46 - Supraventricular Tachycardia Flashcards Preview

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Flashcards in 46 - Supraventricular Tachycardia Deck (21):
1

More difficult to achieve ___ control in patients with atrial flutter than patients with A. Fib

HR

2

The threshold for using catheter ablation is ____ for atrial flutter than for A. Fib

lower

3

List non-pharms

-Cardioversion
-Catheter Ablation
-Percutaneous Left Atrial Appendage Occlusion

4

When is cardioversion used?

to terminate the tachycardia electrically if unresponsive to medical management

for patients with A. fib or flutter > 48 hours

5

Need 3 weeks of ______ prior to cardioversion

anticoagulation

6

Who is catheter ablation 1st line for?

patients with typical atrial flutter

*also an option for those with A. fib who are symptomatic and either don't want or can't have anti-arrhythmic therapy

7

What is Percutaneous Left Atrial Appendage Occlusion used for?

to decrease risk of systemic embolism

only for those with high risk of stroke from whom antithrombotic tx is precluded

8

Control ____ in those with more than minimal symptoms

rhythm

9

Rhythm control:
_____ is more effective than sotalol or propafenone for prevention of recurrences of AF

amiodarone

10

Rhythm control:
What do you need to monitor while on Amiodarone?

Can elevate serum aminotransferases or cause hepatitis

Monitor LFTs and thyroid

11

Rhythm control:
What are some options for chemical cardioversion?

-oral flecanaide
-oral propafenone
-IV amiodarone
-ibutilide
-procainamide

12

Rate control:
List the 2 first line drug classes

-BB
-CCB

13

Rate control:
When should digoxin be considered?

only when response to 1st line agents is inadequate since it is not very effective and there are concerns that it may increase mortality

14

Rate control:
Targets for BP ?

-Resting HR < 80 bpm
-Mean HR < 100 bpm
*using 24 hour Holter monitoring

15

Rate control:
If rate control can't be achieved with meds, consider what?

AV nodal ablation or permanent pacemaker

16

Who is anticoagulation recommended for?

For the prevention of thromboembolic stroke in patients who have A. fib or flutter and are at high risk of stroke

17

use _____ to estimate stroke risk

CHADS2

18

use _____ to estimate bleed risk

HAS-BLED

19

What are some options?

-warfarin
-DOACs

dabigatran and apixaban found to be better than warfarin

*guidelines suggest using DOAC > warfarin

20

What is an option for those who are not candidates for oral anticoagulants?

Percutaneous Left Atrial Appendage Occlusion

21

1st line for management of re-entrant tachycardias and focal atrial tachycardias

catheter ablation

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