Arrhythmias Flashcards
What is an arrhythmia?
Abnormal heart rhythm problems
What are the 4 main types of arrhythmia?
Atrial fibrillation
Heart block
Supraventricular tachycardia
Ventricular tachycardia
How does atrial fibrillation initially present?
Asymptomatic
What are 4 of the signs of atrial fibrillation past the asymptomatic phase?
Palpitations
Dyspnoea
Chest pain
Fatigue
What 3 investigations should be performed for suspected atrial fibrillation?
12 Lead ECG over 24 hours
Blood tests (especially thyroid function
ECHO cardiogram
What anatomical part of the heart is supraventricular tachycardia related to?
AV node
What are 3 signs of supraventricular tachycardia?
Palpitations
Dyspnoea
Dizziness
What are 4 signs of supraventricular tachycardia?
Palpitations
Dyspnoea
Dizziness
Syncope
What 4 investigations should be performed for suspected ventricular tachycardia?
ECG
Bloods
ECHO
Angiogram
In what 2 situations should a temporary pacemaker be fitted?
During intermittent/sustained symptomatic bradycardia
Prophylactic for risk of severe bradycardia
In what 2 situations should a permanent pacemaker be fitted?
2nd/3rd degree AV block
Sinus node disease (with associated symptoms)
Carotid sinus hypersensitivity
What are the 4 Vaughn-Williams classes of arrhythmia drugs?
I - sodium channel blockers
II - beta blockers
III - potassium channel blockers
IV - calcium channel blockers
What are the the 3 different sub-types of class I arrhythmia drugs and their effects on repolarisation?
IA - delays polarisation
IB - accelerates polarisation
IC - little effect on repolarisation
What are class IA arrhythmia drugs used to treat? (3)
Atrial fibrillation
Supraventricular tachyarrhythmias
Ventricular tachyarrhythmias
Give an example of a class IA arrhythmia drug and 2 side effects?
Quinidine (headache, nausea)
What are class IB arrhythmia drugs used to treat?
Ventricular tachyarrhythmias
Give an example of a class IA arrhythmia drug?
Lidocaine
What are class IC arrhythmia drugs used to treat? (2)
Life-threatining supraventricular tachyarrhythmias
Ventricular tachyarrhythmias
Give an example of a class IC arrhythmia drug and a side effect?
Flecainide (can induce life-threatining ventricular tachyarrhythmias)
What are class II arrhythmia drugs (beta blockers) used to treat? (2)
Supraventricular dysarrhythmias
Ventricular dysarrhythmias
Give an example of a class II arrhythmia drug?
Atenolol
What is the class II arrhythmia drug “Bisoprolol” used for?
First line treatment of atrial fibrilation
What effect to class III arrhythmia drugs (pottasium blockers) have on action potential?
Increase the action potential duration
What are class III arrhythmia drugs used to treat? (3)
Life-threatening or sustained ventricular tachycardia
Life-threatening ventricular fibrillation
Atrial fibrillation/flutter
Give an example of a class III arrhythmia drug?
Amiodarone
What effect do class IV (calcium channel blockers) arrhythmia drugs have on depolarisation?
They depress phase 4 depolarisation
What are class IV arrhythmia drugs used to treat? (2)
Paroxysmal supraventricular tachycardia
Rate control for atrial fibrillation/flutter
Give an example of a class IV arrhythmia drug?
Verapamil
What 2 non-classed drugs can be used to treat arrhythmia (contains more than one class property)?
Digoxin
Amiodarone
What are some of the effects of digoxin toxicity? (4)
Nausea and vomiting
Bradycardia
Tachycardia
Arrhythmias: VT and VF
What is Amiodarone used to treat? (2)
Ventricular tachycardia
Supraventricular tachycardia
Which classes of arrhythmia treatment can produce sinus tachycardia as a side effect? (2)
Class II, IV
Which classes of arrhythmia treatment can produce Atrial fibrillation as a side effect? (5)
Class IA, IB, II, III, IV
