Progressive Care Nursing Certification (PCCN) Practice Exam

Which dysrhythmia is most commonly associated with acute decompensated heart failure?

1. Right bundle branch block

2. Ventricular tachycardia

3. Atrial fibrillation

4. Complete heart block

The correct answer is: Atrial fibrillation

Atrial fibrillation is most commonly associated with acute decompensated heart failure due to its prevalence in patients who have underlying heart conditions. In cases of heart failure, the heart's structure and function are compromised, which can lead to electrical disturbances. Atrial fibrillation specifically involves a rapid and irregular heartbeat originating from the atria, which can exacerbate heart failure symptoms by increasing the heart rate and reducing the efficiency of the heart's pumping ability. This can lead to worsened fluid retention and pulmonary congestion, both of which are hallmarks of acute decompensated heart failure. The other dysrhythmias, while serious, are not as routinely linked to acute decompensated heart failure in the general population. Right bundle branch block can occur due to various causes but is not as directly correlated with acute decompensated heart failure as atrial fibrillation. Ventricular tachycardia, although more critical in nature, is not as commonly observed in heart failure cases compared to atrial fibrillation. Finally, complete heart block can lead to significant hemodynamic instability but is not as frequently seen as the acute event that reinforces the existing heart failure context.