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RCE Guidelines Studying > AHA 2018/ESC 2021 Pacing/CRT > Flashcards

AHA 2018/ESC 2021 Pacing/CRT Flashcards

1
Q

When to arrange exercise testing for bradyarrhyhtmia?

A

When associated bradycardia/symptoms with or post exercise

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2
Q

What infection should be tested for in Brady?

A

Lyme titres

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3
Q

When to test for genetic testing for brady?

A

when prsents with < 50y

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4
Q

What frequency of symptoms (or less) to recommend ILR for brady?

A

Monthly or less

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5
Q

2 class 1 indications in SND?

A

-Symptomatic Sinus Node Disease

-Symptomatic Sinus bradycardia from GDMT

Two class 2a:
-Tachy-brady syndrome
-Symptomatic chronotropic incompetence

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6
Q

Recommendations for pacing in AV block?

A

-AF with symptomatic slow ventricular response

-Heart block, Mobitz II or high grade AV block despite symptoms

-2nd degree heart block of CHB or HV > 70 in neuromuscular disease

-Symptomatic AV block due to GDMT

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7
Q

2 class 1 indications for pacing in BBB?

A

-Unexplained syncope with bifascicular block and HV > 70

-Alternating BBB

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8
Q

What is the class 1 indication for reflex syncope?

A
  • > aged 40 with recurred syncope who had asystolic syncope with tilt table testing, cardioinhibitory CSS or spontaneous documented symptomatic asystolic paus > 3s or asymptomatic pauses > 6s
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9
Q

When can leadless pacemakers be considered? (3)

A

-No upper extremity venous access

-Risk of device pocket infection is high (previous infection)

-IHD

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10
Q

Pacing post MI Indications? How long to wait?

A

CHB, Mobitz II, High grade AVB, Alternating bundle branch block

Wait 5 days

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11
Q

How long to wait after CHB for PPM post CABG?

A

5 days

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12
Q

What valve prosthetic to avoid RV lead?

A

-Mechanical TVR

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13
Q

3 ECG predictors of PPM post AVR?

A

-RBBB

-LAFB

-Prolonged PR interval

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14
Q

3 patient related RFs for PPM after AVR?

A

-Older

-Male

-BMI

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15
Q

3 procedural related RFs for PPM in AVR?

A

-Valve in valve

-Self expandable valve

-Larger ratio between prosthesis diameter vs annulus of LVOT

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16
Q

2 class 1 indications for PPM after TAVR?

A

-Alternating BBB

-Persistent high grade AVB

17
Q

What to implant PPM in NMD?

A

-Any second or third degree ABV

-HV > 70

18
Q

What condition where any AVB, BBB or fascicular disease should warrant PPM?

A

Kearns-Sayre

19
Q

What is antibiotic regimen before CIED?

A

-Within 1 hours of skin incision

20
Q

What is definition of Sinus brady according to AHA 2018?

A

< 50 bpm

21
Q

5 Infectious causes of bradycardia?

A

Myocarditis
Lyme disease
Chagas
Toxoplasmosis
Diphtheria
Infective Endocarditis

22
Q

3 inflammatory causes of brady?

A

Scleroderma

RA

SLE

23
Q

Should you get an echo for LBBB?

A

Yes (Class 1 indication)

24
Q

Three electrolyte abnormalities that cause brady?

A

Hyperkalemia

Hypokalemia

Hypoglycemia

25
Q

What are three congenital causes of heart block?

A

-Maternal SLE

-SCN5A mutation

-L-TGA

26
Q

4 infectious causes of heart block?

A

-Toxo

-Lyme

-Endocarditis with abscess

-Chagas

27
Q

3 muscular dystrophies that can cause heart block?

A

“KEMP”

Kearns-Sayre
Erb’s dystrophy
Myotonic dystrophy
Pascicohumeral delay

28
Q

When to implant PPM in Kearns Sayre/Myotonic Dystrophy? When to implant ICD?

A

-CHB, 2nd degree regardless of symptoms, HV > 70 regardless of symptoms

-ICD if survival > 1 year expected

29
Q

What are 2 class 1 indications for PPM in conduction system disease with 1:1 conduction?

A

-Alternating bundle branch blocks

-Syncope with BBB AND HV > 70 msec on EPS

30
Q

What is recommended in patients post Afib surgery?

A

Temporary Epicardial pacing wires

31
Q

5 indications for pacing in congenital heart block?

A

-Symptomatic bradycardia

-Wide QRS escape rhythm

-Mean HR < 50

-Complex ventricular ectopy

-Ventriculaar dysfunction

32
Q

Pacing indications in acute MI?

A

-TVP: Medically refractory symptomatic or hemodynamically significant bradycardia related to SND or AV block

-Permanent: Mobitz II, High grade AV block, CHB, Alternated Bundle branch block after a waiting period

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