Arrythmias + ECG Findings

Question 1

3 categories of arrhythmias?

Answer 1

Sinus node abnormalities
Supraventricular arrhythmias
Ventricular arrhythmias

Question 2

Sinus node abnormalities?

Answer 2

Sinus bradycardia

Sinus tachycardia

Question 3

Main feature of sinus node abnormalities?

Answer 3

P-waves remain associated with QRS complexes confirming normal functioning of cardiac conduction

Question 4

Supraventricular arrhythmias?

Answer 4

Atrial ectopic beats
Paroxysmal tachycardias
Wolff-Parkinson-White syndrome
Atrial flutter
Atrial fibrillation

Question 5

What are paroxysmal tachycardias?

Answer 5

Narrow complexes generated below the sino-atrial node but above the ventricles

Question 6

What is Wolff-Parkinson-White syndrome?

Answer 6

A separate pathway to the atrioventricular node allows pre-excitation and re-entry

Question 7

What is atrial flutter caused by?

Answer 7

Caused by a re-entry pathway allowing rapid re-firing of the ventricles
- rate of 300/min is typical

The AVN will often block some of the beats and additional P-waves appear at a regular rate of 300/min between QRS complexes

Question 8

What is atrial fibrillation?

Answer 8

A form of supraventricular arrhythmia characterised by an irregular heart rate

Question 9

Ventricular arrhythmias?

Answer 9

Ventricular ectopic beats
Torsade de pointes
Ventricular tachycardia
Ventricular fibrillation

Question 10

What does a broad QRS complex tachycardia indicate?

Answer 10

• Ventricular arrhythmia

- Supraventricular arrhythmia with bundle branch block

Question 11

How does AVN re-entry tachycardia occur?

Answer 11

Occurs when two pathways co-exist within the AVN

- the 2 pathways may have differing delays which, in total, present a raised heart rate of between 140-220bpm

Question 12

How are AVN re-entry tachycardias managed?

Answer 12

Adenosine or verapamil

- causes iatrogenic AVN delay