100+ Free IBHRE CCDS Practice Questions

Patient and Device Follow-Up Management

The largest domain. Covers device interrogation and programming, recorded diagnostics, percent pacing, arrhythmia burdens, rate histograms and heart-failure diagnostics, troubleshooting of sensing (over/under-sensing) and capture (failure to capture, anodal, phrenic) problems, pacing-system complications such as Twiddler and subclavian crush, infection management and remote monitoring concepts and alerts.

Device Functions and Algorithms

Bradycardia pacing modes and algorithms (mode switching, auto-capture, noncompetitive atrial pacing), tachycardia functions including ATP, tachyarrhythmia detection and SVT discrimination, and heart-failure device behavior including multi-point and physiologic His/left bundle branch area pacing.

Clinical Assessment and Device Indications

Patient and device system history, physical exam for infection and venous occlusion, interpretation of invasive and noninvasive tests, guideline indications for bradyarrhythmia, tachyarrhythmia, syncope/AF, heart failure and pediatric device therapy, and drug-device interactions and antiarrhythmic effects.

Perioperative and Intraoperative Practice

Implant surgical technique and venous access, intraoperative threshold and DFT testing, leadless and subcutaneous procedures, lead extraction tools, congenital/structural variants, complication management, infection prevention, radiation safety and selection of indicated device parameters.

Device Technology and Design

Sensing of intracardiac and extracardiac signals (filters, slew rate, far-field), stimulation and defibrillation thresholds, strength-duration curve, Ohm's law applications, and timing cycles for single-chamber, dual-chamber, rate-modulated, CRT and leadless devices, including upper-rate behaviors and the NBG code.

Engineering and Electrical Concepts

Basic and derived electrical quantities, Ohm's law and energy, pulse generator energy sources and battery behavior, circuit components and sensors, lead insulation and conductor materials, connectors (IS-1, DF-1, DF4, LV-4), and defibrillation concepts for transvenous, subcutaneous and extravascular ICDs.

Electrocardiography

Interpretation of paced rhythms and pacing site, recognition of CIED malfunction versus pseudo-malfunction (upper-rate behavior, hysteresis, MVP mode, reverse mode switching), device-mediated and native dysrhythmias, and analysis of wearable monitor data.

Safety

Electromagnetic interference sources and mitigation, interactions with concomitant devices such as LVADs, MRI-conditional labeling and pre/post-scan device handling, device advisory and recall risk stratification and notification, and device removal before cremation.

Radiology

Interpretation of immediate and follow-up chest X-rays, fluoroscopy for lead placement and coronary venous anatomy, CT for lead perforation and chamber position, and echocardiography for pericardial effusion and lead position.

Fundamental Knowledge of Electrophysiology

Anatomy and physiology of the heart and conduction system, mechanisms of bradyarrhythmias and tachyarrhythmias (re-entry, AV block, sinus node dysfunction), pathophysiology of conduction abnormalities, and the link between electrical synchrony and heart-failure pathophysiology underlying CRT and conduction-system pacing.