IBHRE CERTIFIED ELECTROPHYSIOLOGY SPECIALIST - PEDIATRIC
(CEPS-P) EXAM PRACTICE QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES Q&A INSTANT DOWNLOAD PDF
139 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Demonstrate mastery of core concepts
2 IBHRE Certified Electrophysiology Specialist
3 Pediatric
4 CEPS
5 Exam Practice Questions And Correct Answers
6 Verified Answers
7 Plus Rationales Q&A Instant Download Pdf
8 Foundations of IBHRE Certified Electrophysiology Specialist - Pediatric (CEPS-P) Exam Practice
Questions And Correct Answers (Verified Answers) Plus Rationales Q&A Instant Download Pdf
9 Applied IBHRE Certified Electrophysiology Specialist - Pediatric (CEPS-P) Exam Practice Questions And
Correct Answers (Verified Answers) Plus Rationales Q&A Instant Download Pdf
10 Advanced IBHRE Certified Electrophysiology Specialist - Pediatric (CEPS-P) Exam Practice Questions
And Correct Answers (Verified Answers) Plus Rationales Q&A Instant Download Pdf
11 IBHRE Certified Electrophysiology Specialist - Pediatric (CEPS-P) Exam Practice Questions And Correct
Answers (Verified Answers) Plus Rationales Q&A Instant Download Pdf Review
Page 1
,Q1 DEMONSTRATE MASTERY OF CORE CONCEPTS
In a pediatric patient with a systemic-to-pulmonary artery shunt and refractory
atrial flutter, which mapping strategy best identifies the critical isthmus when
entrainment is limited by rapid cycle length?
A. Activation mapping during atrial flutter with a high-density grid catheter
B. Substrate mapping during sinus rhythm identifying low-voltage areas and fractionated
electrograms CORRECT
C. Pace mapping at multiple sites to reproduce the flutter QRS morphology
D. Non-contact mapping to reconstruct endocardial activation in a single beat
RATIONALE: In rapid atrial flutter where entrainment is unreliable, substrate mapping in sinus
rhythm can identify the critical isthmus by locating low-voltage, fractionated electrograms, often
adjacent to scar. Activation mapping (A) is difficult with rapid rates, pace mapping (C) is for
ventricular arrhythmias, and non-contact mapping (D) is less validated in pediatric shunts.
Q2 DEMONSTRATE MASTERY OF CORE CONCEPTS
When programming a ventricular tachycardia (VT) zone in a pediatric ICD, which
combination of detection and therapy settings best reduces inappropriate shocks
while maintaining sensitivity for slow VT?
A. High rate cutoff, long duration, and antitachycardia pacing (ATP) before shock CORRECT
B. Low rate cutoff, short duration, and immediate high-energy shock
C. High rate cutoff, short duration, and no ATP
D. Low rate cutoff, long duration, and shock only
RATIONALE: A higher rate cutoff and longer duration reduce inappropriate detection of sinus
tachycardia, while ATP is effective for slow VT and avoids shocks. Low rate cutoffs (B, D)
increase inappropriate shocks, and short durations (B, C) reduce specificity.
Page 2
,Q3 DEMONSTRATE MASTERY OF CORE CONCEPTS
A pediatric patient with congenital complete heart block and a structurally normal
heart has a ventricular paced QRS duration of 160 ms. Which pacing strategy most
effectively minimizes ventricular dyssynchrony?
A. Dual-chamber pacing with a short atrioventricular delay
B. Single-site right ventricular apical pacing
C. Left ventricular epicardial pacing via thoracotomy
D. His bundle pacing with backup ventricular lead CORRECT
RATIONALE: His bundle pacing preserves normal ventricular activation and avoids
pacing-induced dyssynchrony, making it the preferred strategy in children with complete heart
block and normal anatomy. Right ventricular apical pacing (B) is associated with dyssynchrony,
short AV delay (A) may not address site, and epicardial LV pacing (C) is more invasive and less
physiological.
Q4 DEMONSTRATE MASTERY OF CORE CONCEPTS
During an epicardial ablation for ventricular arrhythmia in a pediatric patient with
prior cardiac surgery, which finding is most suggestive of an epicardial origin
rather than an endocardial origin?
A. Pace mapping at the endocardium yields a 12/12 match
B. The earliest endocardial activation precedes the QRS by 30 ms
C. Unipolar electrograms from the epicardium show a QS pattern with a rapid intrinsicoid
deflection CORRECT
D. The arrhythmia terminates with mechanical catheter pressure at the endocardium
RATIONALE: An epicardial origin typically shows a QS pattern on unipolar epicardial recordings
with a sharp intrinsicoid deflection, while endocardial sites show earlier activation (B) and pace
maps (A) may be less specific. Mechanical termination (D) can occur at either site.
Page 3
, Q5 DEMONSTRATE MASTERY OF CORE CONCEPTS
Which parameter derived from a 12-lead ECG most reliably distinguishes typical
atrioventricular nodal reentrant tachycardia (AVNRT) from orthodromic
atrioventricular reentrant tachycardia (AVRT) in a pediatric patient with a manifest
accessory pathway?
A. RP interval during tachycardia CORRECT
B. Presence of retrograde P waves
C. Delta wave in sinus rhythm
D. QRS alternans during tachycardia
RATIONALE: A short RP interval (RP < 70 ms) strongly favors AVNRT, while a longer RP interval
suggests AVRT. Retrograde P waves (B) are present in both, delta waves in sinus rhythm (C)
indicate preexcitation but not the mechanism, and QRS alternans (D) is not specific.
Q6 DEMONSTRATE MASTERY OF CORE CONCEPTS
A pediatric patient with catecholaminergic polymorphic ventricular tachycardia
(CPVT) is refractory to nadolol and flecainide. Which next therapeutic strategy is
most appropriate?
A. Left cardiac sympathetic denervation (LCSD) CORRECT
B. Catheter ablation of the arrhythmia substrate
C. Implantation of a permanent pacemaker
D. Addition of amiodarone
RATIONALE: LCSD is an established adjunctive therapy for CPVT when beta-blockers and
flecainide fail, reducing arrhythmic events. Ablation (B) is ineffective for the diffuse adrenergic
trigger, pacing (C) does not treat CPVT, and amiodarone (D) is not recommended and may be
proarrhythmic.
Page 4
(CEPS-P) EXAM PRACTICE QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES Q&A INSTANT DOWNLOAD PDF
139 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Demonstrate mastery of core concepts
2 IBHRE Certified Electrophysiology Specialist
3 Pediatric
4 CEPS
5 Exam Practice Questions And Correct Answers
6 Verified Answers
7 Plus Rationales Q&A Instant Download Pdf
8 Foundations of IBHRE Certified Electrophysiology Specialist - Pediatric (CEPS-P) Exam Practice
Questions And Correct Answers (Verified Answers) Plus Rationales Q&A Instant Download Pdf
9 Applied IBHRE Certified Electrophysiology Specialist - Pediatric (CEPS-P) Exam Practice Questions And
Correct Answers (Verified Answers) Plus Rationales Q&A Instant Download Pdf
10 Advanced IBHRE Certified Electrophysiology Specialist - Pediatric (CEPS-P) Exam Practice Questions
And Correct Answers (Verified Answers) Plus Rationales Q&A Instant Download Pdf
11 IBHRE Certified Electrophysiology Specialist - Pediatric (CEPS-P) Exam Practice Questions And Correct
Answers (Verified Answers) Plus Rationales Q&A Instant Download Pdf Review
Page 1
,Q1 DEMONSTRATE MASTERY OF CORE CONCEPTS
In a pediatric patient with a systemic-to-pulmonary artery shunt and refractory
atrial flutter, which mapping strategy best identifies the critical isthmus when
entrainment is limited by rapid cycle length?
A. Activation mapping during atrial flutter with a high-density grid catheter
B. Substrate mapping during sinus rhythm identifying low-voltage areas and fractionated
electrograms CORRECT
C. Pace mapping at multiple sites to reproduce the flutter QRS morphology
D. Non-contact mapping to reconstruct endocardial activation in a single beat
RATIONALE: In rapid atrial flutter where entrainment is unreliable, substrate mapping in sinus
rhythm can identify the critical isthmus by locating low-voltage, fractionated electrograms, often
adjacent to scar. Activation mapping (A) is difficult with rapid rates, pace mapping (C) is for
ventricular arrhythmias, and non-contact mapping (D) is less validated in pediatric shunts.
Q2 DEMONSTRATE MASTERY OF CORE CONCEPTS
When programming a ventricular tachycardia (VT) zone in a pediatric ICD, which
combination of detection and therapy settings best reduces inappropriate shocks
while maintaining sensitivity for slow VT?
A. High rate cutoff, long duration, and antitachycardia pacing (ATP) before shock CORRECT
B. Low rate cutoff, short duration, and immediate high-energy shock
C. High rate cutoff, short duration, and no ATP
D. Low rate cutoff, long duration, and shock only
RATIONALE: A higher rate cutoff and longer duration reduce inappropriate detection of sinus
tachycardia, while ATP is effective for slow VT and avoids shocks. Low rate cutoffs (B, D)
increase inappropriate shocks, and short durations (B, C) reduce specificity.
Page 2
,Q3 DEMONSTRATE MASTERY OF CORE CONCEPTS
A pediatric patient with congenital complete heart block and a structurally normal
heart has a ventricular paced QRS duration of 160 ms. Which pacing strategy most
effectively minimizes ventricular dyssynchrony?
A. Dual-chamber pacing with a short atrioventricular delay
B. Single-site right ventricular apical pacing
C. Left ventricular epicardial pacing via thoracotomy
D. His bundle pacing with backup ventricular lead CORRECT
RATIONALE: His bundle pacing preserves normal ventricular activation and avoids
pacing-induced dyssynchrony, making it the preferred strategy in children with complete heart
block and normal anatomy. Right ventricular apical pacing (B) is associated with dyssynchrony,
short AV delay (A) may not address site, and epicardial LV pacing (C) is more invasive and less
physiological.
Q4 DEMONSTRATE MASTERY OF CORE CONCEPTS
During an epicardial ablation for ventricular arrhythmia in a pediatric patient with
prior cardiac surgery, which finding is most suggestive of an epicardial origin
rather than an endocardial origin?
A. Pace mapping at the endocardium yields a 12/12 match
B. The earliest endocardial activation precedes the QRS by 30 ms
C. Unipolar electrograms from the epicardium show a QS pattern with a rapid intrinsicoid
deflection CORRECT
D. The arrhythmia terminates with mechanical catheter pressure at the endocardium
RATIONALE: An epicardial origin typically shows a QS pattern on unipolar epicardial recordings
with a sharp intrinsicoid deflection, while endocardial sites show earlier activation (B) and pace
maps (A) may be less specific. Mechanical termination (D) can occur at either site.
Page 3
, Q5 DEMONSTRATE MASTERY OF CORE CONCEPTS
Which parameter derived from a 12-lead ECG most reliably distinguishes typical
atrioventricular nodal reentrant tachycardia (AVNRT) from orthodromic
atrioventricular reentrant tachycardia (AVRT) in a pediatric patient with a manifest
accessory pathway?
A. RP interval during tachycardia CORRECT
B. Presence of retrograde P waves
C. Delta wave in sinus rhythm
D. QRS alternans during tachycardia
RATIONALE: A short RP interval (RP < 70 ms) strongly favors AVNRT, while a longer RP interval
suggests AVRT. Retrograde P waves (B) are present in both, delta waves in sinus rhythm (C)
indicate preexcitation but not the mechanism, and QRS alternans (D) is not specific.
Q6 DEMONSTRATE MASTERY OF CORE CONCEPTS
A pediatric patient with catecholaminergic polymorphic ventricular tachycardia
(CPVT) is refractory to nadolol and flecainide. Which next therapeutic strategy is
most appropriate?
A. Left cardiac sympathetic denervation (LCSD) CORRECT
B. Catheter ablation of the arrhythmia substrate
C. Implantation of a permanent pacemaker
D. Addition of amiodarone
RATIONALE: LCSD is an established adjunctive therapy for CPVT when beta-blockers and
flecainide fail, reducing arrhythmic events. Ablation (B) is ineffective for the diffuse adrenergic
trigger, pacing (C) does not treat CPVT, and amiodarone (D) is not recommended and may be
proarrhythmic.
Page 4
