Arrhythmias

Question 1

FAST IRREGULAR NARROW

Answer 1

No Ps —> Fib, flutter

If there are Ps —> MAT

Question 2

FAST IRREGULAR WIDE

Answer 2

BBB w fib, flutter, MAT (will see Ps w MAT)

Wolfy a fib (~300)

Question 3

FAST REGULAR NARROW

Answer 3

Jackson 5:
Sinus tach (220-age, slow onset/offset)
EAT (Ps outside Q1, 60% resp to adenosine)
AVNRT and AVRT (pseudo S, pseudo R really Ps, adenosine breaks)
Retrograde AVRT only (ante is wide)
a flutter (230-300, II III avF best leads for sawtooth, adenosine does NOT HELP)

Question 4

FAST REGULAR WIDE

Answer 4

VT - not always Q3 axis, REGULAR, can have nl vitals 1 exception is non-reentry VT, RVOT focus
BBB w/ Jackson 5
WPW (Antidromic AVRT, pseudo Qs inf leads, delta waves, really fast)

Question 5

Upside down Ps in I II avF

Answer 5

NOT SINUS APC w low atrial focus

Question 6

Big R in avL

Answer 6

Aortic stenosis

Question 7

Irregular RR

Answer 7

CANT BE HEART BLOCK

Question 8

MAT

Answer 8

Irregular, lung dz

Question 9

EAT

Answer 9

Reg, Ps monomorphic

Question 10

AVNRT rate

Answer 10

150-200

Question 11

MAT rate

Answer 11

100-150

Question 12

Ashman beat

Answer 12

Looks like a RBBB beat, common in a fib, MAT

Ref Pd AV node proportional to preceding RR, long ref Pd looks like RBBB

Question 13

EAT rate

Answer 13

100-220, ramps up, <100 EAR (rhythm)

Question 14

EAT treatment

Answer 14

IC flecainide, ablation

Question 15

A flutter rate

Answer 15

230-300

Question 16

A fib w REGULAR RR???

Answer 16

Complete HB OR too much AV nodal blocking Rx

Question 17

A fib rate

Answer 17

Lol can be fast slow

Question 18

AVRT rate

Answer 18

150-300

Question 19

Delta waves

Answer 19

Antegrade AVRT (WPW)

Question 20

SLOW REGULAR WIDE

Answer 20

WPW w antegrade accessory pathway, can be slow w Rx

Question 21

V1 big R or QS

Answer 21

WPW

Question 22

Pseudo Qs II, III, avF

Answer 22

WPW

Question 23

Every other P is an APC, does not conduct

Answer 23

Non conducted atrial bigemini

Question 24

WPW features

Answer 24

Undulating NOT rate-related wide-narrow
Delta waves
Pseudo Qs inferior leads

Question 25

Anything >200

Answer 25

WPW until proven otherwise

Question 26

VT features on ekg

Answer 26

Wide (QRS 0.12-0.19)
Regular
Brugada 1 or 2
AV dissoc (mother of dragons)
>= 110 (slower is AIVR)
>30 s = sustained (must be monomorphic)
Wide R V1 >30 ms (0.03 s, ~1 small box = Josephson)
Notching on downslope

Question 27

Brugada criteria

Answer 27

1) NO RS waves precordials

2) If there is RS, R onset - S nadir >2.5 little boxes (100 ms)

Question 28

Josephson sign

Answer 28

Wide R in V1 —> VT