Indications

Question 1

List the 3 class I indications for SND.

Answer 1

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

Question 2

List the 5 class I indications for AV Block.

Answer 2

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

Question 3

What is the one Class IIb indication for SND?

Answer 3

Minimally symptomatic with HR <40bpm during awake hours.

Question 4

List the 2 class IIb indications for AV Block.

Answer 4

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

Question 5

List the 3 class I indications for bifasicular block.

Answer 5

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

Question 6

Which pacing indication class is the following?

‘Asymptomatic CHB with HR >40bpm’.

Answer 6

Class IIa.

Question 7

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

Answer 7

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.

Question 8

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

Answer 8

Class IIa.

Question 9

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

Answer 9

Class IIb.

Question 10

List the only class I indication for reflex syncope.

Answer 10

Recurrent 3 second pauses with syncope from CS stimulation.

Question 11

Yes / No

Does asymptomatic Mobitz II indicate pacing?

Answer 11

Yes.

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

Question 12

Yes / No

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

Answer 12

Yes - Class I indication.

Question 13

True / False

Which class applies?

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

Answer 13

True - Class I indication.

Question 14

Which class applies with respect to permanent PPM insertion?

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

Answer 14

Class I indication.

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

Question 15

Yes / No

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

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

Answer 15

Yes - Class IIa indication.

Question 16

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’.

Answer 16

Yes - Class IIa indication.

SR permanent pacing is reasonable for this patient.

Question 17

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’.

Answer 17

Class I indication.

Question 18

Which class applies with respect to permanent PPM insertion?

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

Answer 18

Class IIa indication.

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

Question 19

Which class applies with respect to device insertion?

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

Answer 19

Class IIa indication.

Permanent PPM or ICD (if required).

Question 20

Which class applies with respect to permanent PPM insertion?

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

Answer 20

Class IIb indication.

Permanent pacing without further observation for reversibility may be considered.

Question 21

Which class applies with respect to temporary transvenous pacing?

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

Answer 21

Class IIa indication.

Question 22

Which class applies?

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

For patients who require prolonged temporary pacing.

Answer 22

Class IIa indication.

Question 23

Which class applies with respect to temporary transcutaneous pacing?

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

Answer 23

Class IIb indication.

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

Question 24

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’.

Answer 24

No - Class III indication.

Question 25

# 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'.

Answer 25

No - Class III indication.

Question 26

# 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'.

Answer 26

Yes - Class I indication.

Question 27

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'.

Answer 27

No - Class III indication.

Question 28

# Yes / No Should a permanent pacing system be implanted in this patient (list class)? 'Patient has vagally mediated AVB without symptoms'.

Answer 28

No - Class III indication.

Question 29

Which class applies with respect to PPM insertion? 'Acquired Mobitz II, high grade AVB or 3rd degree AVB without reversible cause'.

Answer 29

Class I indication. ## Footnote *Irrespective of symptoms a device should be implanted.*

Question 30

Which class applies? 'Neruomuscular disease and associated conduction disease with evidence of 2nd or 3rd degree AVB, Survival \>1yr'.

Answer 30

Class I indication. ## Footnote *Irrespective of symptoms a device should be implanted.*

Question 31

# True / False The following is a Class I indication for permanent pacing. 'Patient has AF with symptomatic bradycardia'.

Answer 31

True.

Question 32

# 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'.

Answer 32

False - Class I. ## Footnote *Pacing is recommended to increase HR and improve symptoms.*

Question 33

Which class applies with respect to permanent pacing? 'Infiltrative cardiomyopathy and Mobitz II or CBH with a survival \>1yr'.

Answer 33

Class IIa indication.

Question 34

# 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'.

Answer 34

False - Class IIa indication.

Question 35

# 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'.

Answer 35

False - Class IIa indication.

Question 36

Which class applies with respect to permanent pacing? 'Neuromuscular disease, PR \>240ms, QRS \>120ms or fascicular block, survivability \>1yr'.

Answer 36

Class IIb indication.

Question 37

Is DR pacing recommended over SR pacing - if so, which class? 'Patient has SND and AVB'.

Answer 37

DR pacing is recommended over SR - Class I indication.

Question 38

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'.

Answer 38

Class I indication.

Question 39

Is revising to a DR system is recommended, if so - which class? 'Patient in sinus rhythm with a SR system whom develops pacemaker syndrome'.

Answer 39

Class I indication.

Question 40

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%'.

Answer 40

Yes - Class IIa indication.

Question 41

# 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'.

Answer 41

False - Class IIb indication.

Question 42

# 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'.

Answer 42

No - Class III indication.

Question 43

# 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'.

Answer 43

Yes - Class I indication.

Question 44

# 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'.

Answer 44

Yes - Class I indication.

Question 45

# 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'.

Answer 45

Yes - Class IIa indication.

Question 46

# 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'.

Answer 46

Yes - Class IIb indication. ## Footnote *Class IIb is debatable due to weaker evidence.*

Question 47

# 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'.

Answer 47

Yes - Class IIb indication. ## Footnote *Class IIb is debatable due to weaker evidence.*

Question 48

# 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'.

Answer 48

No - Class III indication.

Question 49

Which class applies with respect to placement of transcutaneous pacing pads? 'High risk of development of intraoperative or periprocedural bradycardia'.

Answer 49

Class IIa indication.

Question 50

# Yes / No Should prophylactic temporary transvenous pacing be performed - which class? 'Patients who have LBBB and require PA catheterisation for intraoperative monitoring'.

Answer 50

No - Class III indication.

Question 51

# 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'.

Answer 51

Yes - Class I indication.

Question 52

# Yes / No Should there be routine placement of temporary epicardial pacing wires - which class? 'Patients undergoing coronary artery bypass surgery'.

Answer 52

Yes - Class IIa indication.

Question 53

# 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'.

Answer 53

Yes - Class IIb indication. ## Footnote *Class IIb is debateable due to weaker evidence.*

Question 54

# Yes / No Should you place temporary epicardial pacing wires - which class? 'Patients undergoing surgery for AF'.

Answer 54

Yes - Class I indication.

Question 55

# 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'.

Answer 55

Yes - Class I indication.

Question 56

Should you intraoperatively place a permanent epicardial LV lead - which class? 'Patients undergoing AF surgery that likely need future CRT or Vp'.

Answer 56

Class IIb indication. ## Footnote *Class IIb is debateable due to weaker evidence.*

Question 57

# Yes / No Should you place temporary epicardial pacing wires - which class? 'Patients undergoing surgical aortic valve replacement/repair'.

Answer 57

Class I indication.

Question 58

# 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'.

Answer 58

False - Class I indication.

Question 59

# 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'.

Answer 59

Yes - Class IIb indication. ## Footnote *Class IIb is debateable due to weaker evidence.*

Question 60

# 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'.

Answer 60

True - Class I indication.

Question 61

# 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'.

Answer 61

Yes - Class IIa indication.

Question 62

# Yes / No Should you intraoperatively place a permanent epicardial LV lead? 'Patients undergoing aortic valve surgery who will likely need future CRT or Vp'.

Answer 62

Yes - Class IIb indication. ## Footnote *Class IIb is debateable due to weaker evidence.*

Question 63

# Yes / No Should you place temporary epicardial wires - which class? 'Patients undergoing tricuspid valve surgery'.

Answer 63

Yes - Class I indication.

Question 64

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'.

Answer 64

Class I indication.

Question 65

# 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'.

Answer 65

Yes - Class IIa indication.

Question 66

# 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'.

Answer 66

Yes - Class I indication.

Question 67

# Yes / No Should a permanent pacing system be implanted in this patient? 'Has new persistent LBBB following transcatheter aortic valve replacement'.

Answer 67

Yes - Class IIb indication. ## Footnote *Class IIb is debateable due to weaker evidence.*

Question 68

# 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'.

Answer 68

Yes - Class I indication.

Question 69

# 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'.

Answer 69

True - Class IIa indication.

Question 70

# True / False Ventricular based permanent pacing is a class I indication for this diagnosis. 'Adults with ACHD and symptomatic SND or chronotropic incompetence'.

Answer 70

False. ## Footnote *This is a class I indication for atrial based permanent pacing*

Question 71

# True / False The following is a class IIa indication for permanent pacing. 'Adults with ACHD and symptomatic bradycardia respondent to AVB'.

Answer 71

False - Class I indication.

Question 72

# 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'.

Answer 72

True - Class I indication.

Question 73

# 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'.

Answer 73

False - Class I indication.

Question 74

# Yes / No Should a permanent pacing system be implanted in this patient? 'Asymptomatic adults with congenital CHB'.

Answer 74

Yes - Class IIa indication.

Question 75

Is a device with atrial anti-tachycardia capabilities indicated - which class? 'Adults with repaired ACHD who require pacing for bradycardia'.

Answer 75

Yes - Class IIa indication.

Question 76

# Yes / No Should you intraoperatively place epicardial pacing leads - which class? 'ACHD, pre-existing SND and/or AV conduction disease undergoing cardiac surgery'.

Answer 76

Yes - Class IIa indication.

Question 77

# Yes / No Is atrial based pacing for the prevention of atrial arrhythmias indicated - which class? 'Adults with ACHD and pacemakers'.

Answer 77

Yes - Class IIb indication. ## Footnote *Class IIb is debateable due to weaker evidence.*

Question 78

Should endocardial leads be implanted - which class? 'Adults with ACHD and venous to systemic intracardiac shunts'.

Answer 78

No - Class III indication.

Question 79

# 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'.

Answer 79

True - Class I indication.

Question 80

# 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?

Answer 80

Yes - Class I indication.

Question 81

# 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'.

Answer 81

True - Class I indication.

Question 82

# True / False The following is a class IIa indication for permanent pacing. 'Acute MI and transient AVB that resolves after a waiting period'.

Answer 82

False - Class III indication.

Question 83

# 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'.

Answer 83

False - Class III indication.

Question 84

# 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'.

Answer 84

True - Class IIa indication.

Question 85

# 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'.

Answer 85

True - Class I indication.

Question 86

# 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'.

Answer 86

False - Class I indication.

Question 87

# 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'.

Answer 87

False - Class I indication.

Question 88

# 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'.

Answer 88

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

Question 89

# 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'.

Answer 89

True - Class IIa indication.

Question 90

# 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'.

Answer 90

True - Class I indication.

Question 91

# 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'.

Answer 91

False - Class I - rate hysteresis is recommended here.

Question 92

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'.

Answer 92

Class I indication.

Question 93

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'.

Answer 93

Class I indication.

Question 94

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'.

Answer 94

Class I indication.

Question 95

Which primary prevention class is the following? 'Nonhospitalized, NYHA class IV, Candidates for cardiac transplantation or an LVAD, expected survival \>1 year'.

Answer 95

Class IIa indication.

Question 96

Which primary prevention class is the following? 'NYHA class IV, Medication-refractory HF, not candidates for cardiac transplantation, LVAD or CRT defibrillator'.

Answer 96

Class III indication.

Question 97

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'.

Answer 97

Class I indication.

Question 98

Which secondary prevention class is the following? 'NICM, syncope presumed to be due to VA, doesn't meet primary prevention indications'.

Answer 98

Class IIa indication.

Question 99

Which primary prevention class is the following? 'NICM, NYHA II or III, LVEF \<35% despite GDMT, Survival expected \>1yr'.

Answer 99

Class I indication.

Question 100

# 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'.

Answer 100

True - Class IIa indication.

Question 101

# True / False The following is a class IIa primary prevention indication. 'NICM, NYHA I, LVEF \<35%, Survival expected \>1yr'

Answer 101

False - Class IIb indication.

Question 102

Which class of ICD indication is the following? 'ARVC + either: SCA, VT, RVEF or LVEF \<35%'

Answer 102

Class I indication.

Question 103

# True / False The following is a class I ICD indication. 'ARVC with syncope presumed to be due to VA'.

Answer 103

False - Class IIa indication.

Question 104

# 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'.

Answer 104

Class I indication.

Question 105

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'.

Answer 105

Class IIa indication.

Question 106

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'.

Answer 106

Class IIa indication.

Question 107

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'.

Answer 107

Class IIb indication.

Question 108

# True / False The following is a class I ICD indication. 'Identified HCM genotype in the absence of SCD risk factors'.

Answer 108

False - Class III indication.

Question 109

# 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'.

Answer 109

Yes - Class I indication.

Question 110

# Yes / No Would you implant an ICD in the following - which class? 'IHD, Unexplained syncope, inducible sustained monomorphic VT'

Answer 110

Yes - Class I indication.

Question 111

# 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'

Answer 111

False - Class IIa indication.

Question 112

# 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'

Answer 112

False - Class IIb indication.

Question 113

# True / False The following is a class III indication for ICD implantation. 'Giant cell myocarditis, VF or haemodynamically unstable VT, Optimal GDMT, survival \>1yr'.

Answer 113

False - Class IIb indication.

Question 114

# Yes / No Would you implant an ICD for the following - which class? 'Cardiac sarcoidosis, Sustained VT or survivors of SCD, LVEF \<35%, Survival \>1yr'.

Answer 114

Yes - Class I indication.

Question 115

# 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'.

Answer 115

Yes - Class IIa indication.

Question 116

Which class of ICD indication is the following? 'Cardiac sarcoidosis, Positive EP study for inducible VA, Survival \>1yr'.

Answer 116

Class IIa indication.

Question 117

Which class of ICD indication is the following? 'Cardiac sarcoidosis and have a permanent pacing indication'.

Answer 117

Class IIa indication.

Question 118

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'.

Answer 118

Class IIa indication.

Question 119

Which class of ICD indication is the following? 'With LVAD and sustained VA'.

Answer 119

Class IIa indication.

Question 120

Which class of ICD indication is the following? 'Post heart transplant with severe allograft vasculopathy with LV dysfunction, survival \>1yr'.

Answer 120

Class IIb indication.

Question 121

# 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.

Answer 121

True - Class I indication.

Question 122

# 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'.

Answer 122

Yes - Class IIa indication.

Question 123

Which class of ICD indication is the following? 'Myotonic dystrophy type 1 with an indication for a permanent pacemaker'.

Answer 123

Class IIb indication.

Question 124

# Yes / No Would you implant an ICD for the following - which class? 'Cardiac channelopathy and SCD survivor'.

Answer 124

Yes - Class I indication.

Question 125

# True / False The following is a class IIa ICD indication. 'High risk patients with symptomatic long QT syndrome, Beta blockers ineffective'

Answer 125

False - Class I indication.

Question 126

# True / False The following is a class IIa ICD indication. 'Asymptomatic patients with resting QTc \>500ms and receiving beta blocker'

Answer 126

True - Class IIa indication.

Question 127

# 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'.

Answer 127

Yes - Class I indication.

Question 128

# 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'.

Answer 128

True - Class I indication.

Question 129

Which class of ICD indication is the following? 'Early repolarisation pattern on ECG and cardiac arrest or sustained VA, survival \>1yr'.

Answer 129

Class I indication.

Question 130

Which class of ICD indication is the following? 'Short QT syndrome, cardiac arrest or sustained VA, survival \>1yr'.

Answer 130

Class I indication.

Question 131

Which class of ICD indication is the following? 'Resuscitated from SCD due to idiopathic VT or VF, survival \>1yr'.

Answer 131

Class I indication.

Question 132

# Yes / No A pregnant patients needs an ICD, would you perform this procedure while the patient is pregnant?

Answer 132

Yes - Class IIa indication.

Question 133

Which class of ICD indication is the following? 'Older patients (\>75yrs) with significant co-morbidities, meet primary prevention indications, survival \>1yr'.

Answer 133

Class IIa indication.

Question 134

# 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'.

Answer 134

Yes - Class I indication.

Question 135

# True / False The following is a class I ICD indication. 'ACHD, SCD due to VT/VF in absence of reversible causes, survival \>1yr'.

Answer 135

Class I indication.

Question 136

# True / False The following is a class I ICD indication. 'Repaired TOF, inducible VT/VF or spontaneous sustained VT, survival \>1yr'.

Answer 136

True - Class I indication.

Question 137

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'.

Answer 137

Class IIa indication.

Question 138

Which class of ICD indication is the following? 'ACHD and LVEF \<35%, symptoms of heart failure despite GDMT or additional risk factors, survival \>1yr'.

Answer 138

Class IIb indication.

Question 139

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'.

Answer 139

Yes - Class I indication.

Question 140

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'.

Answer 140

Class IIa indication.

Question 141

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'.

Answer 141

Class IIa indication.

Question 142

The following is what CRT indication class? 'LBBB, QRS \>150ms, NYHA I'.

Answer 142

Class IIb indication.

Question 143

# Yes / No Would you implant a CRT device for the following - which class? 'Non LBBB, QRS 120-129ms, NYHA I'.

Answer 143

No - Class III indication.

Question 144

# Yes / No Would you implant a CRT device for the following - which class? 'Non LBBB, QRS 130-149ms, NYHA I'.

Answer 144

No - Class III indication.

Question 145

The following is what CRT indication class? 'LBBB, QRS 120-129ms, NYHA II'.

Answer 145

Class IIa indication.

Question 146

# True / False The following is a class IIa CRT indication? 'LBBB, QRS 130-149ms, NYHA II'.

Answer 146

Class IIa indication.

Question 147

# Yes / No Would you implant a CRT device for the following - which class? 'LBBB, QRS \>150ms, NYHA II'.

Answer 147

Yes - Class I indication.

Question 148

# True / False The following is a class IIa CRT indication. 'Non LBBB, QRS 120-129ms, NYHA II'.

Answer 148

False - Class III indication.

Question 149

# True / False The following is a class III CRT indication. 'Non LBBB, QRS 130-149ms, NYHA II'.

Answer 149

True - Class III indication.

Question 150

The following is what CRT indication class? 'Non LBBB, QRS \>150ms, NYHA II'.

Answer 150

Class IIb indication.

Question 151

The following is what CRT indication class? 'LBBB, QRS 120-129ms, NYHA III'.

Answer 151

Class IIa indication.

Question 152

# True / False The following is a class IIa CRT indication. 'LBBB, QRS 130-149ms, NYHA III'.

Answer 152

True - Class IIa indication.

Question 153

# Yes / No Would you implant a CRT device for the following? 'LBBB, QRS \>150ms, NYHA III'.

Answer 153

Yes - Class I indication.

Question 154

The following is what CRT indication class? 'Non LBBB, QRS 120-129ms, NYHA III'.

Answer 154

Class IIb indication.

Question 155

The following is a class IIb CRT indication. 'Non LBBB, QRS 130-149ms, NYHA III'.

Answer 155

True - Class IIb indication.

Question 156

# True / False The following is a class I CRT indication. 'Non LBBB, QRS \>150ms, NYHA III'.

Answer 156

False - Class IIa indication.

Question 157

The following is what CRT indication class? 'LBBB, QRS 120-129ms, NYHA IV (ambulatory)'.

Answer 157

Class IIa indication.

Question 158

The following is what CRT indication class? 'LBBB, QRS 130-149ms, NYHA IV (ambulatory)'.

Answer 158

Class IIa indication.

Question 159

The following is what CRT indication class? 'Non LBBB, QRS \>150ms, NYHA IV (ambulatory)'.

Answer 159

Class IIa indication.

Question 160

# True / False The following is a class I CRT indication. 'LBBB, QRS \>150ms, NYHA IV (ambulatory)'.

Answer 160

True - Class I indication.

Question 161

The following is what CRT indication class? 'Non LBBB, QRS 120-129ms, NYHA IV (ambulatory)'.

Answer 161

Class IIb indication.

Question 162

The following is what CRT indication class? 'Non LBBB, QRS 130-149ms, NYHA IV (ambulatory)'.

Answer 162

Class IIb indication.

Question 163

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

Answer 163

Class I indication.

Question 164

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

Answer 164

Class III indication.

Question 165

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

Answer 165

Class IIa indication.

Question 166

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

Answer 166

Class I indication.

Question 167

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

Answer 167

Class IIa indication.