AHA SVT 2015 Flashcards

1
Q

What is differential for Wide QRS tachycadia?

A
  • VT
  • SVT with BBB/NSICD pre-existing
  • SVT with rate related aberrancy
  • SVT with wide QRS related to electrolyte or metabolic disorder
  • SVT with conduction over an accessory pathway
  • Paced Rhythm
  • Artifact
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2
Q

What can be done when giving Diltiazem for SVT (Class 2a indication) ?

A

Can give it over 20 minutes

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3
Q

What is more effective in terminating SVT, BB or CCB?

A

CCB

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4
Q

Review SVT treatment algorithm

A
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5
Q

Review chronic management of a Regular SVT

A
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6
Q

What is acute dose of Metoprolol?

A

2.5-5mg IV over 2 minutes, repeat in 10 mins up to 3 doses

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7
Q

What is acute dose of Propranolol in SVT?

A

1mg IV over 1 minute

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8
Q

What is acute dose of Diltiazem?

A

0.25mg/kg/ IV bolus over 2 minutes

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9
Q

What is dose of Verapamil for acute treatment of SVT?

A

5-10mg IV over 2 minutes, can give another 10mg 30 minutes after first dose

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10
Q

How to dose Propranolol chronically?

A

40-160mg divided or single dose with long acting formulations

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11
Q

How to dose Diltiazem chronically?

A

120-360 mg daily

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12
Q

How to dose Verapamil chronically?

A

120-480mg daily

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13
Q

What is starting and max dose of Flecainide?

A

50mg q12h, 150mg q12h

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14
Q

What is Propafenone starting and max dose?

A

225mg BID XR , 425mg BID XR

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15
Q

What is Sotalol starting and max dose?

A

40-80mg q12h, 160mg q12h

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16
Q

What is overall complication rate in SVT ablation?

17
Q

What 2 medications can be used in Innappropriate Sinus Tachycardia?

A

Ivabradine, Beta Blockers

18
Q

how to diagnose Inappropriate Sinus Tachycardia?

A

Mean HR > 90bpm over 24 hours

19
Q

What is recommended for Focal AT as First line form of therapy?

A

Catheter Ablation

20
Q

What is most common kind of SVT?

A

AVNRT (especially in young patients)

21
Q

What is risk of AV block in AVNRT ablation?

22
Q

when can you use AV node blockers in management of AVRT?

A

when Pre excitation not present on baseline ECG

23
Q

When is Catheter ablation indicated in asymptomatic patients with WPW? (2)

A
  • High risk pathway on EPS
    a) RR < 250 msec in induced Afib with preexcitation
    b) Antegrade RP < 240 msec
    c) Sustained AVRT
    d) AVRT precipitating Afib
    e) Multiple pathways

-If presence of pre-excitation precludes specific employment (pilots)

24
Q

What is the only 2 antiarrhythmics that is listed as class 1 for cardioversion of Atrial Flutter?

A

Dofetilide (oral)

Ibutilide (IV)

25
What three drugs can be used to maintain sinus rhythm in Atrial Flutter chronically?
- Amiodarone - Dofetilide - Sotalol
26
Is the fast or slow pathway of the AVNRT supposed to be ablated?
Slow pathway
27
How does recommendations of AV node blockade change in Orthodromic AVRT if pre-excitation is present on resting ECG?
- if pre-excitation present it is a class IIb, (Class 1c is class 2a), ablation Class 1 - If pre-excitation not present, it is a class 1 alongside catheter ablation