Arrhythmia treatment Flashcards
when to treat bradycardia
<40 bpm or symptomatic
treat bradycardia with
atropine IV
no response to atropine in bradycardiA?
temporary pacing wire
atropine mechanisms of action
blocks neuroeffector transmission in the parasympathetic division of the autonomic nervous system by competitive antagonism of muscarinic acetylcholine receptors.
what other condition is atropine used in
anticholinesterase poisoning to reduce parasympathetic activity e.g. bradycardia.
sick sinus syndrome typically causes what
inappropriate sinus bradycardia
what may occurs with sick sinus syndrome
AF and thromboembolism
if sick sinus syndrome is symptomatic we
pace
atrial flutter or fibrillation treatment and aim
control ventricular rate
BB
(digoxin or amiodarone alternatively)
Atrial fibrillation ECG
no P waves and irregular baseline
normal shape QRS
atrial flutter ECG
sawtooth baseline
SVT narrow or broad complex
narrow
SVT treatment
vagotonic manoeuvres eg valsalvo followed by IV adenosine or verapamil
SVT if compromised
DC shock
maintenance of SVT
BB or verapamil
VT broad or narrow complex
broad
VT ECG
wide and abnormal QRS as excitation spreads through an abnormal path through the ventricle
VT treatment
amiodarone or lidocaine
class IB drug
lignocaine
class IC drug
flecainide
what drug is used mainly in VT following MI
Lignocaine
don’t used flecianide in patients with
structural heart disease
amiodarone adverse effect
slate grey rash
amiodarone shouldn’t be used for
long term
serious side effects e.g. photosensitivity, thyroid disorders, neuropathy
