American Board of Internal Medicine (ABIM) Certification Practice Exam

What rhythm post-coronary stenting suggests good reperfusion?

1. Bradycardia

2. Regular wide complex rhythm with no atrial activity

3. Atrial fibrillation

4. Ventricular fibrillation

The correct answer is: Regular wide complex rhythm with no atrial activity

The rhythm that suggests good reperfusion after coronary stenting is characterized by a regular wide complex rhythm with no atrial activity. This type of rhythm is often associated with conditions such as idioventricular rhythm or accelerated idioventricular rhythm, which can occur in the setting of coronary reperfusion. These rhythms indicate that there is some restoration of blood flow to the heart muscle, which is a positive sign following the placement of a stent. The absence of atrial activity suggests that the atria may not be effectively conducting impulses, which can happen if there is a temporary disruption of the normal electrical pathways as the heart's tissue recovers from ischemia. However, a regular wide complex rhythm indicates that the ventricles are depolarizing in a coordinated manner, which is a favorable outcome after reperfusion. Other rhythms presented in the choices do not provide the same indication of reperfusion: - Bradycardia, which is a slow heart rate, does not specifically indicate good blood flow and could signal other concerns, such as increased vagal tone or underlying heart disease. - Atrial fibrillation reflects an irregular rhythm that can be the consequence of atrial damage but doesn’t necessarily indicate effective reperfusion. - Ventricular fibrillation is a life