Electrocardiography -II

This is a timed quiz. You will be given 700 seconds to answer all questions. Are you ready?

700

Selvester QRS scoring system is a scoring system that estimates –

Correct! Wrong!

ANSWER -B
Selvester QRS scoring system is a scoring system based on quantitative criteria from the standard 12-lead electrocardiogram (ECG), which estimates the size and location of myocardial scar in the left ventricle.

All of the following are TRUE regarding Mahaim pathways EXCEPT –

Correct! Wrong!

ANSWER -D
Connections between the right atrium or the AV node and the right ventricle in or close to the right bundle branch.


Mahaim pathways are typically seen on the right side of the heart, with their ventricular connection lying within or close to the right bundle branch.

Commonest sites for accessory pathways –

Correct! Wrong!

ANSWER -C
Commonest sites for accessory pathways are connections between muscle tissue in the atria and the ventricles (atrio-ventricular pathways), bypassing the atrioventricular node.

In Type A pre-excitation Bundle of Kent connects between –

Correct! Wrong!

ANSWER -A
Bundle of Kent is an abnormal extra or accessory conduction pathway between the atria and Ventricle.


Between the left atrium and the left ventricle- termed a "type A pre-excitation" - a positive R wave is seen in V1 ("positive delta") Between the right atrium and the right ventricle -termed a "type B pre-excitation - negative delta wave is seen in lead V1 ("negative delta")

Risk stratification in WPW Syndrome is best performed by –

Correct! Wrong!

ANSWER -D
Higher risk accessory pathway may be suggested by a history of syncope, but risk stratification is best performed by programmed electrical stimulation (PES)

Low QRS voltage is defined as peak-to-trough QRS amplitudes of ------------------------in the chest leads –

Correct! Wrong!

ANSWER -B
Low QRS voltage is arbitrarily defined as peak-to-trough QRS amplitudes of ≤ 5 mm in the six limb leads and/or ≤ 10 mm in the chest leads.

Electrical alternans (P-QRS-T) with sinus tachycardia is a relatively specific sign of –

Correct! Wrong!

ANSWER -D
Total electrical alternans (P-QRS-T) with sinus tachycardia is a relatively specific sign of pericardial effusion, usually with cardiac tamponade.


Electrical alternans is an electrocardiographic phenomenon of alternation of QRS complex amplitude or axis

Generally electrical alternans can be seen with All of the following EXCEPT –

Correct! Wrong!

ANSWER -D
Generally electrical alternans can be seen with tamponade, and narrow AV junctional reentrant tachycardia with an accessory pathway (such as WPW syndrome).

Pseudo-alternans pattern can be seen in all of the following EXCEPT –

Correct! Wrong!

ANSWER -D
Pseudo-alternans- seen in bigeminal (premature ventricular contraction) PVC in the PR interval, alternans pre-excitation, and alternans bundle branch block

Most sensitive criterion for LAE is an increased duration of the terminal negative portion of the P wave in lead V1 –

Correct! Wrong!

ANSWER -B
Munuswamy and colleagues- Most sensitive criterion for LAE is an increased duration (>0.04 second) of the terminal, negative portion of the P wave in lead V1, whereas the most specific criterion for LAE is a wide, notched P wave that resembles the P wave seen in the case of an intra-atrial block.

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