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My1 Cardiology > arrhythmias > Flashcards

arrhythmias Flashcards

(46 cards)

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1
Q

what are the 3 subtypes of arrhythmias

A

supraventricular, ventricular, atrio-ventricular

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2
Q

what are types of supra-ventricular arrhythmias

A

sinus bradycardia, sinus pause, atrial fibrillation, atrial flutter and ectopic atrial tachycardia, SVT and AV block

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3
Q

what are 4 types of ventricular arrhythmias

A

ventricular tachycardia, ventricular fibrillation, asystole, ventricular ectopic beats

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4
Q

where do bradyarrhythmias arise from

A

sinus node block or AV block

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5
Q

where do supraventricular arrhythmias arise from

A

between AV and SV node

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6
Q

where do ventricular arrhythmias arise from

A

below AV node

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7
Q

what are some abnormal anatomy causes of arrhythmias

A

LVH, accessory pathways, congenital disease

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8
Q

what are some autonomic NS causes of arrhythmias

A

sympathetic stimulation, increased vagal tone

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9
Q

what are some metabolic causes of arrhythmias

A

hypoxia, ischaemic myocardium, electrolyte imbalance

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10
Q

what is an ectopic beat?

A

beats that do not originate from SA node, can be a rhythm or individual beats

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11
Q

can ectopic beats be harmful?

A

yes, if originate from contractile area

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12
Q

what is re-entry

A

more than one conduction, an impulse does not die out but comes around again to excite AV node again

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13
Q

what can cause re-entry

A

accessory pathways, MI fibrosis, depressed conduction velocity, short refractory period

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14
Q

symptoms of arrhythmias

A

palpitations, SOB, dizzy, syncope, pre-syncope, angina

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15
Q

investigations

A

ECG, CXR, echocardiogram, electrophysical study

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16
Q

what is normal sinus arrhythmia

A

variation in HR due to decreased vagal tone during inspiration

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17
Q

what is sinus bradycardia, what causes it and how do you treat it?

A

less than 60bpm, drugs, ischaemia and athletic hearts can cause it. treat with atropine or pacemaker

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18
Q

what is sinus tachycardia, what causes it and how do you treat it?

A

100bpm, physiology or drugs, treat underlying cause, if severe Bblockers

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19
Q

what are the 2 types of supraventricular tachycardia

Study These Flashcards
A

AV nodal re-entry tachycardia (AVNRT) and AV re-entry tachycardia (AVRT)

20
Q

how do you treat acute supraventricular tachycardia

Study These Flashcards
A

increase vagal tone - valsava, slow conduction of AVN: adenosine, verapamil

21
Q

how do you treat chronic supraventricular tachycardia

Study These Flashcards
A

radiofrequency ablastion (1st), bblockers, antiarrhythmic drugs

22
Q

what is 1st degree AV block

Study These Flashcards
A

conduction following p waves takes longer, no treatment needed

23
Q

What is 2nd degree AV block and what are the 2 types

Study These Flashcards
A

intermittent block at AVN,

mobitz I and mobitz II

24
Q

what is mobitz I

Study These Flashcards
A

progressively lengthening of PR interval eventually leading to dropped beat, usually vagal

25
what is mobitz II
pathological, some AP dont get through AB node, pacemaker indicated
26
what is 3rd degree AV block
no AP from SA gets to AV, treat with pacemaker
27
what causes ventricular ectopics and how do you treat them
LVH, heart failure, myocarditis, ischaemic HD and electrolytes, treat with Bblockers and ablation
28
what is ventricular fibrillation and how to you treat
irregular waveform and uncoordinated electrical activity, shock shock zap zap
29
what can cause ventricular tachycardia and what is it show on ECG
close together QRS, CAD, previous MI, myocardiopathy are rare.
30
how do you treat acute ventricular tachycardia
DCCV (electrical) and adenosine to confirm diagnosis
31
how do you treat chronic ventricular tachycardia
revascularisation, anti-arrhythmic drugs, VT catheter ablation
32
how would you describe Atrial fibrillation
chaotic and disorganised atrial activity, irregular and increases with age
33
what are the 3 types and characteristics of atrial fibrillation
paroxysmal: sudden and lasts less than 48 hrs, often recurrent , persistent: lasts more than 48hrs, unlikely to revers to NRS on it's own, and permanent: inability of non or pharma to return to NSR
34
what are associated diseases with atrial fibrillation
high BP, heart disease, congenital, pericarditis, obesity
35
what is lone/ idiopathic AFib
absence of heart disease, no evidence of ventricular dysfunction. could be genetic
36
symptoms of AFib
palpitations, presyncope, syncope, chest pain, dyspnoea, sweatiness, fatigue
37
how would you see Afib on an ECG
atrial rate >300bpm, irregularly, irregular, p waves absent
38
what are the 3 things you can do you manage AFib
rhythm control, rate control, anticoagulation for thromboembolism
39
what would you do for restoration of NSR (rythm control) or if they are young?
DCCV is best if unstable, anti-arrhythmic eg amiodarone and lidocaine (class 1 and 3)
40
what would you do for maintenance of NS (rhythm control)
anti-A drugs amiodarone or lidocaine (1 . & 3) and catheter ablation
41
how would you control rate of AFib
digoxin, bblockers and ca antagonists 2 +3
42
how would you recognise an atrial flutter and how would you treat it
looks like a saw tooth with regular rhythm, ablation, DCCV, slow rate and maitain NSR with drugs, warfarin for TE
43
what are class 1 Antiarrhythmic drugs and example
reduce Na channel current, quindine and flecainide
44
what are class II Antiarrhythmic drugs and examples
Bblockers, eg propranolol
45
what are class III Antiarrhythmic drugs and examples
AP prolongation, eg amiodarone and dronedarone
46
what are class IV Antiarrhythmic drugs and examples
Ca channel blockers: verapamil

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