37. Electrophys Flashcards by Kira Harms

intraop 5 lead

II
V5

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intraop 5 lead covers

80% of ischemic changes

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lead II

MEA
RV
inf LV

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lateral LV

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polarized state is mx by

Na+/K+ atpase

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what propagates AP through myocardium

Na+/Ca2+ channels

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what is involved with excitiation/contraction coupling

Ca2+

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what is involved with myosin power stroke

Ca2+

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right heard leads

V1
V2

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interventricular septum leads

V3
V4

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left heart leads

V5
V6

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inotropy

speed and strength of cardiac contraction

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lusitropy

relaxation and ventricular filling

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issue with inotropy causes

systolic heart failure

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issue with lusitropy causes

diastolic heart failure

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1st degree AV block: cause

athlete
digoxin
B blocker
CCB
ischemia
MD

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1st degree AV block: avoid

vagal stimulation
electrolyte abnormalities
ischemia

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1st degree AV block

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2nd degree AV block type 1

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2nd degree AV block type 2

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3rd degree AV block

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adams-stoke attack

sudden fainting spells due to drop in CO
(3rd degree block)

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RBBB ecg

wide QRS > 120 ms in leads 1/2
deep S in leads 1/V6

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RBBB

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Left BBB Ecg

wide QRS > 120 ms no Q wave in 1, V5, V6 broad/notched R wave in 1, aVL, V5, V6

LBBB indicates

ischemic serious heart disease

lab for ischemia

troponin C

LBBB

tachydysrhythmia with narrow QRS

ABOVE BOH: sinus tach a fib a flutter junctional tach paroxysmal atrial tach accessory pathway rachycardia

wide complex tachycardia

BELOW BOH: V TACH SVT w/intraventricular defect SVT w/aberrant conduction SVT w/preexcitation pathway

arrythmia initiation mechanism

1. incr automaticity 2. reentry through abnormal pathway 3. trigger of potential after depolarization

what can induce automaticity

any myocyte

what sets the normal value

the inerrant baseline automaticity

what decreases timeframe for depolarization

phase 4 shift

sinus tachycardia

PAC

paroxysmal SVT

orthodromic

more common narrow QRS no delta

antidromic

less common wide QRS delta wave

orthodromic AVRT conduction

antegrade conduction through AV node

antidromic AVRT conduction

retrograde conduction through AV node

WPW antidromic

WPW orthodromic

afib

afib w/RVR

afib w/RVR criteria

1. afib rhythm 2. HR > 100bpm

aflutter

PVC bigeminy

PVC trigeminy

Nonsustained ventricular tachycardia (grouping of PVCs)

R on T phenomenon

PVC that occurs during middle 3rd of relative refractory period of T wave

long QT males

QT> 440ms

long QT females

QT>460 ms

most common inherited form of long QT

romano-ward syndrome

increased risk of polymorphic VTACH

QT>500ms

treat prolonged QT

mg K discontinue QT prolongation drugs pacing (if neede)

which is worse: SVT or NSVT

NSVT

monomorphic VTACH

polymorphic VTACH

Vfib

sinus brady

junctional pacing comes from

AV node

junction HR

40-60 bpm

junctional bradycardia

junctional tachycardia

adenosine indication

AVNRT AVRT

adenosine CI

SSS 3rd degree AV block without pacer

adenosine antagonist

caffeine theophylline

adenosine dosing

6mg 12mg 12mg

atropine indication

symptomatic bradycardia

atropine dose

0.5mg IV

amiodarone mechanism

K+ channel antagonist

amiodarone dosing

PVT/Vfib: 300 mg initial/150 redose others: 150 mg

beta blocker mechanism

antagonize beta receptors slow AVN conduction

beta blocker CI

2nd degree heart block 3rd degree heart block severe CHF RAD WPW

CCB indication

narrow complex QRS tachycardia afib/aflutter SVT

CCB CI

WPW beta blockers (causes heart block)

CCB dosing

verapamil: 2.5-5mg IV (0.15 mg/kg) diltiazem: 0.25 mg/kg IV

digoxin mechanism

Na/K ATP antagonist

digoxin dosing

400-600 mg total

dopamine indication

2nd line treatment for symptomatic brady

dopamine dosing: incr blood flow

3-5mcg/kg/min

dopamine dosing: b agonist

5-7mcg/kg/min

dopamine dosing: a agonist

> 10mcg/kg/min

epi mechanism

adrenergic agonist

when will you need higher doses of epi

if pt is on beta blocker or CCB

isoproterenol mechanism

B1 and B2 agnoist

isoproterenol dose

2-10mcg/min

lidocaine mechanism

Na+ channel antagnoist

lidocaine dosing

1-1.5 mg/kg (up to 3 mg/kg total)

mg dosing: pulseless

1-2g over 5 mins

mg dosing: pulse

1-2 g over longer period

mg mechanism

cofactor that aids Na/K transport

procainamide mechanism

Na+ channel antagonist

procainamide dosing

50mcg/min

37. Electrophys Flashcards

(95 cards)