Electrophysiology Unit (EPU) 26.19 Practice Test

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• During an EP study, when a VT is unstable, where are pacing maneuvers typically performed first, and what mapping method is used?
• Which substrate is commonly involved in reentrant AVNRT?
• What fraction of patients develop atrial fibrillation associated with a bypass tract that has antegrade conduction?
• Which statement best describes how activation maps are used in ablation planning?
• In typical orthodromic AVRT, retrograde conduction occurs through which structure?
• During RF ablation, which heating mechanism primarily heats tissue immediately beneath the catheter?
• Which of the following are the advantages of using a biphasic pulse?
• What does VANERP look like?
• Which statement best describes the spacing of a standard quadripolar catheter?
• In VT mapping, what does the isthmus refer to?
• Which remapping criterion is most appropriate when the tachycardia cycle length changes during mapping?
• What describes a typical 'jump' in AVNRT when testing conduction?
• The ostium of the coronary sinus opens into which part of the right atrium?
• Which features on the electrocardiogram characterize atrial tachycardia?
• In atrial tachycardia ablation planning, what is the primary purpose of an activation map?
• A PVC that originates from the base of the heart and activates toward the apex will show what deflection in the inferior leads?
• Which structures comprise the Triangle of Koch?
• In typical AVNRT, the repolarization time of the fast pathway is longer than that of the slow pathway.
• What is the spacing on a quadripolar catheter?
• What is a unique feature of MRI compared with CT scans for the heart?
• What mechanism is AVNRT?
• Define long-stimulus to QRS interval and what it indicates.
• Which of the following has an effect on signal quality and noise?
• ECG characteristics of manifest SVT (WPW)?
• Which is a common site for EPS catheter placement?
• Power control mode delivers RF energy (W) to achieve a set temperature (°C). True or False?
• What is the most common SVT?
• Which structure is directly in front of the LPV when using ICE?
• One advantage of ICE imaging in EP procedures is that imaging forms where?
• Which description best defines AVNERP appearance on an EPS?
• Which thaw rate is beneficial for cryo lesion formation?
• Which structure is routinely observed in the ICE home view?
• What is the normal AH?
• Which of the following is a characteristic of AVNRT?
• During mapping, what do QS unipolar signals indicate?
• Measured activity between two electrode pairs is referred to as?
• Accessory pathways are usually located where?
• Which test is used to uncover an accessory pathway if AVRT ablation is not successful?
• What are the AV ratios for Cryo and RF ablations in AVNRT?
• Which electrogram is described as having signals from a single reference and capturing far-field and local signals?
• Which professional role is primarily responsible for anesthesia management during EP procedures?
• Which combination is required for a reentrant circuit to exist?
• Which of the following is an EGM characteristic of AVNRT?
• In EP procedures, which safety practice is recommended for allied staff?
• What is the mapping strategy of AVNRT?
• The SA Node serves as the pacemaker of the heart because
• ____ electrograms include both local and farfield signals and represent a summation of all cardiac activity
• How many milliseconds before the P wave do early signals occur in atrial tachycardia?
• Which mechanism of arrhythmia is associated with accelerated phase 4 Na+ leakage into cardiac cells?
• Where is the crista terminais located?
• After atrial flutter ablation, how is bidirectional block confirmed?
• Which valve is the most anterior?
• What filter allows frequencies higher than its programmed frequency to pass through while blocking low frequencies?
• CS stands for Coronary Sinus; CS stands for which structure?
• In inferior leads, how do P waves appear for counterclockwise vs clockwise typical flutter?
• Which of the following best describes AVNRT features?
• A PVC originating from the left ventricle and propagating to the right ventricle would produce what in lead V1?
• The process where high electric field gradients cause permanent hyperpermeabilization of the cell membrane leading to loss of homeostasis is called what?
• How does pulsed field ablation differ from RF ablation?
• AVNRT affects most commonly which population?
• In VT mapping, what region is identified as the exit site?
• What mapping strategy is used for Antidromic AVRT?
• What are LAVA signals and their use?
• Which device is described as converting analog ECG signals to digital data?
• In eccentric activation mapping, which coronary sinus electrodes show early activation, indicating conduction from the left side?
• AVNRT arises from a micro reentrant circuit present within which structure?
• What is the upper limit of QT interval for men?
• In a RAO view, where is the spine located relative to the heart?
• During AVRT, a HIS-refractory PVC will do what to the arrhythmia?
• Which visualization capability is NOT offered by both transesophageal echocardiography (TEE) and intracardiac echocardiography (ICE)?
• Phase 2 of the cardiac cell action potential corresponds to what?
• Which description best differentiates AVNERP from VANERP?
• A PVC apex-to-base yields what in the inferior leads?
• Which statement best distinguishes AVRT from AVNRT?
• Corrected SNRT (CSNRT) is derived from what calculation?
• Which sites are commonly involved in atrial tachycardia?
• How does a His-refractory PVC affect AVNRT?
• Under intracardiac echocardiography, how do the left pulmonary veins (LPV) appear?
• The ____ is responsible for converting analog ECG signals to digital data.
• Where is the AVNRT mapping target located?
• How do the right pulmonary veins appear under ICE?
• Which combination of factors has a positive effect on lesion formation during cryo ablation?
• Which structure is found at the intersection of the superior vena cava and the right atrium?
• Which statement about P waves during a premature ventricular contraction is correct?
• What is the normal PR range?
• In AVNRT and AVRT, what pacing response should be observed following right ventricular pacing?
• If an SVT terminates without atrial activation upon cessation of VP, the pacing maneuver excludes which tachycardia?
• What are innervated by both the parasympathetic and sympathetic nervous system?
• In AVRT, which pathway shows HIS earliest activation?
• Which mechanism most immediately causes cell death during ablation?
• What is the normal PA interval?
• A PVC originating from the right ventricle and propagating to the left ventricle would produce what deflection in lead V1?
• Phase 3 of the action potential is what?
• Which endpoint is used for VT ablation?
• Which term describes pacing that captures the chamber without eliciting a His bundle signal and is distinct from VANERP?
• The resting potential of nodal cells is primarily maintained by which type of channels?
• Where is the CS ostium located?
• In pacing responses, which term describes pacing that captures the chamber without eliciting a His bundle signal?
• The ability of an amplifier to increase the amplitude of the acquired signals is what?
• How are typical and atypical AVNRT named?
• Which statement best describes a typical PVC on ECG?
• During entrainment of ischemic VT with a long stim to QRS and concealed entrainment (PPI-TCL = 0), the catheter is in a region of what?
• What TCL change would prompt remapping of the activation map?
• The _____ takes care of patient sedation, anesthesia, and monitors patient status throughout the procedure.
• AVNRT entrainment results in PPI-TCL of what?
• A delta wave is the result of concealed retrograde conduction from the ventricle during normal sinus rhythm. True or False?
• Which interval measures conduction from His to the ventricles?
• TCL in electrophysiology stands for Tachycardia Cycle Length. What does this term describe?
• Which set of structures defines the Triangle of Koch?
• If there are infrequent PVCs what mapping strategy can be used to locate the origin?
• Which of the following is a potential advantage of ICE imaging when used with EP procedures?
• What method is used during pace mapping to identify the exit site of VT?
• Which statement best describes a typical PVC on ECG?
• Which autonomic system mediates the fight-or-flight response increasing heart rate and contractility?
• Repolarization of the cardiac action potential results in what?
• In Atrial Tachy pacing following RV pacing, which sequence is observed?
• Which statement correctly pairs PPI-TCL with tachycardia type during entrainment?
• What does concealed entrainment imply during ischemic VT pacing?
• Define Orthodromic and Antidromic AVRT.
• AVRT entrainment results in PPI-TCL of what?
• What mechanism is AVRT?
• Which feature distinguishes MRI from CT in cardiac imaging?
• What does CTI stand for?
• Which statement about cryo ablation lesion factors is true?
• What is the significance of a PPI equal to TCL during entrainment mapping?
• Which of the following describes Typical Flutter's ECG/EGM characteristics?
• What is normal QT?
• What is the normal HV range?
• What structure can hinder access to the coronary sinus ostium?
• Which cardiac structures receive dual autonomic innervation enabling modulation by autonomic tone?
• Which phase of the cardiac action potential corresponds to the plateau period?
• Which factors influence RF lesion size? (three)
• Where are EP catheters placed for EPS?
• Lack of tissue capture may be a result of what factors?
• The principal delay in cardiac depolarization impulse as it passes from the SA node to ventricular myocardial cells occurs where?
• During cryo ablation for AVNRT, what is typically observed?
• Where is the spine in a RAO view?
• Which mechanism of arrhythmia is associated with early afterdepolarizations (EAD) and delayed afterdepolarizations (DAD)?
• At approximately what temperature does irreversible cellular death occur during RF ablation?
• What mapping strategy is used for Orthodromic AVRT?
• Atypical Flutter is typically characterized by which activation pattern?
• Which component is targeted during AVNRT ablation?
• Which of the following is a positive effect of irrigating the ablation electrode during energy delivery?
• During ablation, tissue directly under the catheter experiences which heating, and the surrounding myocardium experiences which heating?
• What is normal QRS?
• What does PPI-TCL indicate in entrainment studies?
• What defines unipolar for a catheter?
• In AVRT, which activation pattern characterizes septal pathways?
• What percentage of SVT are AVNRT?
• In AVRT, which activation pattern characterizes right lateral pathways?
• Which energy modality is characterized by tissue selectivity and sparing of neighboring structures?
• Which statement correctly distinguishes Cryo from RF ablation for AVNRT?
• Which interval is measured from the onset of atrial depolarization to the His bundle?
• In AVRT, which activation pattern characterizes left lateral pathways?
• Which structure provides the main delay for atrioventricular conduction?
• What is the primary endpoint of AVNRT ablation?
• The term used for permanent pore formation in cell membranes caused by strong electric fields is what?
• How does AV block typically affect atrial tachycardia?
• When pacing near the reentrant circuit for entrainment mapping, a PPI equal to TCL is an observation of what?
• In AVNRT, where is the P wave typically observed relative to the QRS?
• In atrial flutter ablation, which strategy is used to interrupt the circuit?
• NSR in the context of AVNRT ablation stands for which heart rhythm?
• Which structure is commonly seen in the ICE home view?
• Which node has the highest intrinsic rate and acts as the heart's natural pacemaker?
• What is the mechanism of ischemic ventricular tachycardia?
• The presence of dual nodal physiology automatically means that the patient will have AVNRT. True or False
• Which tachycardia is often mistaken for atrial fibrillation?
• Which statement about antidromic AVRT is true?
• Which safety steps are expected of industry-employed Allied professionals during an electrophysiology procedure?
• What maps should you create for Aflutter?
• For atrial tachycardia mapping, which map is created and when should remapping occur?
• Regarding PVC QRS morphology, which statement is true?
• During RF ablation for AVNRT, what is typically observed?
• What mechanism is Atrial Flutter?
• Which AVRT pathway is most commonly observed?
• In a left anterior oblique (LAO) view, where is the spine located relative to the heart?
• The system that directly receives, records, and displays all ECG signals from ECG electrodes and EP catheters is the ____.
• What is the narrow band of muscle between the IVC and the tricuspid valve called?
• What is the goal of a diagnostic EPS?
• Which of the following is listed as an AVNRT ablation endpoint?