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CV Test 4 > Electrophysiology > Flashcards

Electrophysiology Flashcards

(59 cards)

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1
Q

What is syncytium?

A

A functional unit of contraction

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2
Q

Why does current conduct easily though originating syncytium?

A

Tight intracellular junctions

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3
Q

What is between the atrial syncyctium and the ventricular syncyctium?

A

A fibrous non-conductive layer

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4
Q

What predicts/shows automaticity?

A

Phase 4

-spontaneous upward drift

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5
Q

Why is there a delay at the AV node?

A

Allows atria to empty before ventricular contraction

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6
Q

What is the connective tissue that allows the signal to pass the fibrous non-conductive layer?

A

Atrioventricular bundle

AKA Bundle of His

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7
Q

What is absolute refractory period?

A

When no stimulus, no matter the size will excite muscle

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8
Q

What time does absolute refractory correspond with?

A

Depolarization

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9
Q

What is relative refractory?

A

Time when muscle does not respond to normal stimulus, but will to a strong stimulus

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10
Q

What causes refractory times?

A

Conformation changes in the Na+ channel to inactivated state

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11
Q

Which electrical therapy has less joules, cardioversion or defibrillation?

A

Cardioversion

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12
Q

When does cardioversion deliver shock?

A

During QRS

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13
Q

What rhythms respond to cardioversion?

A

Afib
A flutter
V tach

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14
Q

Why is cardioversion delivered on QRS?

A

Less chance of inducing more lethal dysrhythmia

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15
Q

With what other treatment does cardioversion carry an increase risk of producing worse dysrhythmia?

A

Digoxin toxicity

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16
Q

What risk does cardioversion of atrial fibrillation carry?

A

Embolization of atrial thrombi

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17
Q

What is usually done to prevent atrial thrombi embolization for cardioversion of Afib?

A

Heparinization

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18
Q

When is heparinzation for cardioversion of Afib not needed?

A

New onset

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19
Q

What medication(s) are usually used for cardioversion?

A

Methohexital

Propofol

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20
Q

What rhythms is defibrillation used for?

A

V fib

Pulseless V tach

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21
Q

First degree HB treatment?

A

Rarely needs treatment

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22
Q

Second degree type I HB treatment?

A

Usually transient, rarely needs treatment

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23
Q

Second degree type II HB treatment?

A

Greater risk of progression to completely HB

-consider prophylaxis pacemaker

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24
Q

What is the output of a pacemaker, and it’s units?

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A

The strength coming from the device

Measured in mili-amps (MA)

25
What is the sensitivity of a pacemaker?
The sensing of intrinsic (patient’s) activity
26
What rhythms is a permanent pacemaker used for?
Bradycardia Heart block Sick Sinus Syndrome
27
What does a magnet do to a permanent pacemaker?
Converts pacemaker to an asynchronous pace | -paces at a set pace no matter what
28
What is a (minor) concern with Succinylcholine and a pacemaker?
Muscle fasiculations may be sensed as cardiac activity
29
What is done to help minimize interference with electrocautery and pacemakers?
Grounding pad placed far from heart Use low setting and short bursts Bipolar bovie is preferred
30
What is the pacemaker code?
Chamber paced Chamber sensed Response of device
31
What is asynchronous mode?
Devices paces at set rate no matter what | VOO
32
What is demand mode?
Devices senses intrinsic activity and responds appropriately VVI
33
What is AV sequential pacing?
Dual chamber pacing
35
What is meant by output on pacemaker?
MA | Causes the spike
36
What is meant by output failure? Fix?
No pacing spike seen Turn up MA Reposition lead
37
What is meant by sensitivity with pacemaker?
The ability to detect patient’s intrinsic cardiac activity
38
What is meant by capture with a pacemaker?
Capture is the appropriate waveform after a pacing spike?
39
What is meant by failure to capture? Fix?
Pacing spike seen, but no waveform follows (MA is less than threshold) Turn up MA Reposition lead
40
What is meant by failure to sense? Fix?
Pacemaker fires when it should not -not detecting intrinsic activity when it occurs Need to increase sensitivity
41
How is sensitivity increased on a pacemaker?
Setting changed to a lower number (this increases sensitivity)
42
What is an AICD?
Automatic implantable cardiac device | -defibrillator
43
Who is an AICD used on?
Patients with repeated ventricular dysrhythmia that is unresponsive to drug therapy
44
What does an AICD do?
Diagnoses rhythm and delivers shock if/when needed
45
What are the precautions with an AICD?
Same as pacemaker
46
During implantation of an AICD, what should anesthesia avoid giving to the patient?
Meds that will inhibit induction of lethal dysrhythmias to test AICD function -lidocaine
47
What is done during surgery when patient has an AICD?
Rep will/can turn off device | Magnets don’t deactivate them all
48
What is sick sinus syndrome?
Aging and wearing out of the SA node
49
What s/sx are often seen with SSS?
``` Bradycardia is common Tachycardia is possible Syncope Palpitations Can be asymptomatic ```
50
What is the treatment for SSS?
Permanent pacemaker | May need SVT suppression meds as well
51
What is pre-excitation syndrome?
An abnormal accessory pathway that bypasses the AV node
52
What occurs do to this bypass of the AV node?
Signal arrives to the ventricle without delay Refractory times occur in different areas Dysrhythmias in the ventricle
53
What is the most common pre-excitation syndrome?
Wolf Parkinson White
54
What is the name of the accessory pathway in Wolf Parkinson White?
Kent’s bundle
55
What kind of symptoms with patient’s with Wolf Parkinson White have?
Paroxysmal supraventricular tachycardia -sudden on set of high HR Sudden death
56
What is the treatment for Wolf Parkinson White?
Cardioversion Procainamide Surgical ablation
57
What should NOT be given to patients with Wolf Parkinson White? Why?
Verapamil Digoxin Dysrhythmia made worse
58
What is the goal with patients with pre-excitation syndrome?
``` Avoid dysrhythmia Reduce SNS stimulation -SNS stimulation increases conduction -adequate depth -avoid ketamine -CV stable NMB use ```
59
It is okay to use anticholinergics to reverse NMB when patient has pre-excitation syndrome?
Yes in appropriate dose
60
What is maintained with AV sequential pacing?
Atrial kick

CV Test 4 (2 decks)

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