246 Atrial Fibrillation

Question 1

Synchronized cardioversion is indicated for which patient?
A. Women with fever, pneumonia, stable chronic heart failure, sinus tachycardia at 125 bpm
B. Man with multifocal atrial tachycardia at 155 bpm, RR 12 cpm, BP 134/88 mmHg
C. Woman with CAD, chest pain, 2 mm ST elevation and sinus tachycardia at 130 bpm
D. Man with rheumatic mitral valve disease, shortness of breath, HR 160 bpm, and BP 80/ 50 mmHg

Answer 1

D. Man with rheumatic mitral valve disease, shortness of breath, HR 160 bpm, and BP 80/ 50 mmHg

Question 2

32M presents with severe palpitations. HR 190 bpm. ECG reveals SVT. Unreponsive to vagal manuevers and initial dose of adenosine 6 mg rapid IV. Becomes hypotensive 80/50 mmHg. HR 210 bpm. What is the next best step?
A. IV amiodarone
B. Increase adenosine to 12 mg 
C. IV procainamide
D. Synchronised cardioversion

Answer 2

D. Synchronised cardioversion