# Shock & Pace

> Free web app, in English and French, with no account, for learning cardiac rhythm management: 1,170 questions with detailed, referenced answers on ECG interpretation, pacemaker and implantable cardioverter-defibrillator (ICD) programming, cardiac resynchronisation therapy (CRT), remote monitoring and electrophysiology, plus a real-time electrophysiology (EP) recording system simulator.

Key facts:

- Audience: cardiologists and trainees, cardiac physiologists, device and EP nurses and technicians, remote monitoring teams, students.
- Languages: English and French (full interface, questions, answers and simulator; chosen on the home screen). The English version is a translation of the French original.
- Modes: training by domain or targeted, adaptive competitive mode with ELO rating (start 600), timed exam, spaced-repetition review, progress tracking.
- Content: ECG (314 questions), Pacemaker and ICD programming (526 questions), Remote monitoring alerts (148 questions), Electrophysiology (182 questions); 61 real 12-lead ECGs (PTB-XL, CC BY 4.0); difficulty 1 to 10; single-answer, multiple-answer, true/false and open questions.
- EP simulator: 17 scenarios (Normal conduction, Dual AV nodal physiology without tachycardia, Typical AVNRT (slow–fast), Atypical AVNRT (fast–slow), Orthodromic AVRT (concealed left lateral accessory pathway), Wolff-Parkinson-White syndrome (left lateral pathway), Typical atrial flutter (counterclockwise, CTI-dependent), Focal atrial tachycardia, Orthodromic AVRT (concealed posteroseptal accessory pathway), Permanent junctional reciprocating tachycardia (Coumel), Mahaim fibres (atriofascicular pathway), Typical AVNRT with 2:1 infra-Hisian block, Left lateral AVRT with functional left bundle branch block, Perimitral flutter (left atrial macro-re-entrant tachycardia), Focal junctional tachycardia, Scar-related ventricular tachycardia, Atrial fibrillation) and scored mystery cases.
- Sources: ESC, EHRA, HRS and ACC/AHA guidelines and consensus documents, indexed articles (DOI) and official manufacturer manuals only; every answer cites its sources.
- Reference guidelines: ESC 2021 pacing and CRT, ESC 2022 ventricular arrhythmias, HRS 2023 remote device clinic, 2015 ICD programming consensus, ESC 2024 AF, ESC 2019 SVT, 2019 ICD programming consensus, ACC/AHA/HRS 2018 bradycardia, ESC 2018 syncope, ESC 2026 heart failure, EHRA 2023 conduction system pacing, EHRA/HRS 2024 AF ablation, HRS 2023 physiologic pacing, ESC/EHRA 2025 conduction system pacing, HRS 2017 MRI, 2019 ventricular arrhythmia ablation consensus, ESC 2026 CVD and kidney disease.
- Privacy: no account, no data transmitted; progress stored locally. Works offline (PWA).
- Limitation: educational tool; does not replace official guidelines, manufacturers' manuals or clinical judgement.
- Contact: contact@shockandpace.com

Question bank updated on 2026-09-26.

## Pages

- [Shock & Pace app, English](https://shockandpace.com/en/): quizzes, competitive ELO mode, electrophysiology simulator
- [About Shock & Pace](https://shockandpace.com/en/presentation.html): topics and subtopics, method, guidelines, sources, FAQ
- [Application Shock & Pace, français](https://shockandpace.com/): quiz, mode compétitif ELO, simulateur d'électrophysiologie
- [Présentation détaillée (français)](https://shockandpace.com/presentation.html) : thèmes, méthode, recommandations, sources, FAQ

## Optional

- [Source code and question format](https://github.com/hacuubo/CHALLENGE-RYTHMO)