Arrythmias

Question 1

what is brugada criteria for VT

Answer 1

1) RS pattern present
2) RS >100ms
3) capture or fusion beats or dissocaiton of p and QRS
4) nil evidence of RBBB or LBBB

Question 2

Which rythym can be d/c cardioverted in an unsynched fashion

Answer 2

Polymorhpic VT

VF

Question 3

Discuss origin of polymorphic VT

Answer 3

If assocaited with long QT likley torseds give mg2+

if not ishcaemic until proven otherwise

Question 4

Discuss causes of acquired long QT`

Answer 4

electrolytes

• hypokalaemia
• hypomagnesaemia

Hypothermia

Drugs

• Class 1 and 3 antiarrhthmics
• antibiotics
• TCA

Intracranial b leeding

Heart block with bradycardia

Question 5

Discuss management of torseds

Answer 5

MG 5-10 mmol over 10-15 minutes regardless of serum levels

-isoproterenol or rapid ventricular pacing

Question 6

Describe multifocal atrial tachycardia

Answer 6

> 3 distince morphologically non sinus p waves
atrial rates of 100-130 bpm
variable AV block

Commonly associated with respiraotry disease and CCF

Exacerbated by

• digoxin or theophylline
• hypokalaemia, hypomagnesaemia, hyponatremia

Dose not respond to D/C cardioversion
treat preceipitants
Can use B blocker or verapamil for rate control

Question 7

Discuss vagul mediated causes of bradycardia in ICU

Answer 7

ICP 
intubation 
suctioning 
urination
defaecation
vomiting and retching

Question 8

Discuss indication for pacing

Answer 8

Sinus bradycardia with symtpoms unresponsive to drug therapy
mobitz type 2
3rd degree
bilateral BBB

As transcutaneous pacing is uncomfortable
transvenous is preferred for long term pacing