Advanced Cardiovascular Life Support (ACLS) Practice Exam

Which rhythm is a potential precursor to more severe complications such as cardiac arrest?

1. Normal sinus rhythm

2. Asystole

3. Fine ventricular fibrillation

4. Sinus bradycardia

The correct answer is: Fine ventricular fibrillation

Fine ventricular fibrillation is indeed a serious cardiac rhythm that can lead to severe complications such as cardiac arrest. In this state, the heart's electrical activity becomes disorganized to the extent that effective pumping of blood is compromised. This arrhythmia is characterized by small, irregular oscillations instead of the broad chaotic waves seen in coarse ventricular fibrillation. While normal sinus rhythm indicates a healthy, functioning heart, asystole represents a total lack of electrical activity in the heart, which is a terminal rhythm rather than a precursor. Sinus bradycardia can occur in many situations, some of which may be benign, and often the heart is still functioning adequately despite the slower rate. In contrast, fine ventricular fibrillation is indicative of critical derangements that can rapidly progress to full cardiac arrest if not treated immediately. It requires urgent intervention, such as defibrillation, to restore normal rhythm and prevent progression to a more severe state.