anythmias Flashcards
how can arrhythmias present
asymptomatic/incidental
palpitations, SOB, chest pain fatigue
embolism
what can cause a embolism
atrial fibrillation
how can a arrhythmia be investigates
ECG - 12 lead for 24hours
blood test - thyroid function
echocardiogram
what are the threptic approaches to arrhythmias
rate control (bpm)
vs
rhythm control (sinus rhythm)
what is the cause of supra ventricular tachycardia
AV node re-entrant tachycardia - the impulse bounces around the atrium
what are the sings/symptoms of supra ventricular tachycardia
palpitations, dyspnoea, dizziness
what is the prognosis
good
RFA is used and high success rate
what is RFA
Radio Frequency Ablation - burring of the effective electrical tissue
what is the treatment for atrial flutter
use drugs or electricity to sort out
control ventricular rate
and be mindful of thromboembolic risk
what is the treatment for ventricular fibrillation
cardiac arrest protocol
- AED
what are the sings/symptoms of ventricular tachycardia
palpitations, dyspnoea, syncope
what usual causes ventricular tachycardia
structural heart disease
get bloods, echo and angiogram
what are the indications for ICD (inter cardiac device)
secondary prevention of disease ie MI caused by -
ventricular tachycardia/ fibrillation
what is 1st degree heart block
first degree atrioventricular block is the PR prolongation lengthened beyond 0.2 seconds
what is 2nd degree heart block
when your heart will skip a QRS complex
what are the two types of 2nd degree heart block
type 1
type 2
what is type 1 2nd degree heart block
when the heart ‘‘builds up’’ to the skipping of a QRS complex - meaning its in a pattern - body can usually cope
what is type 2 2nd degree heart block
when the heart skips a QRS at irregular intervals - body cant cope with this
what is type 3 heart block
when none of the P waves conduct a QRS complex they just happen independently of each other
what can all antiarrhythmics cause
arrhythmias
where is a thrombus most likely to occur in AF
the left atrium appendage
what are indicators for anticoagulation
atrial fibrillation - stroke risk,
DVT, PE
metallic heart valves
post operative patients
high risk medical patients
immobilisation
what is the most use antiplatelet drugs
warfarin, rivaroxaban
what are some adverse effects of antiplatelet therapy’s (warfarin)
bleeding
drug-drug interactions
pregnancy’s - teratogenic
when should pregnant women avoid taking warfarin
first and third trimesters
what are the classes of antiarrhythmic drugs
1A
1B
1C
2
3
4
5
what is a example of a class 1A drug
quinidine
what is a example of a class 1B drug
lidocaine
what is a example of a class 1C drug
flecaindie
what are class 1 antiarrhythmics drugs
membrane stabilising agents
more effective at higher HR
what are examples of class 2 antiarrhythmic drugs
beta blockers - atenolol, propranolol
what do class 2 antiarrhythmic drugs do
prolong phase 4 depolarisation
slows SA discharge
negative effect on contractility
what are the drugs for the first line for atrial fibrillation
class 2 - betablockers (bisoprolol)
what are class 3 effects
increase action potential duration
prolongs ERP
what is ERP
effective refractory period
what are class 3 antiarrhythmic drugs used for
difficult to treat arrhythmias
life-threatening/ sustained ventricular tachycardia
what is a example of a class 3 antiarrhythmic drugs
amiodarone
what are class 4 antiarrhythmic drugs
calcium channel blockers
slows heart rate - slows AV conduction
what is digoxin used for
heart failure
Atrial fibrillation/flutter
what does digoxin do
increase vagal tone
slow SA/AV node conduction
