Arrhythmias

Question 1

Arrhythmias are diagnosed by?

Answer 1

ECG

Question 2

Normal resting Hr is ?

Answer 2

60-100

Question 3

What are common complaints of arrhythmias?

Answer 3

palpitations, dizziness, lightheadedness, SOB, chest pain and fatigue

Question 4

What is the sequence of normal sinus rhythm?

Answer 4

1. SA node initiates electrical impluse
2. impulse spreads through atria resulting in atrial contraction
3. impulse goes to AV node and conduction is slowed
4. impulse travels down to bundle of HIS and divides into bundle branch
5. impulse spreads through ventricle via purkinje fiber

Question 5

What is phase 0 of cardiac action potential?

Answer 5

rapid ventricular depolarization, influx of Na causing ventricular contraction (QRS wave)

Question 6

What is phase 1 of cardiac action potential?

Answer 6

Early repolarization; Na channels close

Question 7

What is phase 2 of cardiac action potential?

Answer 7

Plateau: influx of Ca and efflux of K

Question 8

What is phase 3 of cardiac action potential?

Answer 8

Rapid ventricular repolarization in response to efflux of K (T wave)

Question 9

What is phase 4 of cardiac action potential?

Answer 9

Resting membrane potential; atrial depolarization occurs (P wave)

Question 10

At what phase do Class Ia, Ib, Ic work at?

Answer 10

phase 0

Question 11

At what phase do class III work at?

Answer 11

phase 3

Question 12

Etiology of arrhythmias?

Answer 12

MI, infarction, electrolyte imbalances, elevated sympathetic states, drugs

Question 13

Supraventricular arrhythmias example

Answer 13

sinus tachycardia, A. fib, atrial flutter

Question 14

Ventricular arrhythmia example?

Answer 14

premature ventricular contractions, ventricular tachycardia, ventricular fibrillation

Question 15

When to worry when QT interval is?

Answer 15

> 500 msec

Question 16

what can increase risk of QT prolongation?

Answer 16

hypokalemia, hypomagnesemia

Question 17

Drugs that increase QT interval?

Answer 17

Class 1 antiarrhythmics, antibiotics, azole antifungals, antidepressants, antiemetics, antipsychotics, oncology agents, HIV agents

Question 18

Class I

Answer 18

Ia: disopyramide, quinidine, procainamide
Ib: lidocaine, mexiletine
Ic: flecainide, propafenone

Question 19

Class II

Answer 19

beta blockers

Question 20

Class III

Answer 20

dronedarone, dofetilide, sotalol, ibutilide, amiodarone

Question 21

Class IV

Answer 21

verapamil, diltiazem

Question 22

What is goal resting HR?

Answer 22

< 80 BPM

Question 23

Preferred for rate control?

Answer 23

BB and Non-DHP CCB

Question 24

What is rhythm control consist of?

Answer 24

methods for conversion to NSR and maintenance of NSR

Question 25

What drugs are used for rhythm control?

Answer 25

dofetilide, dronedarone, flecainide, propafenone, sotalol

Question 26

MOA of Ia antiarrhythmics?

Answer 26

block Na and K

Question 27

Which Ia have strong anticholinergic effects?

Answer 27

disopyramide and quinidine

Question 28

Norpace, norpace CR

Answer 28

disopyramide

Question 29

MOA of Ib antiarrhythmics?

Answer 29

pure sodium channel blockers

Question 30

Rythmol

Answer 30

propfenone

Question 31

Nexterone, pacerone

Answer 31

amiodarone

Question 32

Multaq

Answer 32

dronedarone

Question 33

Betapace, sotylize, sorine

Answer 33

sotalol

Question 34

Corvert

Answer 34

ibutilide

Question 35

Tikosyn

Answer 35

dofetilide

Question 36

Therapeutic range of digoxin for Afib ?

Answer 36

0.8-2