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IBHRE questions and answers graded A+ 2025/2026
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IBHRE questions and answers graded A+ 2025/2026
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IBHRECRT: Non responders and hyperresponders - ANS- 30% of CRT pts are "nonresponders"
- In a subset of sufferers CRT therapy led to normalization of LV function. This locating is
found completely inside the subgroup of patients with nonischemic DCM and indicates that
LBBB may be the causal thing DCM in this subgroup of pts.
Where are LV leads implanted - ANSLateral or posterolateral wall
CRT non-responder in all likelihood end result of - ANS- pt choice. Does no longer have
mechanical dyssynchrony
- lead placement. Not mid lateral or may also have had lateral wall infarct
- suboptimal programming: AV or VV timing
Brugada and SIDS - ANS- Genetically determined SCN5A
- Loss of characteristic mutations in SCN5A in 20% of brugada syndome pts
-SCN5A accounts for approximately half of channelopathic SIDS instances
-RBBB, ST elevation precordial leads
- Untreated- Death
-May be treated via ICD
- EKG is definite marker in symptomatic and asymptomatic pts
Brugada syndrome - ANS- Progressed from being a unprecedented sickness to at least one
that is second most effective to vehicle injuries
- Electrocardiographically characterized with the aid of a awesome ST-segment elevation
within the proper precordial leads, the syndrome is related to a high hazard for SCD in young
and in any other case healthy adults, and much less often in toddlers and kids
-patients with spontaneously performing Brugada ECG have a excessive hazard for
surprising arrhythmic loss of life secondary to VT/VF. The ECG manifestations of Brugada
syndrome are often dynamic or hid.
Silicone Rubber - ANS- proven records
- longevity > 15 years
- very bendy
- repairable
- smooth to system
-can tear
- reasonable hard
- thicker partitions
- can abrade
- excessive coefficient of friction
- larger diameter
Polyurethane (80A) - ANS- unfavourable records
, - toughness <7 years
- flexible
- not repairable
- very process dependent
- somewhat tear resistant
- tougher
-thinner walls
-abrasion resistant
- low coefficient of friction
- smaller diameter
Polyurethane (55D) - ANS- most currently used
- proven history
- > 12 years
- much less bendy
- now not repairable
- easy to process
-very tear resistant
-very hard
- thinner walls than 80A
- abrasion resistant
-May be greater liable to RV perforation
Silicone insulation - ANS- Advantages: w/p any acknowledged long term degradation. Inert,
biocompatible, and biostable.
- disadvantages: high friction coefficient (sticky), Handling harm, and length. Soft, at risk of
damage during implant
Expanded Polytetrafluoroethylene ePTFE - ANS- ePTFE is a gortex kind material that has
been shown to enhance the benefit of extraction due to decreasing the diploma of fibrous
increase, specifically at the stunning coils.
- the cloth is electrically inert and does now not impact the DFTs.
-may be removed greater easily than non- ePTFE leads*
- is a strong biomaterial with a chemical shape including a carbon spine with flourine atoms
which form a defensive sheath, generating a chemically inert cloth with low strength surface
homes.
- made by robotically stretching and orienting PTFE to create a porous material with
excessive tensile strength and versatility.
Fluoropolymers (PTFE, ETFE) Insulation - ANS- Advantages: inert, maximum biocompatible,
excessive tensile electricity, small length
- Disadvantages: stiff whilst >0.0003", more vulnerable to creep, tough to fabricate w/o
pinholes
80A Polyurethane - ANS-1995 recalled over 400,000 leads due to insulation screw ups from
MIO
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