Arrhythmia and AF Flashcards
When is external cardiac pacing used in patients with symptomatic Bradycardia?
When Atropine fails to increase the patient’s heart rate
What are some adverse signs associated with symptomatic Bradycardia?
Shock, syncope, myocardial ischaemia, heart failure
What is Bradycardia defined as?
< 60 bpm
What do the QRS complexes appear like in VT and SVT?
VT = Broad complexes SVT = Narrow complexes
What is Tachycardia defined as?
> 100 bpm
A patient with broad complex tachycardia is unstable, what is the first line treatment option?
Cardioversion
A patient with broad complex tachycardia is stable, what is the first line treatment option?
Amiodarone, then Lidocaine, then Procaindamide
A patient with narrow complex tachycardia is unstable, what is the first line treatment option?
Cardioversion
A patient with narrow complex tachycardia is stable, what is the first line treatment option?
Valsalva manoeuvre, if this fails, then Adenosine 6mg, if this fails then Adenosine 12 mg
What are the three ECG changes associated with Atrial Fibrillation?
- Absent p waves
- Presence of fibrillatory waves
- Irregularly irregular QRS complexes
What is the best way to diagnose Paroxysmal AF?
Holter monitoring
Strokes from AF commonly form where?
In left atria appendage
Patients with AF have a _ fold increased risk of stroke
Five-fold risk
What is the HASBLED tool used for?
To assess the 1-year risk of major bleeding in AF patients taking anticoagulants
Discuss the points of HASBLED screening tool? How many points is for each component?
H - Hypertension (1) A - Abnormal renal / liver function (1/2) S - Stroke (1) B - Bleeding (1) L - Labile INR (1) E - Elderly >65 (1) D - Alcohol / drugs (1/2)
Maximum score is 9. >3 is a high risk of bleeding
What is the CHADSVASc tool used for?
Used to assess risk of stroke in AF patients
Discuss the points of CHADSVSc screening tool. How many is for each component?
C - Congestive Heart Failure (1) H - Hypertension (1) A - Age 65-74, >75 (1/2) D - Diabetes (1) S - Stroke / TIA (2) V - Vascular Disease i.e. MI (1) S - Sex i.e. Female (1)
If >2, Offer coagulation
What is Paroxysmal, Persistent and Permanent AF?
Paroxysmal = < 7 days long Persistent = > 7 days, not self-terminating Permanent = > 7 days, resistant to therapy
If a male patient and a female patient had a CHADSVASc score of 1, how does this guide treatment options?
Males - Consider anticoagulation
Females - Do not consider until score is 2