Arrhythmias Flashcards
Atrial Fibrillation
-Definition
Lone (single episode)
Paroxysmal (comes & goes)
Persistent (more than 7 days)
Permanent (chronic; sustained)
Afib Managment
-HR control
-AC
-Cardioversion +/- TEE
-Rhythm control
-Ablation
AC Post Cardioversion
-MI stunning occurs
-AC for minimum 4-6 weeks
-F/up outpatient
-May stop ATC if can prove sustained SR and low risk
Afib management w/ rate control
-BB: metoprolol, Atenolol, Esmolol
-CCB: Diltiazem
-Digoxin (alone is adequate)
Afib management with rhythm control
-Amiodarone
Dofetilide
Dronederone
Flecainide
Propafenone
Sotalol
-EP consult
-Cardioversion
Afib management with procedures
-Ablation
-AV node ablation with pacemaker
-Surgical MAZE procedure
-LAAL: This is done during CABG
Other management of Afib
-Check thyroid function
-Treat underlying cause (infection)
-Reduce post op stress
-Modify triggers (etoh, tobacco, drugs, caffeine, stress)
-Weight loss
-Treat HTN, HF, MI, Valve disease
-Screen for OSA
Aflutter Tx
Adenosine- ACLS
Agents for heart rate contol
Anticoagulation
Cardioverion (+/- TEE)
If sustained Atrial Flutter, consult Electrophysiology to consider Ablation
Cavotricuspid Isthmus (CTI) Ablation is most common
Wolf-Parkinson White Syndrome
-Accessory pathway mediated tachycardia (pre-excitation)
-Tx:
Amiodarone
Procainamide
Consult EP to consider ablation
*NO ADENOSINE (if in AF), DIGOXIN OR AV NODAL BLOCKING AGENTS!!!