Arrythmias Flashcards Preview

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Flashcards in Arrythmias Deck (23):
1

Treatment for atrial ectopic beats?

Asymptomatic
Palpitations
Generally no treatment
B-adrenergic blockers may help
Avoid stimulants (caffeine, cigarettes)

2

Treatment for sinus bradycardia

Treatment
Atropine (if acute, e.g. aMI)
Pacing if

Haemodynamic compromise: hypotension, CHF, angina, collapse

3

What is a tachycardia?

HR > 100 beats

4

Treatment for sinus tachycardia?

Treat underlying cause
B-adrenergic blockers

5

Treatment for supraventricular tachycardia? (stable, narrow QRS complexes)

Vagal manoeuvres --> IV adenosine --> IV verapamil (CCB)


→ vagal maneuvers → adenosine (if regular) → beta-blocker/calcium channel blocker → get an expert

6

Treatment for supraventricular tachycardia (stable, wide/regular/monomoorphic)

Stable (wide/regular/monomorphic) → adenosine → consider antiarrhythmic infusion → get an expert

7

Chronic management for supra-ventricular tachycardias?

Avoid stimulants
Radiofrequency ablation
Antiarrhythmic drugs (class II or IV)
-verapamil
-diltiazem
-class III, IA and IC

8

Which vein are the catheters placed in when carrying out ablation?

Femoral vein

9

What can be used to guide the ablation catheter to the correct positions for ablation and then also to check the success or failure of the treatment, that is, termination of the arrhythmia at the end of the procedure ?

Intracardiac ECG

10

What is lenegres disease?

Idiopathic fibrosis of the cardiac conducting system resulting in heart block

11

Most common cause of restrictive cardiomyopathy?

Amyloidosis

12

1st degree AV block?

Not really “block”
Just P-R interval longer than normal (> 0.2 sec)
Treatment: none
Long term follow up recommended, as more advanced block may develop over time

13

Treatment indicated for Mobitz II 2nd degree heart block?

Permanent pacemaker indicated

Pathological, may progress to complete heart block (3rd degree HB)
Usually 2:1, or 3:1, but may be variable
Permanent pacemaker indicated

14

Mobitz Type 1 2nd degree AV block

Mobitz I:
progressive lengthening of the PR interval, eventually resulting in a dropped beat.
Usually vagal in origin

15

Treatment for 3rd degree AV block?

Ventricular pacing

16

When would you use a ventricular pacemaker?

AF with slow ventricular rate

17

VT acute treatment

DC cardioversion if unstable
If stable: consider pharmacologic cardioversion with AAD
If unsure if VT or something else, consider adenosine to make a diagnosis
Correct triggers

18

Medications that can prolong the QT interview?

Sotalol
Quinidine
Terfenadine
Erythromycin

19

Long term treatment for VT?

Correct ischaemia if possible (revascularisation)
Anti-arrhythmic drugs to date have been shown to be ineffective and are associated with worse outcome
Implantable cardiovertor defbrillators (ICD) if life threatening
Optimise CHF therapies

20

When is adenosine contraindicated?

In asthma!!!

21

Altered automaticity

Ischaemia
Catecholamines

22

Triggered activity

Digoxin

23

Re-entry

e.g. accessory pathway tachycardia (WPW)
Previous myocardial infarction