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Systems 1a Revision Decks > Arrhythmias > Flashcards

Arrhythmias Flashcards

(49 cards)

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1
Q

What is sinus rhythm?

A

Any cardiac rhythm where depolarisation of the cardiac muscle behind at the sinus node

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2
Q

How is sinus rhythm characterised?

A

By the presence of correctly orientated P-waves on ECG

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3
Q

What is sinus arrest?

A

When the SA node transiently ceases to generate the electrical impulses responsible for cardiac contraction

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4
Q

What is heart block?

A

Abnormal heart rhythm here the heart beats too slow (bradycardia)

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5
Q

What is first degree AV block?

A

Simple prolongation of PR-interval >.22 seconds

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6
Q

What is Morbitz I type second degree heart block?

A

Wenckeback block phenomenon

Progressive PR-interval block until P-wave fails to conduct

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7
Q

What is Mobitz II type second degree heart block?

A

When a dropped QRS-complex is not proceeded by an increased PR-interval progression

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8
Q

What is a common feature of Mobitz type II second degree heart block?

A

Broad QRS-complex

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9
Q

What is 2:1 advanced block?

A

Occurs when every two or three P-waves conducts and precedes a QRS-complex

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10
Q

What is third degree heart block?

A

Complete heart block occurs when all atrial activity fails to conduct to the ventricles

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11
Q

What is atrial flutter?

A

Organised atrial rhythm with an atrial rate of approx 250-350bpm showing ECG sawtooth pattern

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12
Q

What proportion of the population have atrial fibrillation?

A

1-2% of adults (5-10% in elderly)

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13
Q

What are the causes of atrial fibrillation ?

A

Any condition resulting in raised atrial pressure ,mass, fibrosis, inflammation or infiltration

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14
Q

What are the most common causes of a.fib?

A

Hypertension and heart failure

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15
Q

What are the signs and symptoms for atrial fibrillation?

A

30% incidental finding
Rapid palpitations
Dyspnoea
Chest pain

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16
Q

What are the indication for implantable cardiac defibrillators?

A

Life threatening arrhythmias cause death in the first year in up to 40% of cases - employed as a preventative measure

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17
Q

What is Wolff-Parkinson-White syndrome?

A

One of several pre-excitation disorders effecting the electrical system of the heart

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18
Q

Wolff-Parkinson-White syndrome is caused by the presence of what?

A

An accessory conduction pathway between the atria and ventricles

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19
Q

Describe the electrical impulse process in Wolff-Parkinson-White syndrome?

A

Electrical signals travel down bundle of Kent and stimulate ventricles to contract prematurely resulting in a unique type of supraventricular tachycardia

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20
Q

What is the special type of tachycardia caused by Wolff-Parkinson-White syndrome?

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A

Atrioventricular Re-entrant Tachycardia

21
Q

What is the ECG telltale sign for Wolff-Parkinson-White Syndrome?

22
Q

What is sustained ventricular tachycardia?

23
Q

What is the presentation of ventricular tachycardia?

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A

Pre-syncope, hypotension and cardiac arrest

24
Q

What is the typical pulse rate of someone experiencing ventricular tachycardia?

25
What is the typical ECG pattern shown with ventricular tachycardia?
Torsades des pointes
26
What is ventricular fibrillation?
Very regular and irregular ventricular contraction with no mechanical effect
27
What is the clinical presentation of ventricular fibrillation?
Patient is pulseless, no respiration and rapidly unconscious
28
What is ventricular fibrillation usually preceeded by?
Ectopic beats
29
What are ectopic beats?
Random extra cardiac contractions
30
What does the ECG of atrial ectopic beats looks like?
Early and abnormal P-waves but usually not proceeded by a QRS-complex
31
What can be said about the need to treat atrial ectopic beats?
Not needed unless it precipitates a more serious arrhythmia
32
What classification for anti-arrhythmic drugs do we use?
Vaughan-Williams system
33
What do class I anti-arrhythmic drugs do?
Membrane depressants that reduce the rate of sodium entry into the myocyte
34
What subclasses of class I anti-arrhythmic drugs are there?
Class Ia - lengthen action potential Class Ib -Delay action potential recovery Class Ic - Stops spontaneous contraction
35
What do class II anti-arrhythmic drugs do?
Anti sympathetic drugs
36
What do class III anti-arrhythmic drugs do?
Prolong refraction period and increase action potential duration
37
What are class IV anti-arrhythmic drugs?
CCBs
38
What are some examples of anti-arrhythmic drugs with no classification?
Digoxin Amiodarone Adenosine Atropine
39
How is the level of coagulation in vivo measured?
International normalised ratio
40
How is INR measured?
Actual thromboplastin time/ Standard thromboplastin time
41
What is the normal value of INR?
1
42
What is the therapeutic range of INR?
2.5-4
43
What risk factors must be considered incase of bleeding when on warfarin?
``` C - congestive heart failure H - hypertension A - aged >75 years old D - diabetes S - stroke (or TIA) ```
44
What electrotherapy is used to treat arrhythmias?
Radio frequency ablation
45
What arrhythmias can be readily ablated?
``` AVNRT Normal heart VT Atrial flutter Atrial tachycardia Atrial fibrillation ```
46
What is the problem with digoxin?
Is not actively removed from the kidneys therefore must be administered with digibind to avoid toxicity
47
What are the signs of digoxin toxicity?
Xanthopsia and reverse tick appearance of ST segment in lateral leads
48
What drug is used to treat Mobitz Type I heart block?
Atropine
49
What anti-arrhythmic drug interacts with digoxin?
Amiodarone

Systems 1a Revision Decks (22 decks)

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