11.2 MTB Step 3 - Arrhythmias (MAT, SVT, & WPW) Flashcards
Cards Complete:
MULTIFOCAL ATRIAL TACHYCARDIA (MAT)
What is the Presentation for MAT?
MAT presents like Atrial Arrhythmia in a patient with
COPD/Emphysema
MULTIFOCAL ATRIAL TACHYCARDIA (MAT)
What are (3) Findings on ECG for MAT?
- Polymorphic P-waves (different Atrial Foci for the QRS complexes)
- Tachycardia (HR > 100bpm)
- Irregular “Chaotic” Rhythm
MULTIFOCAL ATRIAL TACHYCARDIA (MAT)
What is the 2-Step Treatment for MAT?
Step 1: Oxygen
Step 2: Diltiazem
Do NOT use Beta-Blockers!
SUPRAVENTRICULAR TACHYCARDIA (SVT)
What are (3) Common Presenting Signs/Symptoms of SVT?
- Palpitations
- Tachycardia (Ventricular Rate = 160 - 180)
SUPRAVENTRICULAR TACHYCARDIA (SVT)
What are the Best Inpatient & Outpatient Diagnostic Tests for SVT?
Inpatient = Telemetry
Outpatient = Holter Monitor
SUPRAVENTRICULAR TACHYCARDIA (SVT)
What is the Best INITIAL Management for Stable patients with SVT?
Vagal Maneuvers
(Carotid Sinus Massage, Ice Immersion of Face, Valsalva)
SUPRAVENTRICULAR TACHYCARDIA (SVT)
What is the Next BEST Step in Management for Stable patients with SVT who don’t respond to initial treatment?
Adenosine (IV)
Most Frequently asked SVT question
SUPRAVENTRICULAR TACHYCARDIA (SVT)
What is the Best INITIAL Management for Unstable patients with SVT?
Synchronized Cardioversion
SUPRAVENTRICULAR TACHYCARDIA (SVT)
What is the Best Long-Term Management for SVT?
Radiofrequency Catheter Ablation
WOLFF-PARKINSON-WHITE SYNDROME (WPW)
Hows does WPW Present?
WPW presents like SVT that can Alternate with Ventricular Tachycardia (VT)
WOLFF-PARKINSON-WHITE SYNDROME (WPW)
What is a Unique Clue to the Diagnosis of WPW?
Worsening of SVT after the use of:
Calcium-Channel Blockers
or
Digoxin
WOLFF-PARKINSON-WHITE SYNDROME (WPW)
- What is the Best INITIAL Test for WPW?
- What is the Most ACCURATE Test for WPW?
- ECG showing Delta-wave
- Electrophysiologic Studies
WOLFF-PARKINSON-WHITE SYNDROME (WPW)
- What is the Best INITIAL Therapy if the patient is described as being in SVT or VT from WPW?
- What is the Best Long-Term Therapy for WPW?
- Procainamide
- Radiofrequency Catheter Ablation
WOLFF-PARKINSON-WHITE SYNDROME (WPW)
What is the Mechanism of WPW?
- There is an abnormal piece of neutralized cardiac muscle going around the AV node in WPW.
- This can result in either Atrial or Ventricular arrhythmia.
- The slowest conduction in the heart is the AV node.
- Conduction in the aberrant tract is faster; that is why the PR is short (< 120 msec) and there is a Delta-wave of ECG.
- Calcium Channel Blockers and Digoxin block conduction more in the normal AV and force the conduction down the abnormal conduction tract.