Flashcards in ventricular arrhythmias Deck (35)
what are the main VAs? 5
- torsades des pointes
- ventricular fibrillation
- premature ventricular complex
what does TdP look like on an ECG?
like VF but it is actually VT with varying axis
- there is a broad QRS complex and continuously changing QRS morphology
is the rhythm regular or irregulaar in TdP?
what may be the events leading to TdP?
- prolongation of the action potential (drug induced)
- renal impairment (increased drug levels)
what does PVC look like on ecg?
very borad QRS
There is a fall in ___ following the ectopic beat - the patient might feel light headed
There is a fall in BP following the ectopic beat - the patient might feel light headed
what are some of the causes of PVC?
- Ischaemic heart disease,
- hypertension with left ventricular hypertrophy
- heart failure
- May be marker for inherited arrhythmia syndromes e.g. cardiomyopathy
if PVC worse on ______, need to investigate further
If worse on exercise, need to investigate further
what drugs are used in the treatment of PVC?
most patients who get VT have significant heart disease , such as....
- coronary artery disease
- previous MI
what are the rare causes of VT?
- inherited/ familial syndromes
give some examples of inherited/familial arrhythmia syndrome that can cause VT?
what is the difference between monomorphic and polymorphic VT?
monomorphic - the qrs stay relatively stable
why do the QRS stay relatively stable in monomorphic VT?
each ventricular impulse is being generated from the same place in the ventricles
monomorphic VT is usually due to ______
polymorphic VT is usually due to ______ _ _______
what is VF?
a chaotic ventricular electrical activity which causes the heart to lose the ability to function as a pump
what is the treatment for VF?
- DC cardioversion
- cardiopulmonary resuscitation
what is the abnormilty in conduction in brugada syndrome?
there are faulty sodium channels which predispose to fatal arrhythmias
which group of people typically get brugada?
what can trigger brugada?
how do you prevent the arrhythmias caused by brugada if you know someone has it?
how do you manage acute long QT syndrome?
- correct any electrolyte disturbance
- stop causative drugs
- heart rate maintaed with atrial or ventricular pacing
- IV isoprenaline when QT prolongation is acquired
when do you not use isoprenaline in treatment of long QT?
when QT prolongation is congenital
what is the long term management of long QT?
- beta blockers
- left cardiac sympathetic denervation
- pacemaker therapy
what are the causes of VT and VF?
- mainly due to structural heart disease
- can be primary electrical disease though
what is the treatment for acute VT?
- dc cardioversion if unstable
acute CV only if it is an emergency
- if stable consider pharmcologic cardioversion with AAD
- consider adenosine to make a diagnosis
what may be the causes of VT?
- electrolyte- hypokalaemia hypomagnesaemia
- medications that prolong the QT interval
which medications may prolong the QT interval?
sotalol. quinidine, terfenadine, erythromycin, digoxin