2. Ventricular Arrhytmias

Question 1

What is ventricular arrhythmias

Answer 1

Ventricular arrhythmias are abnormal heartbeats that originate in your lower heart chambers, called ventricles. These types of arrhythmias cause your heart to beat too fast, which prevents oxygen-rich blood from circulating to the brain and body and may result in cardiac arrest.

Question 2

Tx

Pulse less or fibrillation

Medical
Emergency

Answer 2

Defibrillation

+

CPR

+

IV Adrenaline every 3-5 mints

Fail?

IV Amiodarone

+

Lidocaine

Question 3

Unstable super-ventricular tachycardia (USVT)

Tx

Answer 3

Direct current cardioversion

Fail?

IV Amiodarone

+
Repeat direct current cardioversion

Question 4

Stable SVT

TX

Answer 4

IV anti arrhythmics (Amiodarone preferred)

Question 5

Non- sustained VT

Tx

Answer 5

B.B

Most patients implant defibrillator

Alternatively or add

BB( incl SOTALOL)

Or

BB + Amiodarone

Question 6

Torsade de pointes

Tx

Answer 6

IV mg sluphate

CI in drugs causing prolonged QT interval such as SOTALOL, Amiodarone, SSRIs

Question 7

Paroxysmal (SVT)

Tx

Answer 7

Terminated spontaneously with basal nerve stimulation:

Face in ice
Strain like pooping
Nose mouth suffocation

Fail?

IV adenosine (CI in COPD/Asthma)

Alternatively

IV verapamil

Question 8

Patient haemodynamically unstable

( Haemodynamic stability is the term used to describe stable blood flow. When it is said that someone is hemodynamically stable, it means the blood pressure and heart rate of that person are stable)

Therefore unstable

Recurrent episode:

Answer 8

Direct cardioversion

Recurrent episode: catheter ablation

OR

BBlockers

Verapamil

Dilitiazem

Flecainide

Propafenone

Question 9

The only (rate limiting) CCB licensed for arrhythmia

Answer 9

Verapamil