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CR Year 3 > Arrhythmias > Flashcards

Arrhythmias Flashcards

1
Q

Treatment for tachycardia causing a patient to be unstable

A

DC Cardioversion

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2
Q

QRS complex width determined by

A

His-Purkinje

Ventricles contracting

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3
Q

Narrow complex tachycardia

A

Ventricles activated via normal conduction system (His-Purkinje)
In terms of mechanism, is supra ventricular tachycardia

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4
Q

Supra ventricular tachycardias categories

A

Atrial flutter/tachycardia
Atrio-Ventricular Nodal Reentrant Tachycardia
Atrio-Ventricular Re-entrant Tachycardia

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5
Q

Atrial flutter/tachycardia

A

Regular narrow complex

Originates from atria- focal or re-entrant circuit

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6
Q

Atrial flutter

A

P wave- saw tooth like, most prominent in inferior (negative in inferior)
Counter-clockwise circuit in RA

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7
Q

Atrial Fibrillation

A

Common
Prevalence increases with age
Fibrillatory waves
R-R waves irregular

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8
Q

AF treatment

A

Acute rate + rhythm management- try to achieve haemodynamic stability
Manage Precipitating factors
Assess stroke risk
In long run, consider if continue with rate management or try to get them out of AF

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9
Q

AF Stroke risk

A

Increased
CHADS VASc score
Oral anticoagulation

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10
Q

AF rate + rhythm management

A

Catheter ablation

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11
Q

Atrio-ventricular nodal re-entrant tachycardia

A

Small circuit that occurs around AV Nodal tissue
Reentry within AV node
Fast regular
Regular narrow complex tachy

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12
Q

Atrio-ventricular re-entrant tachycardia

A

Typically occurs in patients with pre-excitation (initial slurring of QRS complex with short PR interval)

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13
Q

Wolff-Parkinson-White syndrome

A

Arises from atrio-ventricular re-entrant tachycardia

Pre-excited ECG AND documented tachycardia/palpitation symptoms

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14
Q

Orthodromic AVRT

A

Ventricle activated down His Purkinje system, activation going back up atrium via accessory pathway
Narrow QRS

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15
Q

Antidromic AVRT

A

Ventricles activated by accessory pathway
Right ventricle activated before left- goes back up to atrium via AV node
Broad complex tachycardia

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16
Q

Pre-excited AF

A

Fast broad irregular rhythm
AF in top chambers, AF goes down to ventricle via both AV node and accessory pathway
Accessory pathway conducts very fast so can have very fast rhythm- can lead to VF
Medical emergency
DC Cardioversion
Inpatient Ablation for accessory pathway

17
Q

Nodal dependent tachycardia

A

Termination with vagal manouver/adenosine

18
Q

Adenosine in atrial arrhythmias

A

Increase AV block

Doesn’t terminate tachy

19
Q

Narrow QRS- irregular

A

Possible AF

Treat AF

20
Q

Narrow QRS- Regular

A

Supra-ventricular tachy
Vagal manoeuvre to determine if nodal dependent
Adenosine- 6mg rapid bolus, if no effect further 12mg, if no effect further 12mg after –> if terminates, probably nodal dependent SVT
If sinus rhythm not achieved, probably atrial flutter- beta blockers etc.

21
Q

Broad complex tachy

A

Ventricular activation not via normal specialised conduction system

22
Q

VT

A

Ventricle activated not via His but from somewhere else in ventricle
Broad QRS, Regular

23
Q

SVT with abberancy

A

Broad complex QRS
Supraventricular tachy, with bundle branch block (cause of broadness)
Activated by His purkinje system that’s not working as it should

24
Q

Paced rhythm

A

Broad complex QRS

25
Q

Pre-excited rhythm

A

Broad complex QRS

26
Q

VT- clues ECG

A 
Regular broad complex
VA dissociation (fusion beats, capture beats, independent p wave activity)
Ventricular concordance
Bizarre frontal axis
Very broad QRS
27
Q

Broad QRS irregular

A

AF with BBB

Pre-excited AF

28
Q

Complete HB

A

Complete dissociation between p waves and QRS

29
Q

Device therapy

A

Bradycardia- pacemaker
Susceptibility to VT/VF- ICD (implantable cardioverting defibrillator)
Cardiac resynchronisation- BiV/CRT device- works at all times, to make right and left ventricle work in conjunction

30
Q

Situations where risk of arrhythmias

A

Cardiomyopathy patients
History of syncope/FH SCD (brugada syndrome, ARVC, long QT syndrome)
Other medical conditions (infiltrative conditions, myotonic dystrophy)

CR Year 3 (7 decks)

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