Arrhythmias Flashcards
What are the most common initiating factors in arrhythmias in critically ill patients?
Hypoxia
Catecholamines
Electrolytes
Ischaemia
What causes a stable wide complex tachycardia?
Ventricular tachycardia
Supraventricular tachycardia with bundle branch block
Antegrade conduction via accessory AV pathway
What does a fusion beat suggest?
Indicates AV dissociation. Highly suggestive of ventricular tachycardia
What does a capture beat suggest?
Indicates AV dissociation. Highly suggestive of ventricular tachycardia.
A wide complex tachycardia should always be assumed to be:
Ventricular tachycardia.
What is the treatment for monomorphic VT?
If unstable: synchonised cardioversion
If stable: amiodarone, procainamide, sotalol, or antiarrhythmia pacing.
What are some potential drug treatments for monomorphic VT?
Amiodarone
Procainamide
Sotalol
Antiarrhythmia pacing
Polymorphic VT should be assumed to be due to:
Ischaemia
What are some causes of prolonged QTc?
Electrolyte abnormalities (hypo-K, hypo-Mg)
Hypothermia
Drugs (antiarrhyhmics, erythromycin, TCAs)
Intracranial bleeding
Heart-block with bradycardia
How do you manage Torsade?
Withdraw precipitating agent
IV magnesium.
Isoproterenol or rapid ventricular pacing
How do you manage regular supraventricular tachycardia?
- Vagal manoeuvre.
- Valsalva manoeuvre.
- Carotid sinus massage
Contraindications to carotid sinus massage:
Carotid stenosis
Carotid bruit
What is the treatment for wide complex regular supraventricular tachycardia?
Adenosine
If ineffective, can try procainamide or amiodarone.
How should narrow complex regular supraventricular tachycardias be treated?
Adenosine
Verapamil or diltiazem
Can sinus rhythm be restored in chronic AF?
Generally futile
