49 - Ventricular Tachyarrhythmias

Question 1

Non-pharm treatment for monomorphic VT unstable?

Answer 1

• cardioversion is effective and safe

- if this is not considered necessary, antiarrhythmic drug therapy can be given

Question 2

Non-pharm treatment for polymorphic VT or VF?

Answer 2

give shock, repeat as necessary until defibrillation is achieved

Question 3

What are non-pharm options for chronic therapy for prevention of VT/VF recurrence?

Answer 3

ICD, catheter ablation, map-guided endocardial resection

Question 4

What are some pharmacologic choices for immediate therapy for sustained VT or VF?

Answer 4

• amiodarone
• procainamide
• magnesium for torsade de points
• BBs can prevent VT or VF in setting of acute MI
• lidocaine

Question 5

What can amiodarone cause?

Answer 5

hypotension or phlebitis

Question 6

lidocaine at high doses can cause ____ effects

Answer 6

CNS

Question 7

What are some pharmacological options for chronic therapy for prevention of VT/VF recurrence?

Answer 7

• BBs to suppress arrhythmias and reduce mortality after MI or in HF
• amiodarone and sotalol
• if resistant to combo of BB and amiodarone, can add a class 1 agent (mexiletine, quinidine or procainamide)