Question 1
In acute VT management and long-term suppression, which statement is accurate?
Correct Answer:
Lidocaine is useful for acute ischemic VT, amiodarone for both acute VT/VF and long-term suppression
Explanation:
The key idea here is how lidocaine and amiodarone are used differently in ventricular tachycardia based on the situation and duration of therapy. Lidocaine, a sodium-channel blocker with preference for ischemic tissue, acts quickly to suppress arrhythmias that arise during acute ischemia. That makes it useful for acute ischemic VT where rapid control is needed. However, it isn’t typically used for long-term suppression because its efficacy wanes in nonischemic contexts and it carries risks of toxicity with prolonged use. Amiodarone has a broad antiarrhythmic profile, affecting multiple channels and receptors, which makes it effective both in the acute setting (for VT or VF) and as a durable, long-term option to prevent recurrence. Its downside is potential organ toxicity with chronic use, so it requires ongoing monitoring. Thus, the statement that lidocaine is useful for acute ischemic VT and amiodarone is useful for both acute VT/VF and long-term suppression best reflects how these drugs are applied in practice.
Question 2
What is required when initiating dofetilide therapy?
Correct Answer:
Inpatient monitoring of QTc and renal-adjusted dosing
Explanation:
Dofetilide carries a real risk of QT interval prolongation and torsades de pointes because it is a pure IKr blocker with a narrow therapeutic window. To safely start this drug, initiation must occur in a hospital setting where continuous ECG monitoring is available and dosing can be adjusted based on renal function. Before starting, baseline QTc and renal function (creatinine clearance) are assessed, and the dose is tailored to the patient’s kidney function. During initiation, QTc is rechecked after each dose change, and if QTc prolongs beyond a safe threshold or increases significantly, doses are adjusted or held. Correcting electrolytes such as potassium and magnesium is also important to reduce proarrhythmic risk. This careful inpatient approach is essential to prevent dangerous QT prolongation during initiation, which is why inpatient monitoring of QTc and renal-adjusted dosing is required.
Question 3
Wearable cardioverter-defibrillators are used for which scenario?
Correct Answer:
Temporary external defibrillator to reduce sudden death risk when ICD is not yet implanted
Explanation:
Wearable cardioverter-defibrillators provide a temporary external safeguard against sudden death by delivering a shock if a dangerous ventricular arrhythmia is detected. They’re used during a window when a patient is at high risk for malignant arrhythmias but does not yet have an implanted ICD (or while awaiting ICD evaluation/placement due to temporary contraindications). This bridging period allows time to determine whether the risk will persist and to plan permanent therapy. They’re not a long-term replacement for an implanted ICD, they don’t treat heart failure symptoms, and they aren’t used to monitor blood pressure. The device continuously monitors rhythm and can deliver a life-saving shock to restore a normal rate if needed.
Question 4
Describe the initial management of hemodynamically unstable ventricular tachycardia.
Correct Answer:
Immediate synchronized cardioversion
Explanation:
When ventricular tachycardia causes hemodynamic instability, the priority is to rapidly restore perfusion with electrical therapy. If the patient has a pulse, deliver a synchronized cardioversion immediately. Synchronization times the shock with the QRS complex, delivering energy when the ventricles are ready to respond and avoiding on-the-T-wave shocks that could worsen the rhythm. This approach quickly terminates the tachycardia and improves circulation. Vagal maneuvers won’t reliably convert VT and aren’t appropriate as the first step in unstable VT. Antiarrhythmic drugs are important, but they’re adjuncts after stabilization rather than the initial move. If there were no pulse, the protocol would shift to immediate unsynchronized defibrillation, but in this unstable VT with a pulse, synchronized cardioversion is the best initial action.
Question 5
Which statement best describes Ivabradine use in heart failure management?
Correct Answer:
Used when EF <= 35% and resting HR >= 70 bpm in sinus rhythm, after optimizing beta-blockers
Explanation:
Ivabradine works by selectively inhibiting the funny current (If) in the sinoatrial node, which slows the heart rate without changing blood pressure or contractility. In chronic heart failure with reduced ejection fraction, reducing a persistently high resting heart rate has been shown to improve symptoms and reduce hospitalizations, provided the patient is in sinus rhythm and already on optimized guideline-directed medical therapy with beta-blockers. That’s why the best description is using ivabradine when the ejection fraction is ≤35% and the resting heart rate is still at least 70 bpm in sinus rhythm, after beta-blockers have been optimized. It’s not used for acute decompensation, it’s not a diuretic, and it does not raise the resting heart rate—it lowers it.
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Prepare with the Cardiac Electrophysiology and Heart Failure Practice Test practice quiz. This question bank includes 10 questions covering management, ventricular, tachycardia, describes, and heart. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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Cardiac Electrophysiology and Heart Failure Practice Test

This practice set contains 10 questions from the matching question bank and focuses on management, ventricular, tachycardia, describes, and heart. Work through each question carefully, review the provided solutions, and revisit topics that need more study before your next attempt.

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