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Cardio > Arrhythmias > Flashcards

Arrhythmias Flashcards

1
Q

Treatment of VT - Haemodynamically Compromised

A

Emergency DC Cardioversion

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2
Q

Treatment of VT - Haemodynamically Stable

A

IV lidocaine or IV amiodarone

May need DC cardioversion if unsuccessful

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3
Q

Treatment of Bradycardia - Rate >40bpm and Asymptomatic

A

No treatment needed

Look for a cause and stop any drugs which could be contributing

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4
Q

Presentation of Sick Sinus Syndrome

A 
Sinus node dysfunction 
Bradycardia +/- arrest 
Sinoatrial block 
SVT alternating with bradycardia/asystole 
AF and thromboembolism may occur
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5
Q

Treatment of Symptomatic Sick Sinus Syndrome

A

Pacing

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6
Q

Acute Management of SVT

A

Vagotonic manoeuvres
IV adenosine or verapamil
DC shock if compromised

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7
Q

Maintenance Therapy of SVT

A

Beta blockers or verapamil

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8
Q

Maintenance Therapy of AF/flutter

A

Beta blocker or verapamil
Alternatively, digoxin or amiodarone
Flecanide for pre exited AF

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9
Q

Causes of First and Second Degree Heart Block

A 
Normal variant 
Athletes
Sick sinus syndrome 
Ischaemic heart disease 
Acute myocarditis 
Drugs (beta blockers, digoxin)
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10
Q

Treatment of First Degree Heart Block

A

None needed

Follow up recommended to monitor development to ore advanced block

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11
Q

Causes of Mobitz Type I Block

A

Vagal in origin

Usually block in AV node

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12
Q

Treatment of Mobitz Type I Block

A

Generally only requires monitoring

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13
Q

Causes of Mobitz Type II Block

A

Block at infranodal level (e.g. Bundle of His)

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14
Q

Treatment of Mobitz Type II Block

A

Permanent pacing due to higher risk of progression to complete heart block

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15
Q

Causes of Third Degree Heart Block

A 
Ischaemic heart disease 
Idiopathic (fibrosis)
Congenital 
Digoxin toxicity 
Aortic valve calcification 
Cardiac surgery/trauma 
Infiltration
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16
Q

Treatment of Third Degree Heart Block

A

Dependant on cause, but ventricular pacing generally needed

17
Q

Treatment for Bradycardia - Symptomatic or Rate below 40bpm

A

IV Atropine
No response = temporary pacing wire
If needed = Isoprenaline infusion, or external cardiac pacing

18
Q

What is the most common childhood arrhythmia?

A

Supraventricular re-entry tachycardia

19
Q

How does IV Adenosine slow the heart rate?

A

Block the secondary circuit at the AV node to return the heart to sinus rhythm

20
Q

What are the two main mechanisms of arrhythmia production?

A

Defects in impulse formation

Defects in impulse conduction

21
Q

How does pathological altered automaticity lead to arrhythmias?

A

A latent pacemaker subverts the SA node’s function as the heart’s normal pacemaker

22
Q

How does triggered activity lead to arrhythmias?

A

Afterpolarisations are triggered by a normal AP

Can get early after depolarisation or late depolarisation

23
Q

When do Early Afterdepolarisations occur?

A

During the inciting AP within Phase 2 and Phase 3

Associated with prolongation of AP and drugs prolonging QT interval

24
Q

When do Late Afterdepolarisations occur?

A

After complete depolarisation

Associated with Ca2+ overload provoked by catecholamines, digoxin, heart failure

25
Q

What defects in impulse formation lead to arrhythmias?

A

Altered automaticity

Triggered activity

26
Q

What defects in impulse conduction lead to arrhythmias?

A

Re-entry
Conduction block
Accessory tracts

27
Q

How does re-entry lead to arrhythmias?

A

Re-entry occurs when a self sustaining current occurs which stimulates and area of myocardium repeatedly/rapidly

Re-entrant circuits require:
Unidirectional block
Slowed retrograde conduction velocity

28
Q

How do accessory tract pathways lead to arrhythmias?

A

Electrical pathways that bypass AV node (e.g. Bundle of Kent)
Ventricles receive impulses from both normal and accessory pathways

29
Q

Sudden onset tachycardia with recovery of normal sinus rhythm after carotid sinus massage or adenosine is characteristic of which arrhythmia?

A

Paroxysmal Supraventricular Tachycardia

30
Q

What is the most common cause of Paroxysmal Supraventricular Tachycardia?

A

Atrioventricular nodal reentrant tachycardia

31
Q

What are the three kinds of atrial fibrillation?

A

Paroxysmal
Persistent
Permanent

32
Q

What is paroxysmal atrial fibrillation?

A

Episodes of AF terminate spontaneously

33
Q

What is persistent atrial fibrillation?

A

Episodes are non self terminating

34
Q

What is permanent atrial fibrillation?

A

Continuous AF which cannot be cardioverted

Treatment centres on rate control and anticoagulation

Cardio (19 decks)

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