Arrhythmias Flashcards
What is paroxysmal atrial fibrillation?
sudden reoccurrence or intensification of symptoms, lasts <48hrs
What is permanent atrial fibrillation?
unable to restore normal sinus rhythm
What is the acute treatment for sinus bradycardia?
atropine
What are the causes of ventricular ectopics?
LV hypertrophy, heart failure, myocarditis, ischaemic heart disease, electrolyte imbalances, inherited cardiac conditions
What is the chronic treatment for ventricular tachycardia?
correct ischaemia - revascularisation, implantable cardiac defibrillator, catheter ablation
What is the treatment for 1st degree heart block?
no treatment, long term follow up
What is atrial flutter?
rapid and regular atrial tachycardia
What is the acute treatment for ventricular tachycardia?
unstable - direct current cardioversion, stable - anti-arrhythmic drugs, prepare for direct current cardioversion
What are the signs of Torsades de Pointes?
HR = 200-250bpm, irregular pulse
What is the treatment of ventricular fibrillation?
defibrillation, cardiopulmonary resuscitation
What is sinus tachycardia?
> 100bpm
What is the mechanism of atrial fibrillation?
ectopic foci in muscle sleeves in opening of pulmonary veins
What is a single chamber pacemaker?
paces RA or RV only
What is haemodynamic compromise?
hypotension, CHF, angina
What is 2nd degree heart block?
intermittent block - dropped beats
What are the triggers of ventricular tachycardia?
electrolyte imbalance, ischaemia, hypoxia, drugs that prolong QT interval
What is re-entry?
more than one conduction pathway with different conduction speeds
What is persistent atrial fibrillation?
lasts >48hrs
What are the ECG characteristics of Torsades de Pointes?
long QT interval, wide QRS, continuously changing QRS morphology
What is Mobitz II heart block?
usually 2:1 or 3:1
What is seen on an ECG of 1st degree heart block?
PR interval >0.2s
What is the treatment for sinus bradycardia if there is haemodynamic compromise?
pacing
What is the treatment for permanent atrial fibrillation?
slow down AV node conduction - digoxin, beta blockers, verapamil, diltiazem
What is the acute management of regular supraventricular tachycardia?
increase vagal tone - Valsalva (blow through closed object) or carotid massage, slow conduction in AV node - IV adenosine, IV verapamil
What are ectopic beats?
originate outside SA node - take over sinus rhythm if faster
What is the treatment for sinus tachycardia?
beta blockers, treat underlying cause
What is the treatment of atrial fibrillation?
pharmacological or electrical cardioversion - anticoagulation
What are the ECG characteristics of ventricular tachycardia?
rapid, wide, distorted QRS complexes, large T waves with deflections opposite QRS complexes, no P waves
What is a dual chamber pacemaker?
paces RA and RV - maintains AV synchrony - used for AV nodal disease
What is the treatment of atrial flutter?
radiofrequency ablation, pharmacological, warfarin
What is Mobitz I heart block?
progressive lengthening in PR interval - vagal in origin
What is 3rd degree heart block?
no action potentials get through AV node
What are the ECG characteristics of 3rd degree heart block?
broad peaks - originating in myocardium, slow - not using conduction system = escape rhythm - enough to sustain life
What are the ECG characteristics of atrial fibrillation?
atrial rate >300bpm, irregularly irregular rhythm, no P waves, f waves present
What are the symptoms of arrhythmias?
palpitations, dyspnoea, dizziness, syncope, presyncope, sudden cardiac death, heart failure, angina
What is ventricular fibrillation?
chaotic ventricular activity - reduced CO
Give examples of stimulants
caffeine, cigarettes
What is atrial fibrillation?
chaotic atrial activity - reduced diastole - reduced CO
What is the chronic management of regular supraventricular tachycardia?
avoid stimulants, beta blockers, antiarrhythmic drugs, radiofrequency catheter ablation
What are the causes of heart block?
MI, myocarditis, amyloid, beta blockers, calcium channel blockers, calcification of the aortic valve, post aortic valve surgery, genetic
What are the symptoms of atrial ectopic beats?
palpitations
What is the treatment for Mobitz II heart block?
pacemaker
What is normal sinus arrhythmia?
variation in HR - inspiration reduces vagal tone - physiological
What is sinus bradycardia?
<60bpm, normal sinus rhythm
What is the radiofrequency catheter ablation?
selective cauterisation of cardiac tissue
What are the causes of sinus bradycardia?
drugs - e.g. beta blockers, ischaemia - common in inferior STEMIs
What are the causes of regular supraventricular tachycardia?
AV node re-entrant tachycardia, ectopic atrial tachycardia
What is the treatment for atrial ectopic beats?
generally no treatment, beta blockers may help, avoid stimulants
What is presyncope?
faintness
What are the classifications of 2nd degree heart block?
Mobitz I, Mobitz II
What is the mechanism of atrial flutter?
re-entry circuit in RA
What is the treatment for 3rd degree heart block?
pacemaker
What is the treatment of ventricular ectopics?
beta blockers, ablation of focus