HRCR May 2021 Quiz

Editorial note: The following quiz is related to the article Electrical storm in a patient with Takayasu’s arteritis and inferior myocardial scar, by Zimmermann and colleagues from the May 2021 issue of Heart Rhythm Case Reports.

Question 1: According to the most recent guidelines, which of the following statements on management of ventricular arrhythmia (VA) in ischemic heart diseases (IHD) is true?

a. For patients with IHD and ventricular tachycardia (VT) storm refractory to antiarrhythmic drug therapy, a catheter ablation is recommended.
b. Escalation with Mexiletine in patients with reoccurring VT in IHD and baseline Amiodarone therapy is superior to catheter ablation.
c. An ICD implantation after catheter ablation is indicated in every patient with VA in IHD.
d. Bilateral cardiac sympathetic denervation is superior to catheter ablation in patients with reoccurring VA in IHD.

Question 2: Which of the following statements is true regarding signs and symptoms in Takayasu’s arteritis (TA)?

a. Takayasu’s arteritis mainly affects men above 40.
b. Myocardial perfusion defects are the most common cause for myocardial ischemia in patients with TA.
c. TA is a necrotizing arteritis of medium or small arteries without glomerulonephritis or vasculitis in arterioles, capillaries, or venules, and is not associated with antineutrophil cytoplasmic antibodies (ANCAs).
d. Patients with TA are not associated with an increased risk of both venous and arterial thrombosis.

Question 3: Which of the following statements is false regarding implantable cardioverter–defibrillator (ICD) therapy?

a. Subcutaneous ICDs are superior to transvenous ICDs with respect to device-related complications or inappropriate shocks in patients with an indication for defibrillator therapy, but with no indication for pacing.
b. Patients with transvenous ICDs have a higher cumulative incidence of device-related complications than patients with a subcutaneous ICD.
c. Patients with subcutaneous ICDs have a higher cumulative incidence of inappropriate shocks than patients with a transvenous ICD.
d. Transvenous ICDs can incorporate pacing for bradycardia or cardiac resynchronization.

Question 4: Which of the following diagnostic modalities are essential to diagnose a new onset of TA with cardiac manifestation?

a. PET-CT
b. Cardiac scintigraphy
c. CT-angiography
d. MRI-angiography
e. Laboratory findings (especially CRP, ESR)
f. All of the above