Arrhythmia - Pathophysiology, Presentation & Investigation Flashcards
What are some different kinds of arrhythmias?
Supraventricular ectopics
Supraventricular tachycardia
Ventricular tachycardia
What is an ectopic heart beat?
When the heart either skips a beat or adds an extra one
What is it called when the heart either skips a beat or adds an extra one?
Ectopic heart beat
What is the presentation of supraventricular ectopics?
Asymptomatic
Palpitations
Dyspnoea
Chest pain
Fatigue
Embolism
What investigations are done for supraventricular ectopics?
Document arrhythmia on 12 lead ECG (24 hour recording)
Blood tests (especially thyroid function)
Echocardiogram
What are some therapeutic approaches for supraventricular ectopics?
Rate control versus rhythm control
Electrical approaches
Consider anticoagulation
What is used for rate control versus rhythm control for supraventricular ectopics?
Digoxin/beta blocker/calcium antagonist plus warfarin versus class Ic/III drug with or without DC cardioversion
What are electrical approaches to treat supraventricular ectopics?
Pace and ablation of AV node
Substrate modification such as pulmonary vein ostial ablation
What are examples of supraventricular tachycardia?
AV-nodal-re-entrant tachycardia
Atrial flutter
Atrial fibrillation
Ventricular fibrillation
What is the most common kind of supraventricular tachycardia?
AV-nodal re-entrant tachycardia
What is AV-nodal re-entrant tachycardia often due to?
Accessory pathway such as Wolff-Parkinson-White (WPW) syndrome
What does WPW syndrome stand for?
Wolff-Parkinson-White syndrome
What does supraventricular tachycardia manifest as?
Palpitations
Dyspnoea
Dizziness
What is Wolff-Parkinsons-White (WPW) syndrome?
Where in addition to the AV node there is an additional conducting pathway between the atria and ventricles, which conducts action potentials faster than the AV node and therefore results in a short PR interval and a different shaped QRS wave
How does WPW syndrome change the ECG?
Shorter PR interval
Different shaped QRS wave
What is atrial flutter?
Tachycardia of the atria but the beat is regular
What is tachycardia of the atria with a regular beat called?
Atrial flutter
What is atrial fibrillation?
Tachycardia of the atria with an irregular beat
What is tachycardia of the atria with an irregular beat called?
Atrial fibrillation
What is this?
Atrial flutter
What is the treatment of atrial flutter?
Control ventricular rate and thomboembolic risk
Prevent with AA or radiofrequency (RF) ablation of cavotricuspid isthmus
What does RFA stand for?
Radiofrequency ablation
What is radiofrequency ablation (RFA)?
Medical procedure in which part of the electrical conduction system of the heart is ablated (removed) using the heat generated from medium frequency alternating current
What is a medical procedure in which part of the electrical conduction system of the heart is ablated (removed) using the heat generated from medium frequency alternating current?
Radiofrequency ablation (RFA)
What does ablated mean?
Removed
What is ventricular fibrillation?
Heart rhythm problem that occurs when the heart beats with rapid electrical impulse, causing the chambers to quiver uselessly instead of pump blood