Arrhythmias

Question 1

What is an arrhythmia?

Answer 1

Chaotic, irregular atrial rhythm at 300-600 bpm and irregular ventricular rhythm
(only a fraction of these impulses are conducted to the ventricles due to refractory period pf AVN)

Question 2

What causes atrial arrhythmias? (2)

Answer 2

Older age

Any condition that raises atrial pressure

Question 3

What can be seen on an ECG in a patient with atrial fibrillation (AF)? (4)

Answer 3

Irregularly irregular
Absent P
Rapid + irregular QRS
F waves

Question 4

What is a complication of AF and what tool would you use to asses this risk?

Answer 4

STROKE due to clot formation and embolisation

CHADS2VASc score (asses stroke risk in AF)

Question 5

How would you treat AF?

Answer 5

Rate control - BB (bisoprolol) or CCB
Rhythm control - electrical DC cardioversion or amiodarone/ flecainide
Anticoagulate - warfarin

Question 6

What is the target INR when treating AF with warfarin?

Answer 6

INR 2-3

Question 7

What would you see on ECG of a patient with atrial flutter? (2)

Answer 7

Regularly irregular
Sawtooth flutter (F waves)