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Arrhythmias Flashcards

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1
Q

1st degree heart block ECG feature

A

Prolonged PR interval

>0.2s

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2
Q

Subtypes of heart block

A

1st degree
2nd degree
3rd degree

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3
Q

Subtypes of 2nd degree heart block

A

Mobitz type 1

Mobitz type 2

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4
Q

Mobitz type 1 ECG feature

A

Progressive PR interval prolongation until a QRS complex is missed

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5
Q

Mobitz type 2 ECG feature

A

Every *th QRS complex is missed

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6
Q

3rd degree heart block ECG feature

A

No QRS complexes

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7
Q

> 60bpm is what type of arrhythmia

A

Bradycardia

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8
Q

<100bpm is what type of arrhythmia

A

Tachycardia

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9
Q

Treatment of Bradycardia

A

Atropine

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10
Q

Supraventricular tachycardia treatment

A

1st - vagal manoeuvres (pop ears)
2nd - carotid massage
3rd - adenosine IV
4th - verapamil, diltiazem, beta-blockers

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11
Q

what is Paroxysmal AF

A

lasts <48hrs

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12
Q

what is Persistent AF

A

lasts >48hrs

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13
Q

what is Permanent AF

A

lasts >48hrs + CANNOT be cardioconverted to normal rhythm

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14
Q

What would a typical ECG of a patient with AF look like

A

No p waves

QRS is rapid + irregular

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15
Q

An irregular irregular rhythm is associated with?

A

AF

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16
Q

ACUTE Treatment of AF

A 
Amiodrone OR flecainide (if haem stable)
DC cardioversion (if harm unstable)

If cardioversion isn’t possible within 24-48hrs then put on warfarin for 6-8wks then bring back to cardiovert.

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17
Q

Long-term treatment of AF

A

Beta-blockers
Ca2+ channel blocker (verampil)
Digoxin

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18
Q

What arrhythmia is associated with AF?

A

Atrial flutter

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19
Q

“saw-tooth” waves on ECG

A

Atrial flutter

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20
Q

Treatment of Atrial flutter

A

Electrical cardioversion

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21
Q

Treatment of recurrent Atrial flutter

A

1st - radio frequency ablation

2nd - amiodrone

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22
Q

What drugs can cause Bradycardia?

A

Beta-blockers

verapamil

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23
Q

Treatment of Bradycardia

A

treat underlying cause
atropine
pacing if haemodynamically compromised (CHF, angina, collapse, hypotension)

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24
Q

What arrhythmia does sick sinus syndrome cause?

A

Bradycardia

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25
Athletes may have what arrhythmia?
Bradycardia
26
What arrhythmia is generally well tolerated?
Bradycardia
27
What would a typical ECG of a patient with ventricular Tachycardia look like?
Broad, abnormal QRS
28
Acute treatment of ventricular Tachycardia
haem unstable = emergency DC cardioversion | haem stable = IV Lidocaine/lignocaine OR amidrone
29
Symptoms of ventricular Tachycardia
pre-syncope, hypotension, cardiac arrest
30
Patient is pulseless and becomes rapidly unconscious, what arrhythmia do they have
V.fib
31
What would a typical ECG of a patient with ventricular Fibrillation look like?
shapeless, rapid oscillations, no organisation | toddler's scribble
32
Acute treatment of V. Fib
Defib
33
Long-term treatment of V.Fib
Implantable cardioverter Defib
34
Most common cause of death following an MI
V.fib
35
ECG is shapeless, rapid oscillations, no organisation | toddler's scribble
V.Fib
36
ECG has Broad, abnormal QRS
V.tach
37
ECG has No p waves and QRS is rapid + irregular
AF
38
What is Long QT syndrome?
ventricular repolarisation is greatly prolonged.
39
Torsades de pointes is associated with?
Long QT syndrome
40
where do SVT originate from
above the ventricle | includes: atrial muscle, av node,
41
what are the 2 types of SVT
AF | Atrial flutter
42
what are the 3 types of ventricular arrhythmias
V.tach V.fib asystole
43
what are the 2 types of AV node arrhythmias
``` AV block (3 subtypes) AVN re-entry tachycardia ```
44
what are ectopic beats
beats or rhythms that originate in places other than the SA node
45
what is re-entry
requires more than 1 conduction pathway with different speed of conduction and recover of excitability
46
how can ectopics cause tachycardia
may cause single beats or a sustained run of beats that is faster than sinus rhythm take over the intrinsic rhythm
47
how can re-entry cause tachycardia
triggered by an ectopic beat it results in a self perpetuating circuit
48
symptoms of arthymias (general)
``` palpitations "pounding heart" SOB dizzy loss of consciousness/faintness sudden death ```
49
investigations of arrhythmias (general)
ECG (12 lead, stress, 24hr) CXR echocardiogram
50
what is an 12 lead ECG used for
assess rhythm | signs of previous MI or pre-excitation
51
what is an exercise ECG used for
assess for ischaemia | to look for exercise induced arrhythmia
52
what arrhythmia does an exercise ECG look for
exercise induced arrhythmia
53
what arrhythmia does a 24hr ECG look for
paroxysmal arrhythmia
54
what are the physiological causes of tachycardia
anxiety fever hypotension anaemia
55
treatment of sinus tachycardia
b-blockers
56
acute management of SVT
haem stable: increase vagal tone via carotid massage slow conduction in AV node via IV adenosine or Verapamil haem unstable: cardioversion
57
long-term management of SVT
b-blockers | ablation
58
causes of heart block
``` old age MI myocarditis drugs (b-blockers, Ca2+ channel blockers) genetic ```
59
what drugs can cause heart block
b-blockers | Ca2+ channel blockers
60
treatment of 1st degree heart block
none | monitor
61
what is lone/idiopathic AF
absence of any HR disease and no evidence of ventricular dysfunction could be genetic
62
what causes AF (physiology)
multiple waves of re-entry
63
what is the atrial rate in AF
>300bpm
64
what drugs are used in rate control in AF
digoxin B-blockers Ca2+ channel blockers
65
how is normal sinus rhythm achieved in AF
``` pharmacological cardioversion (e.g. amidarone) direct current cardioversion (DCCV) ```
66
what is the main mutation in long QT syndrome
potassium channel KCNQ1
67
what ECG changes are observed in long QT syndrome
QT prolongation: males >440ms females>460ms
68
what is the main mutation in brugada syndrome
cardiac sodium channel mutation SCNSA
69
treatment for brugada syndrome
implantable cardiac device (unless asymptomatic without FHx)
70
what arrhythmia is most commonly linked to sudden cardiac death
Long QT syndrome
71
long term treatment of ventricular Tachycardia
revascularisation (correct ischemia) implantable cardiovertor defibs VT catheter ablation
72
what is the treatment for 2nd degree heart block
ventricular pacing
73
what is the treatment for 3rd degree heart block
ventricular pacing

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