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Flashcards in Arrhythmias Deck (20):
1

Tx of unstable bradycardia

1. Atropine (vagolytic)
2. Epinephrine, dopamine (positive chronotropic)

2

Tx of unstable tachycardia

Synchronized cardioversion
Amiodarone, beta-blocker, lidocaine

3

Tx of Orthodromic Parxoysmal Supraventricular Tachycardia
(Wide/Narrow) complex?

1. Vagal maneuver
2. adenosine
3. beta-blockers, CCB
Unstable --> synchronized cardioversion
Sustained --> catheter ablative sx

Narrow

4

WPW has ___ waves, (narrow/wide) QRS, (long/short) PRI.
What accessory pathway?

Delta, wide QRS, short PRI
Kent Bundle

5

Tx of WPW

Vagal maneuver
Procainamide*, Amiodarone
Radiofrequency ablation = definitie tx

6

MC rhythm seen in digitalis toxicity

AV junctional dysrhythmia

7

Atrial fibrillation
Rate:
Medication rate control: (w/ and w/o HF)

350-600 bpm
Rate control:
W/ HF: digoxin, amiodarone, dronedarone
w/o HF: beta-blocker (metroprolol, esmolol), CCB (diltiazem, verapamil)

Cardioversion after 3-4 weeks of anticoag or TEE showing no atrial thrombi

8

Atrial flutter MC seen in ___

COPD

9

Atrial flutter
Rate:
Medication rate control:

250-350 bpm
beta-blocker (metroprolol, esmolol), CCB (diltiazem, verapamil)
Cardioversion if unstable
Radiofrequency ablation = definitive tx

10

What electrolyte abnormalities associated w/ Torsades de pointes?

Tx?

Hypomagnesemia
Hypokalemia

Tx: IV magnesium

11

Recurrent syncope, QT interval 0.5-0.7s long, ventricular arrhythmias, sudden death =

Long QT syndrome

12

Syncope, ventricular fibrillation, sudden death during sleep. Common in ___

Brugada syndrome
Asian men

13

Tx of acute V tach

1. amiodarone
2. lidocaine
3. procainamide

14

What kind of heart block?
Constant prolonged PRI --> dropped QRS

Tx?

Mobitz II (2nd degree AV block)

Tx: Permanent pacemaker

15

What kind of heart block?
Progressive prolonged PRI --> dropped QRS

Tx?

Mobitz I/Wenckebach (2nd degree AV block)

Tx: atropine, epinephrine, +/- pacemaker

16

Multifocal atrial tachycardia is associated w/

severe COPD

HR > 100 bpm + 3 P wave morphologies

17

Wandering atrial pacemaker =

Multifocal atrial tachycardia =

Wandering atrial pacemaker = HR < 100 bpm + 3 P wave morphologies

Multifocal atrial tachycardia = HR > 100 bpm + 3 P wave morphologies

18

Alcohol excess or alcohol withdrawal precipitates this kind of arrhythmia

Atrial fibrillation

19

Match Antiarrythmic drug class to its action
1. Beta-blockers, slow AV conduction
2. Slow calcium channel blockers
3. Shorten repolarization
4. Na channel blockers, depress phase 0 depolarization, slow conduction, prolong repolarization
5. Depress phase 0 repolarization, slow conduction
6. Potassium channel blockers, prolong action potential
7. Slow conduction through AV node, interrupts reentry pathway
8. Direct action on cardiac mm and indrect action on CV system via ANS

Ia, Ib, Ic, II, III, IV, V

1. II: esmolol, propranolol, metoprolol
2. IV: verapamil, diltiazem
3. Ib: lidocaine, mexiletine
4. Ia: quinidine, procainamide, disopyramide, moricizine
5. Ic: Flecainide, propafenone
6. III: Amiodarone, sotalol, dofetilide, ibutilide
7. V: Adenosine
8. V: Digoxin

20

Treatment of symptomatic bradycardia

First Line: atropine.
Second: epinephrine
Permanent: Permanent pacemaker