Arrhythmias (Sandilands flow chart) Flashcards Preview

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Flashcards in Arrhythmias (Sandilands flow chart) Deck (11)
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1

What ECG morphologies are used to categories tachycardias?

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

2

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

- Sinus tachycardia
- Atrial flutter
- SVT (AVRT)
- Ectopic atrial tachycardia

3

Name the regular narrow QRS complex arrhythmia without P waves

AVN re-entrant tachycardia

4

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

5

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.

6

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.

7

Outline the presentation of AVRT and AVNRT

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

Commonly terminated by Valsalva manoeuvres.

8

Outline management of AVRT and AVNRT

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

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

9

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

10

Outline the types of ventricular arrhythmia

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

11

State 4 causes of VT

-MI
-Drugs
-Hypokalaemia
-Hypomagnesemia
-Long QT syndrome - torsades de pointes