IBHRE Cheat Sheet 2026

The 30 highest-yield IBHRE facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Neurogenic orthostatic hypotension is commonly associated with which of the following conditions? → Parkinson's disease
2. In cardiac electrophysiology, what is an "ablation" procedure primarily used for? → To destroy or isolate areas of heart tissue that are causing abnormal electrical signals
3. The risk of atrioesophageal fistula, a rare but potentially fatal complication, is most associated with? → Posterior left atrial ablation for atrial fibrillation
4. Which of the following is the most common type of sustained arrhythmia in clinical practice? → Atrial fibrillation
5. Which arrhythmia is typically associated with a prolonged QT interval and can lead to Torsades de Pointes? → Long QT syndrome
6. Where is the 'slow pathway' targeted during catheter ablation of AVNRT? → Posteroseptal region near the coronary sinus os
7. Which of the following is a key consideration when performing an electrophysiology study (EPS) on a pediatric patient? → The use of general anesthesia
8. Ranolazine's antiarrhythmic properties are primarily due to inhibition of which sodium current? → Late INa
9. What constitutes the endpoint of successful accessory pathway catheter ablation? → Loss of pre-excitation on ECG and non-inducibility of AVRT
10. Orthostatic hypotension is defined as a sustained reduction in systolic blood pressure of at least how many mmHg within 3 minutes of standing? → 20 mmHg
11. Which electrophysiological test is used to identify and map the origin of arrhythmias in the heart? → Electrophysiology study (EPS)
12. Lidocaine (Class IB) is most effective for treating which type of arrhythmia? → Ventricular tachycardia and fibrillation
13. The primary purpose of open-irrigated tip catheters in RF ablation is? → To allow larger, deeper lesions by preventing surface char formation
14. What is the primary physiological reason for the long absolute refractory period in ventricular myocardial cells? → To prevent summation of contractions and tetany of the cardiac muscle.
15. In pediatric patients with Wolff-Parkinson-White (WPW) syndrome, which type of arrhythmia is most commonly observed? → Atrioventricular reentrant tachycardia (AVRT)
16. The standard tilt table test is typically performed at what upright angle? → 70 degrees
17. Why is systemic heparin anticoagulation routinely administered during left-sided EP procedures? → To prevent thromboembolism from catheter and sheath surfaces in the left heart
18. Which serious complication is uniquely associated with transseptal puncture for left-sided EP procedures? → Cardiac tamponade from aortic or atrial perforation
19. Which component of a pacemaker or ICD is responsible for detecting the heart's intrinsic electrical activity? → The lead(s)
20. What is the primary function of the sinoatrial (SA) node in the heart? → To initiate and regulate the heart's electrical impulses
21. How does dronedarone structurally differ from amiodarone? → It is non-iodinated
22. Informed consent for EP ablation procedures must include discussion of? → Risks, benefits, alternatives, and expected outcomes
23. Femoral venous access for right-sided cardiac ablation routes catheters to the heart via? → The inferior vena cava
24. Which of the following devices is used to treat both bradycardia and tachycardia? → Implantable Cardioverter Defibrillator (ICD)
25. On an implantable loop recorder (ILR) in a patient with recurrent syncope, which finding best supports a neurally mediated (vasovagal) mechanism? → Gradual progressive bradycardia leading to asystole coinciding with syncope
26. High-density mapping catheters improve VT ablation procedures by? → Simultaneously recording from many electrodes to create detailed scar and activation maps
27. Which of the following structures is considered the primary and most consistent pathway for electrical impulse conduction between the right and left atria? → Bachmann's Bundle
28. In the VASIS (Vasovagal Syncope International Study) classification, Type 2B vasovagal syncope is characterized by: → Cardioinhibitory response with asystole ≥3 seconds
29. Contrast-induced nephropathy during EP procedures is best prevented by? → Adequate pre-procedure IV hydration and minimizing contrast volume
30. The spontaneous Phase 4 depolarization characteristic of pacemaker cells in the sinoatrial (SA) node is primarily mediated by which ionic current? → Inward 'funny' current (If)