Arrhythmias IV Flashcards Preview

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Flashcards in Arrhythmias IV Deck (61):
1

WCT + AV dissociation = ?

VT

2

WCT + concordance= ?

VT

3

what does dig tox VT look like on EKG?

narrow complex

4

what does SVT due to drugs look like on EKG?

WCT

5

RBBB> ? = VT

140ms

6

LBBB>? = VT

160ms

7

WCT with R - in I and F = ?

VT

8

what does the presence of negative concordance in WCT rule out?

antidromic tachycardia

9

WCT w/ broad, slurred, notched QRS= ?

VT

10

WCT w/ atypical RBBB/LBBB = ?

VT

11

R/S ratio < 1 in V6 w/ WCT = ?

VT

12

QS in V6 w/ WCT = ?

VT

13

criteria for LBBB

1. QRS > 120ms
2. broad monomorphic R in I, V6 w/o Q waves
3. broad monomorphic S in V1, may have small R

14

criteria for RBBB

1. QRS>120 ms
2. Slurred S in I, V6
3. RSR' in V1 w/ R'>R

15

Brugada Algorithm

1. No RS in precordial leads
2. R-S>100ms in one precordial lead
3. AV dissociation
4. VT Morphology in V1-V2

16

Sn and Sp of AV dissociation for VT

Sn 82%
Sp 98%

17

Sn and Sp for No RS in precordial leads for VT (Brugada)

Sn 21%
Sp 100%

18

Sn and Sp for R-S>100ms for VT (Brugada)

Sn 21%
Sp 100%

19

Sn and Sp for VT if morphology criteria are met in Brugada algorithm

Sn 99%
Sp 97%

20

aVR criteria for VT

- presence of R wave
- r or q > 40ms
- if QRS -, should be a notch on descending limb

21

what will the HV interval be on an EPS for SVT w/ aberrancy?

normal

22

lidocaine dosing for VT

1mg/kg bolus + .5mg/kg gtt after 5 mins

23

procainamide dosing for VT

20-50 mg/min bolus
watch for hypotension

24

can you use adenosine for acute Rx of VT?

yes

25

can you use BB, CCB or Dig in acute Rx of VT?

No

26

name a good drug for VT,SVT, or preexcitation

procainamide

27

antiarrhythmic Rx for out of hospital arrest (VT)

amio

28

antiarrhythmic for ischemic VT

lidocaine

29

4 drugs you can use for acute VT Rx

lidocaine
amio
adenosine
procainamide

30

does cardiac sarcoid predispose to SCD?

yes

31

does infiltrative CM predispose to SCD?

yes

32

most common cause of SCA in young people?

HCM

33

what can MVP syndrome cause?

SCD

34

Catecholaminergic VT

defect in calcium handling (RYR2/CASQ2 genes)
- exercise induced polymorphic VT

35

LQT1

swimming
Rx BB
ICD if SCA/syncope

36

LQT2

Sound (alarm clocks)
Rx: BB

37

LQT3

sleep

38

channels involved in LQT1,2,3.

LQT1: Ks
LQT2: Kr
LQT3: Na (gain of fxn)

39

classic EKG finding in Brugada syndrome

IRBBB w/ ST Elevation

40

most common mech of arrhythia causing SCD in structural heart disease?

reentry

41

if exertional syncope, think of?

Cathecholaminergic VT
Rx: BB, verapamil or ICD

42

AVID trial

Amio vs ICD in Secondary Prevention of SCD
>30%mortality reduction at 3 yrs w/
EF< 35% benefited most

43

what is the only good risk stratifier for SCD in CAD pt's?

Decreased LVEF

44

which trial was stopped early and showed benefit of ICD over OMT in pts w/ prior MI and EF<30% ?

MADIT II

45

Trial that showed pt's w/ ICM or NICM and Class II or III HF had decreased mortality with ICD but not w/ Amio in Primary Prevention of SCD.

SCD-HeFT

46

Trial that showed Amio = Placebo in SCD Primary Prevention

SCD-HeFT

47

which two trials are the US guidelines for ICD usein primary prevention? what do they use for risk stratification?

MADIT II
SCD-HEFT
LVEF

48

Which trial is the basis for ICD use in secondary prevention?

AVID

49

How manu joules of stored energy does an ICD keep?

34J

50

*what is the most common cause for ICD giving inappropriate shocks?

atrial arrhythmias (like afib)

51

how long after an I with EF<35% can you put in ICD?

40d

52

which trial made ICD Class I indication for prior MI/EF< 40%/NSVT/inducible VT?

MUSTT

53

Does CRT-D decrease both morbidity and mortality?

yes(COMPANION)

54

can VT be irregular in the beginning of an EKG?

yes

55

what does a superior "northwest" axis of -90 to +/- 180 (towards aVR) strongly suggest?

VT

56

acute Rx of unstable VT

DC SYNCHRONIZED shock

57

Brugada syndrome mech

loss of fxn of SCN5A

58

Clinical presentation of Brugada

syncope after fever or illmess

59

most common arrhythmia seen with Brugada syndrome

VF

60

can you put an ICD into a pt with prior MI (>40d), LVEF <40%, NSVT and inducible VT?

yes, Class I, MUSST

61

name two arrhythmias causing VF/VT that are amenable to surgery or ablation and are Class III for ICD placement

WPW + RVOT/LVOT VT