Arrhythmias

Question 1

What is an arrhythmia?

Answer 1

Abnormal heart rhythm problems

Question 2

What are the 4 main types of arrhythmia?

Answer 2

Atrial fibrillation
Heart block
Supraventricular tachycardia
Ventricular tachycardia

Question 3

How does atrial fibrillation initially present?

Answer 3

Asymptomatic

Question 4

What are 4 of the signs of atrial fibrillation past the asymptomatic phase?

Answer 4

Palpitations
Dyspnoea
Chest pain
Fatigue

Question 5

What 3 investigations should be performed for suspected atrial fibrillation?

Answer 5

12 Lead ECG over 24 hours
Blood tests (especially thyroid function
ECHO cardiogram

Question 6

What anatomical part of the heart is supraventricular tachycardia related to?

Answer 6

AV node

Question 7

What are 3 signs of supraventricular tachycardia?

Answer 7

Palpitations
Dyspnoea
Dizziness

Question 8

What are 4 signs of supraventricular tachycardia?

Answer 8

Palpitations
Dyspnoea
Dizziness
Syncope

Question 9

What 4 investigations should be performed for suspected ventricular tachycardia?

Answer 9

ECG
Bloods
ECHO
Angiogram

Question 10

In what 2 situations should a temporary pacemaker be fitted?

Answer 10

During intermittent/sustained symptomatic bradycardia

Prophylactic for risk of severe bradycardia

Question 11

In what 2 situations should a permanent pacemaker be fitted?

Answer 11

2nd/3rd degree AV block
Sinus node disease (with associated symptoms)
Carotid sinus hypersensitivity

Question 12

What are the 4 Vaughn-Williams classes of arrhythmia drugs?

Answer 12

I - sodium channel blockers
II - beta blockers
III - potassium channel blockers
IV - calcium channel blockers

Question 13

What are the the 3 different sub-types of class I arrhythmia drugs and their effects on repolarisation?

Answer 13

IA - delays polarisation
IB - accelerates polarisation
IC - little effect on repolarisation

Question 14

What are class IA arrhythmia drugs used to treat? (3)

Answer 14

Atrial fibrillation
Supraventricular tachyarrhythmias
Ventricular tachyarrhythmias

Question 15

Give an example of a class IA arrhythmia drug and 2 side effects?

Answer 15

Quinidine (headache, nausea)

Question 16

What are class IB arrhythmia drugs used to treat?

Answer 16

Ventricular tachyarrhythmias

Question 17

Give an example of a class IA arrhythmia drug?

Answer 17

Lidocaine

Question 18

What are class IC arrhythmia drugs used to treat? (2)

Answer 18

Life-threatining supraventricular tachyarrhythmias

Ventricular tachyarrhythmias

Question 19

Give an example of a class IC arrhythmia drug and a side effect?

Answer 19

Flecainide (can induce life-threatining ventricular tachyarrhythmias)

Question 20

What are class II arrhythmia drugs (beta blockers) used to treat? (2)

Answer 20

Supraventricular dysarrhythmias

Ventricular dysarrhythmias

Question 21

Give an example of a class II arrhythmia drug?

Answer 21

Atenolol

Question 22

What is the class II arrhythmia drug “Bisoprolol” used for?

Answer 22

First line treatment of atrial fibrilation

Question 23

What effect to class III arrhythmia drugs (pottasium blockers) have on action potential?

Answer 23

Increase the action potential duration

Question 24

What are class III arrhythmia drugs used to treat? (3)

Answer 24

Life-threatening or sustained ventricular tachycardia
Life-threatening ventricular fibrillation
Atrial fibrillation/flutter

Question 25

Give an example of a class III arrhythmia drug?

Answer 25

Amiodarone

Question 26

What effect do class IV (calcium channel blockers) arrhythmia drugs have on depolarisation?

Answer 26

They depress phase 4 depolarisation

Question 27

What are class IV arrhythmia drugs used to treat? (2)

Answer 27

Paroxysmal supraventricular tachycardia | Rate control for atrial fibrillation/flutter

Question 28

Give an example of a class IV arrhythmia drug?

Answer 28

Verapamil

Question 29

What 2 non-classed drugs can be used to treat arrhythmia (contains more than one class property)?

Answer 29

Digoxin | Amiodarone

Question 30

What are some of the effects of digoxin toxicity? (4)

Answer 30

Nausea and vomiting Bradycardia Tachycardia Arrhythmias: VT and VF

Question 31

What is Amiodarone used to treat? (2)

Answer 31

Ventricular tachycardia | Supraventricular tachycardia

Question 32

Which classes of arrhythmia treatment can produce sinus tachycardia as a side effect? (2)

Answer 32

Class II, IV

Question 33

Which classes of arrhythmia treatment can produce Atrial fibrillation as a side effect? (5)

Answer 33

Class IA, IB, II, III, IV