Ventricular Arrhythmia

Question 1

What are the 3 steps to diagnosing VT?

Answer 1

• Is there an RS? No = VT
• Onset of R to nadir of S >100ms? Yes = VT
• Is there AV dissociation? Yes = VT

Question 2

A Torsades de Pointes rhythm usually begins after what?

Answer 2

“Short-long-short” complex; After an early complex that follows a long pause

Question 3

Cardiac arrest is really what rhythm?

Answer 3

V-Fib

Question 4

When ventricular rate > 200 bpm and tracing resembles a continuous sine wave rhythm is called what?

Answer 4

Ventricular flutter

Question 5

This type of rhythm occurs when higher pacing sites fail. It is commonly a result of increased vagal tone or advanced heart disease.

Answer 5

Idioventricular rhythms

Question 6

What are the 2 causes of ventricular tachycardia?

Answer 6

• irritable area in ventricle acting as a rapid pacemaker

- reentry (most common!)

Question 7

This heart rhythm is usually associated with acute ischemia/infarct. It has a HR of > 200 bpm and variating QRS morphology. It can degenerate into ventricular fibrillation.

Answer 7

Polymorphic VT

Question 8

This type of rhythm has a HR of 20-40, regular RR, and an absence of P-waves.

Answer 8

Idioventricular rhythms

Question 9

This type of rhythm is commonly seen following thrombolytic reperfusion therapy acute MI.

Answer 9

Accelerated Idioventricular rhythms

Question 10

This phenomenon occurs when R wave of premature beat overlaps with T wave of previous beat and can precipitate VF or VT.

Answer 10

R on T phenomenon

Question 11

This ventricular arrhythmia is associated with prolonged QT syndrome.

Answer 11

Torsades de Pointes

Question 12

Multifocal ventricular contractions that are rapid, irregular and ineffective are consistent with what rhythm?

Answer 12

Ventricular fibrillation

Question 13

If an EKG looks like a VT but does not meet criteria what is a possible second diagnosis?

Answer 13

SVT w/ aberrancy