops Mobitz II, High grade AVB or CHB post septal ablation or surgical myectomy’.

A

Yes - Class I indication.

69
Q

True / False

The following is a class IIa indication for ICD implantation.

‘HCM patients who require PPM for rate support post septal ablation/myectomy and are at risk for SCD with meaningful survival >1yr’.

A

True - Class IIa indication.

70
Q

True / False

Ventricular based permanent pacing is a class I indication for this diagnosis.

‘Adults with ACHD and symptomatic SND or chronotropic incompetence’.

A

False.

This is a class I indication for atrial based permanent pacing

71
Q

True / False

The following is a class IIa indication for permanent pacing.

‘Adults with ACHD and symptomatic bradycardia respondent to AVB’.

A

False - Class I indication.

72
Q

True / False

The following is a class I indication for permanent pacing.

‘Symptomatic adults with ACHD and CHB, Wide QRS, Mean HR >50bpm, complex VEs or ventricular dysfunction’.

A

True - Class I indication.

73
Q

True / False

The following is a class III indication for permanent pacing.

‘Adults with ACHD and postoperative Mobitz II, high grade AVB or CHB that is not expected to resolve’.

A

False - Class I indication.

74
Q

Yes / No

Should a permanent pacing system be implanted in this patient?

‘Asymptomatic adults with congenital CHB’.

A

Yes - Class IIa indication.

75
Q

Is a device with atrial anti-tachycardia capabilities indicated - which class?

‘Adults with repaired ACHD who require pacing for bradycardia’.

A

Yes - Class IIa indication.

76
Q

Yes / No

Should you intraoperatively place epicardial pacing leads - which class?

‘ACHD, pre-existing SND and/or AV conduction disease undergoing cardiac surgery’.

A

Yes - Class IIa indication.

77
Q

Yes / No

Is atrial based pacing for the prevention of atrial arrhythmias indicated - which class?

‘Adults with ACHD and pacemakers’.

A

Yes - Class IIb indication.

Class IIb is debateable due to weaker evidence.

78
Q

Should endocardial leads be implanted - which class?

‘Adults with ACHD and venous to systemic intracardiac shunts’.

A

No - Class III indication.

79
Q

True / False

The following is a class I indication to place a temporary pacing wire.

‘MI patients with haemodynamically significant bradycardia related to SND or AV block’.

A

True - Class I indication.

80
Q

Yes / No

Should patients who present with SND or AV block in the setting of acute MI be entered into a waiting period before being implanted with a permanent pacemaker?

A

Yes - Class I indication.

81
Q

True / False

The following is a class I indiciation for permanent pacing following a waiting period.

‘Acute MI, High grade AVB, Mobitz II, Alternating BBB or third degree AVB’.

A

True - Class I indication.

82
Q

True / False

The following is a class IIa indication for permanent pacing.

‘Acute MI and transient AVB that resolves after a waiting period’.

A

False - Class III indication.

83
Q

True / False

The following is a class IIb indication for permanent pacing.

‘Acute MI and new BBB or isolated fascicular block in the absence of 2nd or 3rd degree AVB’.

A

False - Class III indication.

84
Q

True / False

The following is a class IIa indication for permanent pacing.

‘Epilepsy associated with severe symptomatic bradycardia (ictal) where anti-epileptic medications are ineffective’.

A

True - Class IIa indication.

85
Q

True / False

The following is a class I indication.

‘When permanent pacing is indicated, evaluation of the future risk of ventricular arrhythmias and a need for defibrillation should be performed’.

A

True - Class I indication.

86
Q

True / False

The following is a class III indication.

‘Clinicians and patients should utilise a shared decision making process based on the patients goals of care, preferences and values, not just the best medical evidence’.

A

False - Class I indication.

87
Q

True / False

The following is a class III indication.

‘Prior to all pacing related procedures, the patient should be informed of both the short and long term risks and possible alternative therapy in line with their goals of care, preferences and values’.

A

False - Class I indication.

88
Q

True / False

The following is a class I indication for permanent pacing.

‘In patients with a pacing indication but significant co-morbidities such that pacing therapy is unlikely to provide clinical benefit or if patients goals of care preclude implantation’.

A

False - Class III - permanent pacing should not be performed.

89
Q

True / False

The following is a class IIa indication.

‘Patients who present for revision or generator change, whereby the original indication has resolved, or is in question - discontinuation of pacemaker therapy is reasonable after a monitoring period where the pacing therapy is off’.

A

True - Class IIa indication.

90
Q

True / False

The following is a class I indication.

‘With respect to pacing mode choice, the preservation of spontaneous AV conduction is recommended in patients with documented intermittent bradycardia’.

A

True - Class I indication.

91
Q

True / False

The following is a class III indication.

‘Dual chamber pacing with rate hysteresis in patients with reflex asystolic syncope in order to preserve spontaneous sinus rhythm’.

A

False - Class I - rate hysteresis is recommended here.

92
Q

Which primary prevention class is the following?

‘LVEF <35% due to IHD, 40 days post MI & 90 days postrevascularization, NYHA class II or III despite GDMT, expected survival >1 year’.

A

Class I indication.

93
Q

Which primary prevention class is the following?

‘LVEF <30% due to IHD, 40 days post MI & 90 days postrevascularization, NYHA class I despite GDMT, expected survival >1 year’.

A

Class I indication.

94
Q

Which primary prevention class is the following?

‘NSVT due to prior MI, LVEF <40%, inducible sustained VT or VF at EP study, expected survival >1 year’.

A

Class I indication.

95
Q

Which primary prevention class is the following?

‘Nonhospitalized, NYHA class IV, Candidates for cardiac transplantation or an LVAD, expected survival >1 year’.

A

Class IIa indication.

96
Q

Which primary prevention class is the following?

‘NYHA class IV, Medication-refractory HF, not candidates for cardiac transplantation, LVAD or CRT defibrillator’.

A

Class III indication.

97
Q

Which secondary prevention class is the following?

‘NICM, survives SCD due to VT/VF or experience hemodynamically unstable VT or stable sustained VT not due to reversible causes’.

A

Class I indication.

98
Q

Which secondary prevention class is the following?

‘NICM, syncope presumed to be due to VA, doesn’t meet primary prevention indications’.

A

Class IIa indication.

99
Q

Which primary prevention class is the following?

‘NICM, NYHA II or III, LVEF <35% despite GDMT, Survival expected >1yr’.

A

Class I indication.

100
Q

True / False

The following is a class IIa primary prevention indication?

‘NICM due to Lamin AC mutation and 2 or more risk factors (NSVT, LVEF <45%, Male), Survival expected >1yr’.

A

True - Class IIa indication.

101
Q

True / False

The following is a class IIa primary prevention indication.

‘NICM, NYHA I, LVEF <35%, Survival expected >1yr’

A

False - Class IIb indication.

102
Q

Which class of ICD indication is the following?

‘ARVC + either: SCA, VT, RVEF or LVEF <35%’

A

Class I indication.

103
Q

True / False

The following is a class I ICD indication.

‘ARVC with syncope presumed to be due to VA’.

A

False - Class IIa indication.

104
Q

True / False

The following is a class I ICD indication.

‘HCM who has survived SCA due to VT/VF or has spontaneous VT causing syncope, survival expected >1yr’.

A

Class I indication.

105
Q

Which class of ICD indication is the following?

‘HCM with 1 or more of the following: LV wall thickness >30mm, SCD in 1 or more 1st degree relatives, 1 or more syncopal episodes in the last 6m’.

A

Class IIa indication.

106
Q

Which class of ICD indication is the following?

‘HCM with spontaneous NSVT or abnormal BP response to exercise who have additional SCD risk modifiers, Survival expected >1yr’.

A

Class IIa indication.

107
Q

Which class of ICD indication is the following?

‘HCM with spontaneous NSVT or abnormal BP response to exercise who have no SCD risk modifiers, Survival expected >1yr’.

A

Class IIb indication.

108
Q

True / False

The following is a class I ICD indication.

‘Identified HCM genotype in the absence of SCD risk factors’.

A

False - Class III indication.

109
Q

Yes / No

Would you implant an ICD in the following - which class?

‘IHD, Survive SCA due to VT/VF or has haemodynamically unstable VT or stable sustained VT not due to reversible causes’.

A

Yes - Class I indication.

110
Q

Yes / No

Would you implant an ICD in the following - which class?

‘IHD, Unexplained syncope, inducible sustained monomorphic VT’

A

Yes - Class I indication.

111
Q

True / False

The following is a class III indication for ICD implantation.

‘IHD, resuscitated SCA due to coronary artery spasm, medical therapy not tolerated, survival >1yr’

A

False - Class IIa indication.

112
Q

True / False

The following is a class III indication for ICD implantation.

‘IHD, resuscitated SCA due to coronary artery spasm, medical therapy well tolerated, survival >1yr’

A

False - Class IIb indication.

113
Q

True / False

The following is a class III indication for ICD implantation.

‘Giant cell myocarditis, VF or haemodynamically unstable VT, Optimal GDMT, survival >1yr’.

A

False - Class IIb indication.

114
Q

Yes / No

Would you implant an ICD for the following - which class?

‘Cardiac sarcoidosis, Sustained VT or survivors of SCD, LVEF <35%, Survival >1yr’.

A

Yes - Class I indication.

115
Q

Yes / No

Would you implant an ICD for the following - which class?

‘Cardiac sarcoidosis, LVEF >35%, Syncope and/or Evidence of myocardial scar and/or pacing indication, survival >1yr’.

A

Yes - Class IIa indication.

116
Q

Which class of ICD indication is the following?

‘Cardiac sarcoidosis, Positive EP study for inducible VA, Survival >1yr’.

A

Class IIa indication.

117
Q

Which class of ICD indication is the following?

‘Cardiac sarcoidosis and have a permanent pacing indication’.

A

Class IIa indication.

118
Q

Which class of ICD indication is the following?

‘HFrEF, awaiting heart transplant and wouldn’t otherwise qualify for an ICD with plan to discharge at home’.

A

Class IIa indication.

119
Q

Which class of ICD indication is the following?

‘With LVAD and sustained VA’.

A

Class IIa indication.

120
Q

Which class of ICD indication is the following?

‘Post heart transplant with severe allograft vasculopathy with LV dysfunction, survival >1yr’.

A

Class IIb indication.

121
Q

True / False

For patients with neuromuscular disorders, Primary & Secondary prevention ICDs are recommended for the same indications as for patients with NICM if survival >1yr.

A

True - Class I indication.

122
Q

Yes / No

Would you implant an ICD for the following - which class?

‘Has Emery-Dreifuss and limb-girdle type IB muscular dystrophies with progressive cardiac involvement’.

A

Yes - Class IIa indication.

123
Q

Which class of ICD indication is the following?

‘Myotonic dystrophy type 1 with an indication for a permanent pacemaker’.

A

Class IIb indication.

124
Q

Yes / No

Would you implant an ICD for the following - which class?

‘Cardiac channelopathy and SCD survivor’.

A

Yes - Class I indication.

125
Q

True / False

The following is a class IIa ICD indication.

‘High risk patients with symptomatic long QT syndrome, Beta blockers ineffective’

A

False - Class I indication.

126
Q

True / False

The following is a class IIa ICD indication.

‘Asymptomatic patients with resting QTc >500ms and receiving beta blocker’

A

True - Class IIa indication.

127
Q

Yes / No

Would you implant an ICD for the following - which class?

‘Catecholaminergic polymorphic VT and sustiained VT or syncope with maximally tolerated beta blocker’.

A

Yes - Class I indication.

128
Q

True / False

The following is a class I ICD indication.

‘Brugada syndrome, spontaneous type 1 Brugada pattern, cardiac arrest, sustained VA or syncope presumed due to VA with survival >1yr’.

A

True - Class I indication.

129
Q

Which class of ICD indication is the following?

‘Early repolarisation pattern on ECG and cardiac arrest or sustained VA, survival >1yr’.

A

Class I indication.

130
Q

Which class of ICD indication is the following?

‘Short QT syndrome, cardiac arrest or sustained VA, survival >1yr’.

A

Class I indication.

131
Q

Which class of ICD indication is the following?

‘Resuscitated from SCD due to idiopathic VT or VF, survival >1yr’.

A

Class I indication.

132
Q

Yes / No

A pregnant patients needs an ICD, would you perform this procedure while the patient is pregnant?

A

Yes - Class IIa indication.

133
Q

Which class of ICD indication is the following?

‘Older patients (>75yrs) with significant co-morbidities, meet primary prevention indications, survival >1yr’.

A

Class IIa indication.

134
Q

Yes / No

Would you implant an ICD for the following - which class?

‘ACHD with haemodynamically unstable VT, appropriate treatment for lesions/ventricular dysfunction, survival >1yr’.

A

Yes - Class I indication.

135
Q

True / False

The following is a class I ICD indication.

‘ACHD, SCD due to VT/VF in absence of reversible causes, survival >1yr’.

A

Class I indication.

136
Q

True / False

The following is a class I ICD indication.

‘Repaired TOF, inducible VT/VF or spontaneous sustained VT, survival >1yr’.

A

True - Class I indication.

137
Q

Which class of ICD indication is the following?

‘Repaired moderate/severe complexity ACHD, unexplained syncope and at least moderate ventricular dysfunction or marked hypertrophy, survival >1yr’.

A

Class IIa indication.

138
Q

Which class of ICD indication is the following?

‘ACHD and LVEF <35%, symptoms of heart failure despite GDMT or additional risk factors, survival >1yr’.

A

Class IIb indication.

139
Q

Would you implant a subcutaneous ICD for the following - which class?

‘Meets criteria for an ICD who have inadequate vascular access or are at high risk for infection, and in whom pacing for bradycardia or VT termination or as part of CRT is neither needed nor anticipated’.

A

Yes - Class I indication.

140
Q

Which class of subcutaneous ICD indication is the following?

‘Meets indication for an ICD, pacing for bradycardia or VT termination or as part of CRT is neither needed nor anticipated’.

A

Class IIa indication.

141
Q

Which class of wearable ICD indication is the following?

‘In patients with an ICD and a history of SCA or sustained VA in whom removal of the ICD is required (as with infection), a wearable cardioverter-defibrilator is reasonable for the prevention of SCD’.

A

Class IIa indication.

142
Q

The following is what CRT indication class?

‘LBBB, QRS >150ms, NYHA I’.

A

Class IIb indication.

143
Q

Yes / No

Would you implant a CRT device for the following - which class?

‘Non LBBB, QRS 120-129ms, NYHA I’.

A

No - Class III indication.

144
Q

Yes / No

Would you implant a CRT device for the following - which class?

‘Non LBBB, QRS 130-149ms, NYHA I’.

A

No - Class III indication.

145
Q

The following is what CRT indication class?

‘LBBB, QRS 120-129ms, NYHA II’.

A

Class IIa indication.

146
Q

True / False

The following is a class IIa CRT indication?

‘LBBB, QRS 130-149ms, NYHA II’.

A

Class IIa indication.

147
Q

Yes / No

Would you implant a CRT device for the following - which class?

‘LBBB, QRS >150ms, NYHA II’.

A

Yes - Class I indication.

148
Q

True / False

The following is a class IIa CRT indication.

‘Non LBBB, QRS 120-129ms, NYHA II’.

A

False - Class III indication.

149
Q

True / False

The following is a class III CRT indication.

‘Non LBBB, QRS 130-149ms, NYHA II’.

A

True - Class III indication.

150
Q

The following is what CRT indication class?

‘Non LBBB, QRS >150ms, NYHA II’.

A

Class IIb indication.

151
Q

The following is what CRT indication class?

‘LBBB, QRS 120-129ms, NYHA III’.

A

Class IIa indication.

152
Q

True / False

The following is a class IIa CRT indication.

‘LBBB, QRS 130-149ms, NYHA III’.

A

True - Class IIa indication.

153
Q

Yes / No

Would you implant a CRT device for the following?

‘LBBB, QRS >150ms, NYHA III’.

A

Yes - Class I indication.

154
Q

The following is what CRT indication class?

‘Non LBBB, QRS 120-129ms, NYHA III’.

A

Class IIb indication.

155
Q

The following is a class IIb CRT indication.

‘Non LBBB, QRS 130-149ms, NYHA III’.

A

True - Class IIb indication.

156
Q

True / False

The following is a class I CRT indication.

‘Non LBBB, QRS >150ms, NYHA III’.

A

False - Class IIa indication.

157
Q

The following is what CRT indication class?

‘LBBB, QRS 120-129ms, NYHA IV (ambulatory)’.

A

Class IIa indication.

158
Q

The following is what CRT indication class?

‘LBBB, QRS 130-149ms, NYHA IV (ambulatory)’.

A

Class IIa indication.

159
Q

The following is what CRT indication class?

‘Non LBBB, QRS >150ms, NYHA IV (ambulatory)’.

A

Class IIa indication.

160
Q

True / False

The following is a class I CRT indication.

‘LBBB, QRS >150ms, NYHA IV (ambulatory)’.

A

True - Class I indication.

161
Q

The following is what CRT indication class?

‘Non LBBB, QRS 120-129ms, NYHA IV (ambulatory)’.

A

Class IIb indication.

162
Q

The following is what CRT indication class?

‘Non LBBB, QRS 130-149ms, NYHA IV (ambulatory)’.

A

Class IIb indication.

163
Q

The phrase ‘‘It is recommended’ typically relates to what indication class?

A

Class I indication.

164
Q

The phrase ‘‘may do harm’’ typically relates to what indication class?

A

Class III indication.

165
Q

Reasonable to omit DFT testing in left sided transvenous ICD implants is what indication class?

A

Class IIa indication.

166
Q

Reasonable to perform DFT S-ICD testing is what class?

A

Class I indication.

167
Q

Reasonable to perform DFT testing in transvenous ICD right sided implants is what indication class?

A

Class IIa indication.

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