Arrythmias

Question 1

Name common medications that can cause Bradycardia?

Answer 1

1) Beta-Blockers
2) Ca-Channel Blockers
3) Donepazil / Galantamine / Rivastigmine
4) Digoxin
5) Amiodarone
6) Sotalol

Question 2

List some causes of Reversible Bradycardia

Answer 2

1) Hypothyroidism/Myxedema
2) Lyme Disease
3) Medication O/D
4) Sepsis
5) Hypoglycemia
6) Hypothermia
7) Increased Intracranial Pressure

Question 3

What treatment is needed for sick sinus syndrome?

Answer 3

Beta-Blocker or Ca-channel blockers for Tachycardia control

Permanent Pacemaker for Bradycardia

Question 4

What Treatment options are available for WPW? When do you give each?

Answer 4

Procainamide or Ibutilide –> Given if patient has Atrial Fibrillation

Beta-Blocker/Ca-Channel Blocker can be given if pt is stable with baseline WPW morphology to prevent patient from going into tachyarrythmia, these settings are called Orthodromic WPW (have narrow complex QRS).

Question 5

What can happen if you give Adenosine or Beta-Blocker to WPW patient in A Fib?

Answer 5

Further dissociation via AV nodal rate decrease, and lead to ventricular fibrillation.

Question 6

What work-up is needed for patients with WPW? How does Asymptomatic Vs Symptomatic change the work-up?

Answer 6

Asx –> patient do NOT need EP Study

*Only acception, if patient has a high risk job –> then even Asx patients with WPW will need EP study and risk stratification.

All SX WPW patients will require EP study and risk stratification.

Question 7

What job is considered high risk jobs for patients with WPW syndrome?

Answer 7

Pilots

Question 8

Most Common Wide Complex Tachycardia?

Answer 8

Ventricular Tachycardia