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Systems 1a Revision Decks > Arrhythmias > Flashcards

Arrhythmias Flashcards

1
Q

What is sinus rhythm?

A

Any cardiac rhythm where depolarisation of the cardiac muscle behind at the sinus node

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2
Q

How is sinus rhythm characterised?

A

By the presence of correctly orientated P-waves on ECG

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3
Q

What is sinus arrest?

A

When the SA node transiently ceases to generate the electrical impulses responsible for cardiac contraction

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4
Q

What is heart block?

A

Abnormal heart rhythm here the heart beats too slow (bradycardia)

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5
Q

What is first degree AV block?

A

Simple prolongation of PR-interval >.22 seconds

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6
Q

What is Morbitz I type second degree heart block?

A

Wenckeback block phenomenon

Progressive PR-interval block until P-wave fails to conduct

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7
Q

What is Mobitz II type second degree heart block?

A

When a dropped QRS-complex is not proceeded by an increased PR-interval progression

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8
Q

What is a common feature of Mobitz type II second degree heart block?

A

Broad QRS-complex

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9
Q

What is 2:1 advanced block?

A

Occurs when every two or three P-waves conducts and precedes a QRS-complex

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10
Q

What is third degree heart block?

A

Complete heart block occurs when all atrial activity fails to conduct to the ventricles

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11
Q

What is atrial flutter?

A

Organised atrial rhythm with an atrial rate of approx 250-350bpm showing ECG sawtooth pattern

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12
Q

What proportion of the population have atrial fibrillation?

A

1-2% of adults (5-10% in elderly)

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13
Q

What are the causes of atrial fibrillation ?

A

Any condition resulting in raised atrial pressure ,mass, fibrosis, inflammation or infiltration

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14
Q

What are the most common causes of a.fib?

A

Hypertension and heart failure

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15
Q

What are the signs and symptoms for atrial fibrillation?

A

30% incidental finding
Rapid palpitations
Dyspnoea
Chest pain

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16
Q

What are the indication for implantable cardiac defibrillators?

A

Life threatening arrhythmias cause death in the first year in up to 40% of cases - employed as a preventative measure

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17
Q

What is Wolff-Parkinson-White syndrome?

A

One of several pre-excitation disorders effecting the electrical system of the heart

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18
Q

Wolff-Parkinson-White syndrome is caused by the presence of what?

A

An accessory conduction pathway between the atria and ventricles

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19
Q

Describe the electrical impulse process in Wolff-Parkinson-White syndrome?

A

Electrical signals travel down bundle of Kent and stimulate ventricles to contract prematurely resulting in a unique type of supraventricular tachycardia

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20
Q

What is the special type of tachycardia caused by Wolff-Parkinson-White syndrome?

A

Atrioventricular Re-entrant Tachycardia

21
Q

What is the ECG telltale sign for Wolff-Parkinson-White Syndrome?

A

Delta waves

22
Q

What is sustained ventricular tachycardia?

A

> 30s

23
Q

What is the presentation of ventricular tachycardia?

A

Pre-syncope, hypotension and cardiac arrest

24
Q

What is the typical pulse rate of someone experiencing ventricular tachycardia?

A

120-220bpm

25
Q

What is the typical ECG pattern shown with ventricular tachycardia?

A

Torsades des pointes

26
Q

What is ventricular fibrillation?

A

Very regular and irregular ventricular contraction with no mechanical effect

27
Q

What is the clinical presentation of ventricular fibrillation?

A

Patient is pulseless, no respiration and rapidly unconscious

28
Q

What is ventricular fibrillation usually preceeded by?

A

Ectopic beats

29
Q

What are ectopic beats?

A

Random extra cardiac contractions

30
Q

What does the ECG of atrial ectopic beats looks like?

A

Early and abnormal P-waves but usually not proceeded by a QRS-complex

31
Q

What can be said about the need to treat atrial ectopic beats?

A

Not needed unless it precipitates a more serious arrhythmia

32
Q

What classification for anti-arrhythmic drugs do we use?

A

Vaughan-Williams system

33
Q

What do class I anti-arrhythmic drugs do?

A

Membrane depressants that reduce the rate of sodium entry into the myocyte

34
Q

What subclasses of class I anti-arrhythmic drugs are there?

A

Class Ia - lengthen action potential

Class Ib -Delay action potential recovery

Class Ic - Stops spontaneous contraction

35
Q

What do class II anti-arrhythmic drugs do?

A

Anti sympathetic drugs

36
Q

What do class III anti-arrhythmic drugs do?

A

Prolong refraction period and increase action potential duration

37
Q

What are class IV anti-arrhythmic drugs?

A

CCBs

38
Q

What are some examples of anti-arrhythmic drugs with no classification?

A

Digoxin
Amiodarone
Adenosine
Atropine

39
Q

How is the level of coagulation in vivo measured?

A

International normalised ratio

40
Q

How is INR measured?

A

Actual thromboplastin time/ Standard thromboplastin time

41
Q

What is the normal value of INR?

A

1

42
Q

What is the therapeutic range of INR?

A

2.5-4

43
Q

What risk factors must be considered incase of bleeding when on warfarin?

A 
C - congestive heart failure 
H - hypertension 
A - aged >75 years old
D - diabetes
S - stroke (or TIA)
44
Q

What electrotherapy is used to treat arrhythmias?

A

Radio frequency ablation

45
Q

What arrhythmias can be readily ablated?

A 
AVNRT
Normal heart VT
Atrial flutter
Atrial tachycardia 
Atrial fibrillation
46
Q

What is the problem with digoxin?

A

Is not actively removed from the kidneys therefore must be administered with digibind to avoid toxicity

47
Q

What are the signs of digoxin toxicity?

A

Xanthopsia and reverse tick appearance of ST segment in lateral leads

48
Q

What drug is used to treat Mobitz Type I heart block?

A

Atropine

49
Q

What anti-arrhythmic drug interacts with digoxin?

A

Amiodarone

Systems 1a Revision Decks (22 decks)

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