Arrhythmia

Question 1

Incidence of post op A-fib

Answer 1

35%

Question 2

How to decrease risk of post-op afib

Answer 2

Pretreat with Amiodarone, beta block, and/or statin (ACC/AHA level of evidence B)

Question 3

What is cardiac resynchronization therapy (CRT)?

Answer 3

Coordinates the contraction of the right and left ventricles by synchronous pacing of both ventricles with separate leads. This minimizes interventricular conduction delays, used to manage CHF. (LV lead is placed in the coronary sinus).

Question 4

Inclusion criteria for CRT (5)

Answer 4

1. Cardiomyopathy (ischemic or nonischemic)
2. NYHA III or IV despite optimal medical management
3. LV EF < 35%
4. QRS >120 msec (bundle branch block)
5. Sinus rhythm

Question 5

Contraindication for CRT (2)

Answer 5

Afib (relative exclusion criteria)

Chronic inotropic support requirement

Question 6

Cause of WPW

Answer 6

accessory pathway between atria/ventricle (bundle of kent)

Question 7

Diagnostic features of WPW

Answer 7

Short PR interval (120 ms)
Delta wave (slurrying of QRS)

Question 8

Treatment for WPW

Answer 8

1. Synchronized cardioversion
2. Procainamide or amiodarone
3. Avoid AV nodal blockers!!!!
4. Catheter-based ablation of accessory pathway

Question 9

Cox-Maze III operation

Answer 9

Standard cut-and-sew- lesions of the right and left atria, which block the reentrant circuits that perpetuate atrial fibrillation. Benefits include decreased risk of stroke and improved late LV function

Question 10

Cure rate of Cox Maze III

Answer 10

70%

Question 11

COPD patients have higher rates of what complication after open heart surgery

Answer 11

Arrhythmia