Arrhythmias (Sandilands flow chart) Flashcards Preview

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Flashcards in Arrhythmias (Sandilands flow chart) Deck (11)
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What ECG morphologies are used to categories tachycardias?

- Narrow vs Broad complex QRS
- Regular vs irregular R-R intervals
- Presence of P waves


Name 4 regular arrhythmias associated with P waves and narrow QRS complexes

- Sinus tachycardia
- Atrial flutter
- Ectopic atrial tachycardia


Name the regular narrow QRS complex arrhythmia without P waves

AVN re-entrant tachycardia


Describe atrioventricular re-enterant tachycardia

Formation of an accessory pathway between the atria and ventricles enable conduction to spread up from the ventricles into the atria.

The atria contract earlier than the SAN ➔ tachycardia unto 200-300bpm


Define Wolff-Parkinson-White Syndrome

Episodes of tachycardia, with the presence of a congenital accessory pathways (Bundle of Kent).

Asymptomatic referred to as having WPW pattern on ECG.

Delta waves are characteristic of WPW.


Describe AVN re-entrant tachycardia

Premature atrial beat travels down (anterograde) the slow alpha pathway and up (retrograde) the fast beta pathway whilst it is still in its long refractory period.

This creates a slow-fast (typical AVNRT) re-entry loop that continuously depolarises the bundle of His ➔ tachycardia.


Outline the presentation of AVRT and AVNRT

Short-duration symptoms of palpitations, SoB, dizziness, syncope (rare). Rarely life-threatening.

Commonly terminated by Valsalva manoeuvres.


Outline management of AVRT and AVNRT

- Valsalva manoeuvre or carotid sinus massage
- IV adenosine: highly effective for AVRT and AVNRT
NB. Adenosine contraindicated in asthmatics

- Rate control (Beta-blockers, CCBs, digoxin)
- DC cardioversion
- Accessory pathway ablation: definitive Tx


Differentiate Atrial Fibrillation and Atrial Flutter

Atrial fibrillation is an irregular-irregular tachycardia without P waves. Wavy baseline is typical. Disorganised contraction of atria.

Atrial flutter is a regular tachycardia with P waves. Sawtoothing is typical. Generally faster rate than AF. Organised contraction of atria ➔ more impulses pass the AVN


Outline the types of ventricular arrhythmia

-Life-threatening ventricular tachyarrhythmias
-Normal heart ventricular tachycardia
-Non-sustained ventricular tachycardia
-Ventricular ectopics


State 4 causes of VT

-Long QT syndrome - torsades de pointes