arrhythmias Flashcards
treatment of sinus tachycardia
find and treat cause
treatment of sinus bradycardia with haemodynamic compromise
atropine + pacing
treatment of sinus arrhythmia
no treatment if asymptomatic
find and treat cause
treatment of sinus pause/arrest
atropine + pacing
treatment of AF
- CCB/B-blocker (rate control, not both together)
- digoxin (rate control)
- amiodarone, flecanide (pharmacological cardioversion, rhythm control)
- synchronised cardioversion (rhythm control)
who should have rate control as first-line treatment for AF
Everyone
Except in patient with:
A reversible cause for their AF
New onset atrial fibrillation (within the last 48 hours)
Heart failure caused by atrial fibrillation
Symptoms despite being effectively rate controlled
when should rhythm control be offered in AF
A reversible cause for their AF
New onset atrial fibrillation (within the last 48 hours)
Heart failure caused by atrial fibrillation
Symptoms despite being effectively rate controlled
treatment of atrial flutter
CCB/b-blocker/digoxin (rate control)
DC cardioversion (rhythm control)
Pharmacological cardioversion (rhythm control)
If haemodynamically unstable = DC cardioversion
treatment for supraventricular tachycardia (AVRT, AVNRT (Wolff-Parkinson-White))
- vagal manoeuvres
- adenosine (x3 doses if doesn’t work)
- verapamil or b-blocker
- cardioversion (1st if haemodynamically unstable)
treatment for VF
ALS, defibrillation (unsynchronised DC cardioversion)
treatment for pulseless VT
ALS, defibrillation (unsynchronised DC cardioversion)
treatment for monomorphic VT
DC cardioversion (synchronised)
amiodarone
treatment for polymorphic VT (torsades de pointes)
magnesium sulfate
isoprenaline
b-blocker
pacemaker
treatment for asystole
CPR
adrenaline
treatment for PEA
find and treat cause
CPR + adrenaline
treatment of 1st degree heart block
no treatment needed
rule out other pathology
treatment of mobitz 1
no treatment needed
treatment of mobitz 2
pacemaker
DO NOT GIVE ATROPINE
treatment of 3rd degree heart block
pacemaker + atropine
treatment of BBB
IV atropine + pacemaker
what intracranial haemorrhage can cause torsades de pointes
subarachnoid haemorrhage
when can AF patients undergo cardioversion without prior anticoagulation
if symptoms present for <48hrs
when should an ECG be repeated post-thrombolysis for STEMI
60-90mins
ST elevation in AVR is highly suggestive of…
3 vessel disease causing myocardial infarction
causes of left axis deviation (7)
left anterior hemiblock
left bundle branch block
inferior myocardial infarction
Wolff-Parkinson-White syndrome* - right-sided accessory pathway
hyperkalaemia
congenital: ostium primum ASD, tricuspid atresia
minor LAD in obese people
causes of right axis deviation (9)
right ventricular hypertrophy
left posterior hemiblock
lateral myocardial infarction
chronic lung disease → cor pulmonale
pulmonary embolism
ostium secundum ASD
Wolff-Parkinson-White syndrome* - left-sided accessory pathway
normal in infant < 1 years old
minor RAD in tall people
