CCDS IBHRE EXAM LATEST 2026 UPDATED QUESTIONS
AND VERIFIED 100% SOLUTIONS (2026/2027) |A+
GRADED |GUARANTEED PASS
What are the types of lead insulation? - Answers -silicone rubber and polyurethane
polyurethane leads P80A and P55D - which one is no longer used - Answers -P80A is no longer
used because it tends to biodegrade, resulting in cracks and insulation failure
pros of silicone rubber leads - Answers -repairable, low process sensitivity, easy to fabricate,
very flexible
pros of polyurethane insulation - Answers -high tear strength, resistant to cutting, low friction,
thin, abrasion resistant, relatively nonthrombogentic/fibrotic
cons of silicone rubber insulation - Answers -tears/cuts easily
low abrasion resistance
high friction
thicker
more thrombogenic and fibrotic
cold flow failure
calcifies due to absorption of lipids
1|Page
,cons of polyurethane insulation - Answers -not repairable
stuff
difficult to build
four possible insulator/conductor configurations for pacing electrodes - Answers -1. Coaxial
configuration - with an inner coil being the cathode and the insulator wrapped with a conductor
being the anode
2. two insulated, unifilar conductors surrounded by lead body insulation
3. bipolar lead with a quadrifilar inner coil insulated by a thin layer of silicone or polyurethane,
then the quadrifilar anodal coil that is insulated with the outer coating of the lead
4. Unipolar lead with quadrifilar coil is surrounded by insulator
The connector - IS-1 and IS-4 - Answers -IS-1 connector body incorporates a maximum diameter
of 3.23mm with cathodal pin diameter of 1.59mm, or .34mm larger than the connector pin for
the DF-1 connector. This prevents the low voltage lead from being accidentally connected to a
high voltage port in a defibrillator.
differences and similarities of IS-1, VS-1A, and IS-1B or VS-1B - Answers -they are all 3.2mm
diameter
VS-1A has longer receptacle for lead terminal
while VS-1B has sealing rings in header AND longer receptacle for lead terminal.
Tetralogy of Fallot - Answers -- ventricular septal defect
2|Page
,- many levels of obstruction from the RV to the lungs(pulmonary stenosis)
- the aorta lies directly over the ventricular septal defect
- the RV develops thickened muscle
temporary surgical intervention: shunt between the aorta and the pulmonary artery
complete repair: close the ventricular septal repair, opens the RV outflow tract by removing
some thickened muscle below the pulmonary valve, repairing or removing the pulmonary valve
and enlarging the peripheral pulmonary arteries. Sometimes a tube is placed between the RV
and the pulmonary artery(Rastelli repair).
Transposition of the Great Arteries - Answers -- the aorta and pulmonary artery are reversed
- the aorta receives the oxygen-poor blood from the RV, then carried back to the body without
receiving more oxygen, the pulmonary artery receives the oxygen-rich blood from the LV but
carries it back o the lungs
surgical treatment: requires surgery early in life! Temp intervention: enlarge the PFO and lets
the blood mix
1. tunnel between the atria (atrial or venous switch= Mustard procedure=Senning procedure)2.
arterial switch operation(switching the aorta and the pulmonary artery back). then reattach the
coronary arteries also
Truncus Arteriosus - Answers -- a large ventricular septal defect which single great vessel carries
blood both to the body and to the lungs
surgical intervention: close the ventricular septal defect, disconnect the pulmonary arteries
from the single great vessel, place a tube from the RV to the pulmonary arteries
3|Page
, atrial septal defect - Answers -atrioventricular canal defect = endocardial cushion defect =
atrioventricular septal defect
one large valve allowing flow into the heart (instead of mitral and tricuspid)
commonly seen in children with down syndrome
Coarctation of the aorta - Answers -narrowing of a portion of the aorta and often seriously
decreases the blood flow from the heart out to the lower portion of the body
Hypoplastic left heart syndrome - Answers -when the LV, mitral valve, and aortic valve are
underdeveloped and unable to pump blood adequately to the entire body
Patent ductus arteriosus - Answers -the blood vessel(between pulmonary artery and the aorta)
in the developing fetus that diverts circulation away from the lungs and sends it directly to the
body. When ductus arteriosus does not close, it results in too much blood flow to a newborn's
lungs
common in premature babies
Pulmonary atresia - Answers -pulmonic valve does not open at all or completely absent
or the pulmonary artery may be malformed and the RV can be abnormally small
pulmonary stenosis - Answers -pulmonic valve is stiffened and has a narrowed opening
4|Page
AND VERIFIED 100% SOLUTIONS (2026/2027) |A+
GRADED |GUARANTEED PASS
What are the types of lead insulation? - Answers -silicone rubber and polyurethane
polyurethane leads P80A and P55D - which one is no longer used - Answers -P80A is no longer
used because it tends to biodegrade, resulting in cracks and insulation failure
pros of silicone rubber leads - Answers -repairable, low process sensitivity, easy to fabricate,
very flexible
pros of polyurethane insulation - Answers -high tear strength, resistant to cutting, low friction,
thin, abrasion resistant, relatively nonthrombogentic/fibrotic
cons of silicone rubber insulation - Answers -tears/cuts easily
low abrasion resistance
high friction
thicker
more thrombogenic and fibrotic
cold flow failure
calcifies due to absorption of lipids
1|Page
,cons of polyurethane insulation - Answers -not repairable
stuff
difficult to build
four possible insulator/conductor configurations for pacing electrodes - Answers -1. Coaxial
configuration - with an inner coil being the cathode and the insulator wrapped with a conductor
being the anode
2. two insulated, unifilar conductors surrounded by lead body insulation
3. bipolar lead with a quadrifilar inner coil insulated by a thin layer of silicone or polyurethane,
then the quadrifilar anodal coil that is insulated with the outer coating of the lead
4. Unipolar lead with quadrifilar coil is surrounded by insulator
The connector - IS-1 and IS-4 - Answers -IS-1 connector body incorporates a maximum diameter
of 3.23mm with cathodal pin diameter of 1.59mm, or .34mm larger than the connector pin for
the DF-1 connector. This prevents the low voltage lead from being accidentally connected to a
high voltage port in a defibrillator.
differences and similarities of IS-1, VS-1A, and IS-1B or VS-1B - Answers -they are all 3.2mm
diameter
VS-1A has longer receptacle for lead terminal
while VS-1B has sealing rings in header AND longer receptacle for lead terminal.
Tetralogy of Fallot - Answers -- ventricular septal defect
2|Page
,- many levels of obstruction from the RV to the lungs(pulmonary stenosis)
- the aorta lies directly over the ventricular septal defect
- the RV develops thickened muscle
temporary surgical intervention: shunt between the aorta and the pulmonary artery
complete repair: close the ventricular septal repair, opens the RV outflow tract by removing
some thickened muscle below the pulmonary valve, repairing or removing the pulmonary valve
and enlarging the peripheral pulmonary arteries. Sometimes a tube is placed between the RV
and the pulmonary artery(Rastelli repair).
Transposition of the Great Arteries - Answers -- the aorta and pulmonary artery are reversed
- the aorta receives the oxygen-poor blood from the RV, then carried back to the body without
receiving more oxygen, the pulmonary artery receives the oxygen-rich blood from the LV but
carries it back o the lungs
surgical treatment: requires surgery early in life! Temp intervention: enlarge the PFO and lets
the blood mix
1. tunnel between the atria (atrial or venous switch= Mustard procedure=Senning procedure)2.
arterial switch operation(switching the aorta and the pulmonary artery back). then reattach the
coronary arteries also
Truncus Arteriosus - Answers -- a large ventricular septal defect which single great vessel carries
blood both to the body and to the lungs
surgical intervention: close the ventricular septal defect, disconnect the pulmonary arteries
from the single great vessel, place a tube from the RV to the pulmonary arteries
3|Page
, atrial septal defect - Answers -atrioventricular canal defect = endocardial cushion defect =
atrioventricular septal defect
one large valve allowing flow into the heart (instead of mitral and tricuspid)
commonly seen in children with down syndrome
Coarctation of the aorta - Answers -narrowing of a portion of the aorta and often seriously
decreases the blood flow from the heart out to the lower portion of the body
Hypoplastic left heart syndrome - Answers -when the LV, mitral valve, and aortic valve are
underdeveloped and unable to pump blood adequately to the entire body
Patent ductus arteriosus - Answers -the blood vessel(between pulmonary artery and the aorta)
in the developing fetus that diverts circulation away from the lungs and sends it directly to the
body. When ductus arteriosus does not close, it results in too much blood flow to a newborn's
lungs
common in premature babies
Pulmonary atresia - Answers -pulmonic valve does not open at all or completely absent
or the pulmonary artery may be malformed and the RV can be abnormally small
pulmonary stenosis - Answers -pulmonic valve is stiffened and has a narrowed opening
4|Page
