Arrhythmia Flashcards
What is the presentation of arrhythmia?
Can be asymptomatic.
Signs - palpitations, embolism.
Symptoms - SOB, chest pain, fatigue.
10% of >80yr olds have AF.
What are the investigations of arrhythmia?
ECG - irregularly irregular, oscillations of baseline, no P waves, 120-180bpm.
Bloods - thyroid function.
Echocardiogram.
What is the treatment for arrhythmia?
BBs, CCBs, digoxin, flecainide, amiodarone.
DC cardioversion.
Pace and ablasion of the AVN, pulmonary vein isolation, surgery.
NOACs and warfarin (bleeding < stroke).
What is SVT?
AVN re-entrant tachycardia, or via an accessory pathway (WPW can occur).
Signs - palpitations, SOB, dizziness.
Treatment - RFA (waves interrupt pain signals to the brain, high success rate, low recurrent rate).
Prognosis - good.
What is the management and treatment of AF?
Management - controls ventricular rate and thromboembolic risk.
Treatment - cardioversion, AA drugs, or RFA of cavotricuspid isthmus.
What is VF?
Requires cardiac arrest protocol.
What are the signs, symptoms, and investigations of VT?
Signs - palpitations, cerebral palsy.
Symptoms - dyspnoea, dizziness, syncope (usually caused by structural heart disease).
Investigations -12 lead ECG, bloods, echo, angio.
What is the treatment of VT?
Cardiac arrest protocol, DC cardiovert.
Drugs for underlying causes - AA drugs, ICD (implantable cardioverter-defibrillator).
What is TdP?
Torsades de Pointes.
A type of ventricular tachycardia, due to congenital heart block (CHB) or AF.
Short-long-short RR intervals.
Prolonged repolarisation.
What is Long QT syndrome?
Congenital (autosomal dominant) or acquired.
May cause TdP.
Treatment - withdraw offending drugs, correct electrolyte balance, reduce HR (if heart block).
What are the indications for ICD?
Secondary prevention - cardiac arrest due to VF/VT, not due to transient or reversible causes (early phase of acute MI).
Sustained VT, causing syncope/compromise, or with poor LV function.
What is sick sinus syndrome?
A type of heart rhythm disorder, causing slow heartbeats, pauses, and arrhythmias.
Post MI - an asymptomatic SAN.
What is 2nd degree heart block?
Mobitz Type I - PR intervals elongate, until a QRS complex is missed.
Mobitz Type II - PR intervals stay the same, but some QRS complexes are missed.
What is 3rd degree heart block?
Regular P wave, but with no relationship to the QRS complexes or ventricular activity.
What are the indications for pacemakers?
2nd/3rd degree heart block.
After (or preparing for) AVN ablation.
Alternating RBBB or LBBB.
Sinus node disease with symptoms.
Poor LV function with LBBB (cardiac resynchronisation therapy pacemaker or defibrillator).
