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My1 Cardiology > arrhythmias > Flashcards

arrhythmias Flashcards

1
Q

what are the 3 subtypes of arrhythmias

A

supraventricular, ventricular, atrio-ventricular

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2
Q

what are types of supra-ventricular arrhythmias

A

sinus bradycardia, sinus pause, atrial fibrillation, atrial flutter and ectopic atrial tachycardia, SVT and AV block

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3
Q

what are 4 types of ventricular arrhythmias

A

ventricular tachycardia, ventricular fibrillation, asystole, ventricular ectopic beats

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4
Q

where do bradyarrhythmias arise from

A

sinus node block or AV block

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5
Q

where do supraventricular arrhythmias arise from

A

between AV and SV node

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6
Q

where do ventricular arrhythmias arise from

A

below AV node

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7
Q

what are some abnormal anatomy causes of arrhythmias

A

LVH, accessory pathways, congenital disease

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8
Q

what are some autonomic NS causes of arrhythmias

A

sympathetic stimulation, increased vagal tone

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9
Q

what are some metabolic causes of arrhythmias

A

hypoxia, ischaemic myocardium, electrolyte imbalance

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10
Q

what is an ectopic beat?

A

beats that do not originate from SA node, can be a rhythm or individual beats

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11
Q

can ectopic beats be harmful?

A

yes, if originate from contractile area

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12
Q

what is re-entry

A

more than one conduction, an impulse does not die out but comes around again to excite AV node again

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13
Q

what can cause re-entry

A

accessory pathways, MI fibrosis, depressed conduction velocity, short refractory period

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14
Q

symptoms of arrhythmias

A

palpitations, SOB, dizzy, syncope, pre-syncope, angina

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15
Q

investigations

A

ECG, CXR, echocardiogram, electrophysical study

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16
Q

what is normal sinus arrhythmia

A

variation in HR due to decreased vagal tone during inspiration

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17
Q

what is sinus bradycardia, what causes it and how do you treat it?

A

less than 60bpm, drugs, ischaemia and athletic hearts can cause it. treat with atropine or pacemaker

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18
Q

what is sinus tachycardia, what causes it and how do you treat it?

A

100bpm, physiology or drugs, treat underlying cause, if severe Bblockers

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19
Q

what are the 2 types of supraventricular tachycardia

A

AV nodal re-entry tachycardia (AVNRT) and AV re-entry tachycardia (AVRT)

20
Q

how do you treat acute supraventricular tachycardia

A

increase vagal tone - valsava, slow conduction of AVN: adenosine, verapamil

21
Q

how do you treat chronic supraventricular tachycardia

A

radiofrequency ablastion (1st), bblockers, antiarrhythmic drugs

22
Q

what is 1st degree AV block

A

conduction following p waves takes longer, no treatment needed

23
Q

What is 2nd degree AV block and what are the 2 types

A

intermittent block at AVN,

mobitz I and mobitz II

24
Q

what is mobitz I

A

progressively lengthening of PR interval eventually leading to dropped beat, usually vagal

25
Q

what is mobitz II

A

pathological, some AP dont get through AB node, pacemaker indicated

26
Q

what is 3rd degree AV block

A

no AP from SA gets to AV, treat with pacemaker

27
Q

what causes ventricular ectopics and how do you treat them

A

LVH, heart failure, myocarditis, ischaemic HD and electrolytes, treat with Bblockers and ablation

28
Q

what is ventricular fibrillation and how to you treat

A

irregular waveform and uncoordinated electrical activity, shock shock zap zap

29
Q

what can cause ventricular tachycardia and what is it show on ECG

A

close together QRS, CAD, previous MI, myocardiopathy are rare.

30
Q

how do you treat acute ventricular tachycardia

A

DCCV (electrical) and adenosine to confirm diagnosis

31
Q

how do you treat chronic ventricular tachycardia

A

revascularisation, anti-arrhythmic drugs, VT catheter ablation

32
Q

how would you describe Atrial fibrillation

A

chaotic and disorganised atrial activity, irregular and increases with age

33
Q

what are the 3 types and characteristics of atrial fibrillation

A

paroxysmal: sudden and lasts less than 48 hrs, often recurrent , persistent: lasts more than 48hrs, unlikely to revers to NRS on it’s own, and permanent: inability of non or pharma to return to NSR

34
Q

what are associated diseases with atrial fibrillation

A

high BP, heart disease, congenital, pericarditis, obesity

35
Q

what is lone/ idiopathic AFib

A

absence of heart disease, no evidence of ventricular dysfunction. could be genetic

36
Q

symptoms of AFib

A

palpitations, presyncope, syncope, chest pain, dyspnoea, sweatiness, fatigue

37
Q

how would you see Afib on an ECG

A

atrial rate >300bpm, irregularly, irregular, p waves absent

38
Q

what are the 3 things you can do you manage AFib

A

rhythm control, rate control, anticoagulation for thromboembolism

39
Q

what would you do for restoration of NSR (rythm control) or if they are young?

A

DCCV is best if unstable, anti-arrhythmic eg amiodarone and lidocaine (class 1 and 3)

40
Q

what would you do for maintenance of NS (rhythm control)

A

anti-A drugs amiodarone or lidocaine (1 . & 3) and catheter ablation

41
Q

how would you control rate of AFib

A

digoxin, bblockers and ca antagonists 2 +3

42
Q

how would you recognise an atrial flutter and how would you treat it

A

looks like a saw tooth with regular rhythm, ablation, DCCV, slow rate and maitain NSR with drugs, warfarin for TE

43
Q

what are class 1 Antiarrhythmic drugs and example

A

reduce Na channel current, quindine and flecainide

44
Q

what are class II Antiarrhythmic drugs and examples

A

Bblockers, eg propranolol

45
Q

what are class III Antiarrhythmic drugs and examples

A

AP prolongation, eg amiodarone and dronedarone

46
Q

what are class IV Antiarrhythmic drugs and examples

A

Ca channel blockers: verapamil

My1 Cardiology (16 decks)

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