Arrhythmias

Question 1

What is paroxysmal atrial fibrillation?

Answer 1

sudden reoccurrence or intensification of symptoms, lasts <48hrs

Question 2

What is permanent atrial fibrillation?

Answer 2

unable to restore normal sinus rhythm

Question 3

What is the acute treatment for sinus bradycardia?

Answer 3

atropine

Question 4

What are the causes of ventricular ectopics?

Answer 4

LV hypertrophy, heart failure, myocarditis, ischaemic heart disease, electrolyte imbalances, inherited cardiac conditions

Question 5

What is the chronic treatment for ventricular tachycardia?

Answer 5

correct ischaemia - revascularisation, implantable cardiac defibrillator, catheter ablation

Question 6

What is the treatment for 1st degree heart block?

Answer 6

no treatment, long term follow up

Question 7

What is atrial flutter?

Answer 7

rapid and regular atrial tachycardia

Question 8

What is the acute treatment for ventricular tachycardia?

Answer 8

unstable - direct current cardioversion, stable - anti-arrhythmic drugs, prepare for direct current cardioversion

Question 9

What are the signs of Torsades de Pointes?

Answer 9

HR = 200-250bpm, irregular pulse

Question 10

What is the treatment of ventricular fibrillation?

Answer 10

defibrillation, cardiopulmonary resuscitation

Question 11

What is sinus tachycardia?

Answer 11

> 100bpm

Question 12

What is the mechanism of atrial fibrillation?

Answer 12

ectopic foci in muscle sleeves in opening of pulmonary veins

Question 13

What is a single chamber pacemaker?

Answer 13

paces RA or RV only

Question 14

What is haemodynamic compromise?

Answer 14

hypotension, CHF, angina

Question 15

What is 2nd degree heart block?

Answer 15

intermittent block - dropped beats

Question 16

What are the triggers of ventricular tachycardia?

Answer 16

electrolyte imbalance, ischaemia, hypoxia, drugs that prolong QT interval

Question 17

What is re-entry?

Answer 17

more than one conduction pathway with different conduction speeds

Question 18

What is persistent atrial fibrillation?

Answer 18

lasts >48hrs

Question 19

What are the ECG characteristics of Torsades de Pointes?

Answer 19

long QT interval, wide QRS, continuously changing QRS morphology

Question 20

What is Mobitz II heart block?

Answer 20

usually 2:1 or 3:1

Question 21

What is seen on an ECG of 1st degree heart block?

Answer 21

PR interval >0.2s

Question 22

What is the treatment for sinus bradycardia if there is haemodynamic compromise?

Answer 22

pacing

Question 23

What is the treatment for permanent atrial fibrillation?

Answer 23

slow down AV node conduction - digoxin, beta blockers, verapamil, diltiazem

Question 24

What is the acute management of regular supraventricular tachycardia?

Answer 24

increase vagal tone - Valsalva (blow through closed object) or carotid massage, slow conduction in AV node - IV adenosine, IV verapamil

Question 25

What are ectopic beats?

Answer 25

originate outside SA node - take over sinus rhythm if faster

Question 26

What is the treatment for sinus tachycardia?

Answer 26

beta blockers, treat underlying cause

Question 27

What is the treatment of atrial fibrillation?

Answer 27

pharmacological or electrical cardioversion - anticoagulation

Question 28

What are the ECG characteristics of ventricular tachycardia?

Answer 28

rapid, wide, distorted QRS complexes, large T waves with deflections opposite QRS complexes, no P waves

Question 29

What is a dual chamber pacemaker?

Answer 29

paces RA and RV - maintains AV synchrony - used for AV nodal disease

Question 30

What is the treatment of atrial flutter?

Answer 30

radiofrequency ablation, pharmacological, warfarin

Question 31

What is Mobitz I heart block?

Answer 31

progressive lengthening in PR interval - vagal in origin

Question 32

What is 3rd degree heart block?

Answer 32

no action potentials get through AV node

Question 33

What are the ECG characteristics of 3rd degree heart block?

Answer 33

broad peaks - originating in myocardium, slow - not using conduction system = escape rhythm - enough to sustain life

Question 34

What are the ECG characteristics of atrial fibrillation?

Answer 34

atrial rate >300bpm, irregularly irregular rhythm, no P waves, f waves present

Question 35

What are the symptoms of arrhythmias?

Answer 35

palpitations, dyspnoea, dizziness, syncope, presyncope, sudden cardiac death, heart failure, angina

Question 36

What is ventricular fibrillation?

Answer 36

chaotic ventricular activity - reduced CO

Question 37

Give examples of stimulants

Answer 37

caffeine, cigarettes

Question 38

What is atrial fibrillation?

Answer 38

chaotic atrial activity - reduced diastole - reduced CO

Question 39

What is the chronic management of regular supraventricular tachycardia?

Answer 39

avoid stimulants, beta blockers, antiarrhythmic drugs, radiofrequency catheter ablation

Question 40

What are the causes of heart block?

Answer 40

MI, myocarditis, amyloid, beta blockers, calcium channel blockers, calcification of the aortic valve, post aortic valve surgery, genetic

Question 41

What are the symptoms of atrial ectopic beats?

Answer 41

palpitations

Question 42

What is the treatment for Mobitz II heart block?

Answer 42

pacemaker

Question 43

What is normal sinus arrhythmia?

Answer 43

variation in HR - inspiration reduces vagal tone - physiological

Question 44

What is sinus bradycardia?

Answer 44

<60bpm, normal sinus rhythm

Question 45

What is the radiofrequency catheter ablation?

Answer 45

selective cauterisation of cardiac tissue

Question 46

What are the causes of sinus bradycardia?

Answer 46

drugs - e.g. beta blockers, ischaemia - common in inferior STEMIs

Question 47

What are the causes of regular supraventricular tachycardia?

Answer 47

AV node re-entrant tachycardia, ectopic atrial tachycardia

Question 48

What is the treatment for atrial ectopic beats?

Answer 48

generally no treatment, beta blockers may help, avoid stimulants

Question 49

What is presyncope?

Answer 49

faintness

Question 50

What are the classifications of 2nd degree heart block?

Answer 50

Mobitz I, Mobitz II

Question 51

What is the mechanism of atrial flutter?

Answer 51

re-entry circuit in RA

Question 52

What is the treatment for 3rd degree heart block?

Answer 52

pacemaker

Question 53

What is the treatment of ventricular ectopics?

Answer 53

beta blockers, ablation of focus