Arrhythmia Clinical Treatment

Question 1

with disorders of reduced automaticity like junctional rhythms or sinus bradycardia, what is the best treatment option?

Answer 1

beta agonist like isoproteronol

or atropine…M2 antagonist

Question 2

what are the treatment protocols for 1st degree, 2nd degree and 3rd degree AV block?

Answer 2

1st needs no treatment
2nd may need beta agonist or cholinergic antagonist
3rd does not really respond

Question 3

what is the best treatment option for patients with symptomatic bradycardia?

Answer 3

pacemaker that can sense heart activity and crank it up when needed

Question 4

for 3rd degree AV block, what is best type of treatment?

Answer 4

ventricular pacing

Question 5

beta blockers and class IV anti arrhythmic drugs can treat what 3 things?

Answer 5

reduce likelihood of abnormal automaticity
reduce likelihood of triggered activity
reduce likelihood of reentrant circuit initiation

they pretty much cause the AV nodal cells and other cells to slow down

Question 6

what three drugs/classes help treat reentrant rhythms and how?

Answer 6

class I, III and adenosine…they do it by increasing refractory and decreasing conduction velocity

Question 7

what is the drug of choice for AVRT ofAVNRT?

Answer 7

adenosine cause it resets the AV node

Question 8

what does a cardioversion do?

Answer 8

it shocks cardiomyocytes and causes them to depolarize simultaneously so you lose any reentrant circuits with the reset and allows the SA node to take back over

Question 9

what is the difference between cardioversion and defibrillation?

Answer 9

with cardioversion you shock at the start of the QRS (synchronize) and defib it does not matter

Question 10

when do you use defib over cardioversion?

Answer 10

if patient in V fib or V tach

Question 11

what is antitachycardia pacing and how does it work?

Answer 11

when you pace at a faster rhythm than the heart is actually beating…it will actually lead to extinction of the reentrant arrythmia

Question 12

when do we use antitachycardia pacing?

Answer 12

with a reentrant arrhythmia

Question 13

do defib, cardioversion or antitachycardia pacing prevent future arrhythmias?

Answer 13

hell no

Question 14

what is an AICD and who do we give it to?

Answer 14

automatic implantable cardioverter defibrillator

give it to patients at risk of vent tach or vent fib…will sense when these start and defibrillate

Question 15

what is the only treatment that can prevent future arrhythmias and how does it work?

Answer 15

ablation…kill of the myocytes with the problem via surgery…sorta like cauterizing them

Question 16

what are some common times to use ablation therapy?

Answer 16

when you have a reentrant circuit, or abnormal automaticity tissue

examples include atrial fibrillation and knocking out the pulmonary vein automaticity tissue
Taking out accessory pathways in AVRT