Arrhythmias III Flashcards Preview

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Flashcards in Arrhythmias III Deck (64):
1

how long after TEE DCCV do you A/C?

4 weeks

2

which SVT is due to automaticity?

AT

3

Rx for MAT?

treat underlying dz
CCBs

4

which SVT has a pseudo RSR' and retrograde p?

AVNRT

5

if you see an EPS w/ everything lined up in a row, what does this mean?

simultaneous A & V activation
Pathognomonic for AVNRT

6

Rx for recurrent symptomatic AVNRT

ablation
Verapamil, dilt
BB

7

Rx for recurrent AVNRT refracgtory to BB, CCB and pt does not want ablation?

flecainide, propafenone, sotalol

8

what happens to AVNRT w/ adenosine?

abrupt termination

9

is "no therapy" a Class I indication for AVNRT that is well tolerated?

yes
(also can treat with meds or ablation)

10

pre-excitation + ? = WPW

sxs

11

*what is a Class I Rx for Pre-excitation?

Nothing. (this is not WPW unless sxs)

12

*What is a class I Rx for WPW?

catheter ablation

13

*name 3 meds not to give in WPW

verapamil/dilt/dig

14

*can you give BB in WPW?

yes (class IIa), unless in afib!

15

*can you do ablation on Pre-excitation?

yes (class IIa), but doing nothing is Class I.

16

*if pt. refuses ablation for WPW, what meds can you give?

flecainide/propafenone
sotalol/amio
BB

17

what meds are contraindicated in WPW/pre-excitation with a fib?

BB
CCB

18

meds that can cause AT

Dig (AT w/ 2:1 AVB)
Albuterol
catecholamines/caffeine

19

mechanisms of AT

automatic
triggered
reentrant

20

MAT

>3 p waves
- look for chronic dz

21

AT response to adenosine

variable
can be diagnostic

22

Rx for hemodynamically unstable AT

DCCV

23

acute Rx for AT rate control (Class I)

BB, vera/dilt

24

Class I Rx for RECURRENT AT

ablation
BB
CCB

25

do you treat non sustained & asymptomatic AT?

No

26

ablation success rate in AT

90

27

ablation success rate in AT

90

28

whats the best rate-control Rx for poorly tolerated Afl?

BB>CCB

29

whats the best conversion med for stable Afl?

ibutilide

30

3 EKG findings in AFL

- sawtooth in II, III, F
- +p in V1, V2
- -p in V3-V6.

31

effects of BB on fetus

FGR
reduce placental weight
brady/hypoglycemia
preterm labor & reduced baby weight

32

effects of BB on fetus

FGR
reduce placental weight
brady/hypoglycemia
preterm labor & reduced baby weight

33

can you use CCBs in pregnancy?

No

34

Amio effects on fetus

congenital goiter
hypo/hyperthyroid
Long QT

35

Amio effects on fetus

congenital goiter
hypo/hyperthyroid
Long QT

36

can you perform DCCV on pregnant pt's?

yes

37

quinidine side effects on fetus

oxytocic properties/preterm labor

38

Class I recs to acutely convert pregnant pt. in SVT

Vagal maneuvers
DCCV
Adenosine

39

*Class III recs for SVT Rx in pregnant pt's

atenolol
amio

40

Class III recs for SVT Rx in pregnant pt's

atenolol
amio

41

what BB can you NEVER use in pregnancy

atenolol

42

what is NOT associated with RVOT VT?

structural heart dz

43

ECG findings for RVOT VT

- LBBB-like
- tall R in II, III, F

44

Rx for 1st episode of RVOT VT

BB
CCB

45

Rx for RVOT VT refractory to meds or unstable or with syncope/pre-syncope

ablation

46

which drug used pre-transplant can cause arrhythmia post-OHT?

Amio

47

Ddx of arrhythmia etiology in OHT

rejection
Pre-OHT amio
suture lines (AFL)
surgical trauma to SAN/AVN
accelerated atherosclerosis/preservation ischemia

48

what is the most common EKG abnormality post-OHT?

Incomplete -RBBB

49

Is VT/VF common post-OHT

No. look for other causes (MI/rejection/CM)

50

are AF/AFL commonly assoc. w/ rejection post-OHT?

yes!

51

what to do if you see AF/AFL post-OHT

Bx-->steroids

52

why don't you give adenosine post-OHT

due to adenosine supersensitivity (5-fold inc in response by SAN/AVN after loss of parasympathetics)

53

what determines the onset/prognosis of tachycardia-induced CM?

rate and duration

54

Rx for Tachycardia CM

rate control
CHF OMT
ablation

55

can you reverse all types of tachycardia-CM?

no

56

How quickly is Tachycardia-CM reversed?

48hrs, full resolution in 2 weeks
(not all TCM are reversible)

57

PVC burden of ?% distinguishes CM vs. nl EF? what to do if PVC burden > 10%?

40%
ischemic w/u

58

What type of SVT is WPW?

AVRT

59

Name the type of AVRT (orthodromic or antidromic):
Down AVN, up bypass tract, narrow complex

Orthodromic

60

Name the type of AVRT (orthodromic or antidromic):
Down bypass tract, up AVN, wide complex

Antidromic

61

Which SVT does. It require AVN, His-purkinje, or accessory pathway for its initiation or maintenance?

A tach

62

Mech of RVOT VT

cAMP mediated triggered activity

63

Precipitates for RVOT VT

Exercise
Stress
Caffeine

64

Why is the initial treatment of RVOT VT counterintuitive?

Because you give BB or CCB, NOT ablation/ICD