Arrhythmias Flashcards
Define arrhythmia
Conditions where the heart beats with an irregular beat or abnormal rhythm
What is the aetiology of arrhythmias
Heart disease The wrong balance of electrolytes (such as sodium or potassium) in your blood Changes in your heart muscle Injury from a heart attack Healing process after heart surgery Thyroid problems
What is the different types of arrhythmias
Premature ventricular contractions
atrial fibrillation
atrial flutter
Wolff-Parkinson white syndrome
- Supraventricular tachycardia
Ventricular tachycardia/ fibrillation
Long QT syndrome
sinus node dysfunction
heart block
What is the symptoms of arrhythmias
Asymptomatic Palpitations Dizziness or feeling light-headed /Fainting Shortness of breath Chest pain Fatigue
What occurs in PVCs
and what is the cause
They’re the “skipped heartbeat” we all occasionally feel.
Cause:
stress or too much caffeine or nicotine, sometimes due to heart disease or electrolyte imbalance
Define atrial fibrillation
-what does this result in
irregular irregular heart rhythm due to the disorganised contraction of the atria
irregularly irregular pattern since the rate is faster and there is no distinct rhythm
Define atrial flutter
Abnormally rapid contraction of the atria
but are not disorganised or random
What is the aeitology of atrial fibilration and flutter
Idiopathic
ischaemic heart disease
thyroid disease
hypertension
MI
pulmonary embolus
rheumatic mitral / tricuspid valve disease
What is the pathology if supraventricular tachycardia
Wolff-parkinson white syndrome
You can get a rapid heart rate because there is an extra shorter electrical pathway between the heart’s artria and venticles
resulting in a rapid heart rate with normal rhythm
PSVT begins and ends suddenly.
what is the presentation of supraventricular tachycardia
It can cause heart palpitations, fainting, or heart failure
you can stop it simply by breathing in and bearing down e.g. valsalva manoever - as this increases your vagal tone on AV node
Whats occur in Ventricular tachycardia (V-tach).
A rapid heart rhythm starting from the heart’s lower chambers. Because the heart is beating too fast, it can’t fill up with enough blood.
When does ventricular fibrillation occur
This happens when the heart’s lower chambers quiver and can’t contract or pump blood to the body.
How is ventricular fibrillation treated
This is a medical emergency that must be treated with CPR and defibrillation as soon as possible.
What is the outcomes of Long QT syndrome
dangerous arrhythmias
syncope
seizure
sudden death
What is the treatment of `long QT syndrome
Doctors can treat it with medications or devices called defibrillators.
What occurs in Sinus node dysfunction, what is the solution
A slow heart rhythm is due to a problem with the heart’s sinus node.
A pacemaker
What occurs in heart block
There is a delay or a complete block of the electrical impulse as it travels from the heart’s sinus node to its lower chambers. The heart may beat irregularly and, often, more slowly
How do you diagnose arrhythmias
ECG - record electrical activity of your heart
Blood test - investigate thyroid
ECHO - evaluate heart muscle and valve
what is the drug therapy used to treat arrhythmia
Anti arrhythmic drugs (control heart rhythm) - Beta blocker - CCB Anticoagulant - Warfarin - Aspirin
antiplatelet therapy.
What is examples of non drug therapy treatment for arrhythmias
Electrical carioversion/ Defibrillator
- Electric shock to allow normal rhythm to restart
Pacemaker
- small electrical impulses to the heart to maintain rate
Implantable cardioverter defibrillator
- Detect fast, abnormal heart rhythm and deliver electric shock to heart to beat normal rhythm again
catheter ablation
- Catheter through leg, deliver high frequency to heart and disconnects the pathway of the abnormal rhythm
Maze surgery
“maze,” of cuts in the heart’s upper chambers to
keep the heart’s electrical impulses going only on certain pathways.
What is the different methods of causing the heart to beat to a normal rhythm again
Anti-tachycardia pacing
-series of small electrical impulses to the heart muscle
Defibrillation - high energy shock
What further procedures are used in the treatment of atrial fibrillation
Maze procedure surgery
What is the indication for ICD therapy
Ventricular Tachycardia /fibrillation
After Cardiac arrest
Sustained causing syncope
With poor LV function
What is the indications for temporary pacemaker
Sustained symptomatic bradycardia (syncope)
prophylatic to sever bradycardia e.g. post MI/asymptomatic/AV block
What is indications for permanent Pacemaker
symptomatic or profound 2nd/3rd degree AV block,
Sinus node disfunction
Define Tachycardia and bradycardia
T - rate above 100bmp
B - Rate below 60bmp
What can be seen on an ECG of atrial fibrillation
no P waves
irregularly irregular
normal QRS complexes
What can be seen on an ECG of atrial fluter
saw-tooth F waves of baseline
normal QRS complexes
regularly irregular
What can be seen on an ECG of supra ventricular tachycardia
normal P waves
short PR interval
slurred QRS complex = delta wave
regularly irregular
What is the aeitiology of long QT syndrome
emotion
exercise
drugs
