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Arrhythmias IV Flashcards

1
Q

WCT + AV dissociation = ?

A

VT

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2
Q

WCT + concordance= ?

A

VT

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3
Q

what does dig tox VT look like on EKG?

A

narrow complex

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4
Q

what does SVT due to drugs look like on EKG?

A

WCT

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5
Q

RBBB> ? = VT

A

140ms

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6
Q

LBBB>? = VT

A

160ms

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7
Q

WCT with R - in I and F = ?

A

VT

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8
Q

what does the presence of negative concordance in WCT rule out?

A

antidromic tachycardia

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9
Q

WCT w/ broad, slurred, notched QRS= ?

A

VT

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10
Q

WCT w/ atypical RBBB/LBBB = ?

A

VT

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11
Q

R/S ratio < 1 in V6 w/ WCT = ?

A

VT

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12
Q

QS in V6 w/ WCT = ?

A

VT

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13
Q

criteria for LBBB

A
  1. QRS > 120ms
  2. broad monomorphic R in I, V6 w/o Q waves
  3. broad monomorphic S in V1, may have small R
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14
Q

criteria for RBBB

A
  1. QRS>120 ms
  2. Slurred S in I, V6
  3. RSR’ in V1 w/ R’>R
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15
Q

Brugada Algorithm

A
  1. No RS in precordial leads
  2. R-S>100ms in one precordial lead
  3. AV dissociation
  4. VT Morphology in V1-V2
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16
Q

Sn and Sp of AV dissociation for VT

A

Sn 82%

Sp 98%

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17
Q

Sn and Sp for No RS in precordial leads for VT (Brugada)

A

Sn 21%

Sp 100%

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18
Q

Sn and Sp for R-S>100ms for VT (Brugada)

A

Sn 21%

Sp 100%

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19
Q

Sn and Sp for VT if morphology criteria are met in Brugada algorithm

A

Sn 99%

Sp 97%

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20
Q

aVR criteria for VT

A
  • presence of R wave
  • r or q > 40ms
  • if QRS -, should be a notch on descending limb
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21
Q

what will the HV interval be on an EPS for SVT w/ aberrancy?

A

normal

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22
Q

lidocaine dosing for VT

A

1mg/kg bolus + .5mg/kg gtt after 5 mins

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23
Q

procainamide dosing for VT

A

20-50 mg/min bolus

watch for hypotension

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24
Q

can you use adenosine for acute Rx of VT?

A

yes

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25
Q

can you use BB, CCB or Dig in acute Rx of VT?

A

No

26
Q

name a good drug for VT,SVT, or preexcitation

A

procainamide

27
Q

antiarrhythmic Rx for out of hospital arrest (VT)

A

amio

28
Q

antiarrhythmic for ischemic VT

A

lidocaine

29
Q

4 drugs you can use for acute VT Rx

A

lidocaine
amio
adenosine
procainamide

30
Q

does cardiac sarcoid predispose to SCD?

A

yes

31
Q

does infiltrative CM predispose to SCD?

A

yes

32
Q

most common cause of SCA in young people?

A

HCM

33
Q

what can MVP syndrome cause?

A

SCD

34
Q

Catecholaminergic VT

A

defect in calcium handling (RYR2/CASQ2 genes)

- exercise induced polymorphic VT

35
Q

LQT1

A

swimming
Rx BB
ICD if SCA/syncope

36
Q

LQT2

A

Sound (alarm clocks)

Rx: BB

37
Q

LQT3

A

sleep

38
Q

channels involved in LQT1,2,3.

A

LQT1: Ks
LQT2: Kr
LQT3: Na (gain of fxn)

39
Q

classic EKG finding in Brugada syndrome

A

IRBBB w/ ST Elevation

40
Q

most common mech of arrhythia causing SCD in structural heart disease?

A

reentry

41
Q

if exertional syncope, think of?

A

Cathecholaminergic VT

Rx: BB, verapamil or ICD

42
Q

AVID trial

A

Amio vs ICD in Secondary Prevention of SCD
>30%mortality reduction at 3 yrs w/
EF< 35% benefited most

43
Q

what is the only good risk stratifier for SCD in CAD pt’s?

A

Decreased LVEF

44
Q

which trial was stopped early and showed benefit of ICD over OMT in pts w/ prior MI and EF<30% ?

A

MADIT II

45
Q

Trial that showed pt’s w/ ICM or NICM and Class II or III HF had decreased mortality with ICD but not w/ Amio in Primary Prevention of SCD.

A

SCD-HeFT

46
Q

Trial that showed Amio = Placebo in SCD Primary Prevention

A

SCD-HeFT

47
Q

which two trials are the US guidelines for ICD usein primary prevention? what do they use for risk stratification?

A

MADIT II
SCD-HEFT
LVEF

48
Q

Which trial is the basis for ICD use in secondary prevention?

A

AVID

49
Q

How manu joules of stored energy does an ICD keep?

A

34J

50
Q

*what is the most common cause for ICD giving inappropriate shocks?

A

atrial arrhythmias (like afib)

51
Q

how long after an I with EF<35% can you put in ICD?

A

40d

52
Q

which trial made ICD Class I indication for prior MI/EF< 40%/NSVT/inducible VT?

A

MUSTT

53
Q

Does CRT-D decrease both morbidity and mortality?

A

yes(COMPANION)

54
Q

can VT be irregular in the beginning of an EKG?

A

yes

55
Q

what does a superior “northwest” axis of -90 to +/- 180 (towards aVR) strongly suggest?

A

VT

56
Q

acute Rx of unstable VT

A

DC SYNCHRONIZED shock

57
Q

Brugada syndrome mech

A

loss of fxn of SCN5A

58
Q

Clinical presentation of Brugada

A

syncope after fever or illmess

59
Q

most common arrhythmia seen with Brugada syndrome

A

VF

60
Q

can you put an ICD into a pt with prior MI (>40d), LVEF <40%, NSVT and inducible VT?

A

yes, Class I, MUSST

61
Q

name two arrhythmias causing VF/VT that are amenable to surgery or ablation and are Class III for ICD placement

A

WPW + RVOT/LVOT VT

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