Arrhythmias Flashcards
1
Q
What are arrhythmias?
A
Abnormal Heart rhythms
2
Q
Shockable rhythms
A
- Ventricular tachycardia
- Ventricular fibrillation
3
Q
Non shockable rhythyms
A
- Pulseless electrical activity(all electrical activity except VF/VT, including sinus rhythm without a pulse)
- Asystole
4
Q
What is A Fib
A
- chaotic irregular atrial arrhythmia and is considered a type of supraventricular tachycardia
- Most common A
- M > F
5
Q
RFs for A Fib
A
- Age
- DM
- HT
- Hyperthyroidism
- Congestive HF
- Valvular Heart disease
6
Q
A fib pathophysiology
A
- SA node produces electrical activity coordinates contraction of atria of heart
- A fib contraction of atria is uncoordinated, rapid and irregular - due to disorganised electrical activity overriding normal organised activity
7
Q
What does A Fib lead to?
A
Irregular conduction of impulses to ventricals - leads to:
- Irregularly irregularventricular contractions
- Tachycardia
- Heart failuredue topoor fillingof the ventricles duringdiastole
- Risk ofstroke
8
Q
Types of A fib
A
- First episode
- Paroxysmal: recurrent episodes that stop on their own in less than 7 days
- Persistent: recurrent episodes that last more than 7 days
- Permanent:
9
Q
Causes of A Fib - PIRATES
A
- Pulmonary- PE and COPD
- IHD
- Rheumatic heart disease
- Aneamia + Age
- Thyroid - hyper
- Electrolye - hypo/hyperkalemia
- Sepsis + Sleep apnoea
10
Q
S + S of Afib
A
- Irregular irregular pulse
- Hypotension:red flag; suggest haemodynamic instability
- Evidence of heart failure:red flag; such as pulmonary oedema
- Palpitations
- Dyspnoea
- Chest pain: red flag
- Syncope: red flag
11
Q
Features to do DC cardioversion with AFib
A
- Shock
- Syncope
- MI
- HF
12
Q
Investigations for Afib
A
- ECG: Irregularly irregular QRS complexes + absent P waves and chaotic baseline
- Serum electrolytes
- TFTs
13
Q
What do we have to for Afib management
A
- Determine if rate control or rhythm control is more appropriate
- Rate control - patient not in sinus rhythym - aim to get HR under 100
- Rhthym - restore normal sinus - known as cardioversion
14
Q
Haemodynamic unstable management
A
Unstable - Emergency electrical synchronised DC cardioversion
15
Q
Stable haemodynamically management
A
- Onset of AF < 48 hours: 1) rate control or 2) rhythm-control
- Onset of AF > 48 hours / unknown onset: offer rate-control and anticoagulation for at least 3 weeks, then offer rhythm control if appropriate e.g. if rate control is unsuccessful or the patient remains symptomatic