46 - Supraventricular Tachycardia Flashcards
More difficult to achieve ___ control in patients with atrial flutter than patients with A. Fib
HR
The threshold for using catheter ablation is ____ for atrial flutter than for A. Fib
lower
List non-pharms
- Cardioversion
- Catheter Ablation
- Percutaneous Left Atrial Appendage Occlusion
When is cardioversion used?
to terminate the tachycardia electrically if unresponsive to medical management
for patients with A. fib or flutter > 48 hours
Need 3 weeks of ______ prior to cardioversion
anticoagulation
Who is catheter ablation 1st line for?
patients with typical atrial flutter
*also an option for those with A. fib who are symptomatic and either don’t want or can’t have anti-arrhythmic therapy
What is Percutaneous Left Atrial Appendage Occlusion used for?
to decrease risk of systemic embolism
only for those with high risk of stroke from whom antithrombotic tx is precluded
Control ____ in those with more than minimal symptoms
rhythm
Rhythm control:
_____ is more effective than sotalol or propafenone for prevention of recurrences of AF
amiodarone
Rhythm control:
What do you need to monitor while on Amiodarone?
Can elevate serum aminotransferases or cause hepatitis
Monitor LFTs and thyroid
Rhythm control:
What are some options for chemical cardioversion?
- oral flecanaide
- oral propafenone
- IV amiodarone
- ibutilide
- procainamide
Rate control:
List the 2 first line drug classes
- BB
- CCB
Rate control:
When should digoxin be considered?
only when response to 1st line agents is inadequate since it is not very effective and there are concerns that it may increase mortality
Rate control:
Targets for BP ?
- Resting HR < 80 bpm
- Mean HR < 100 bpm
- using 24 hour Holter monitoring
Rate control:
If rate control can’t be achieved with meds, consider what?
AV nodal ablation or permanent pacemaker
