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Arrhythmias III Flashcards

1
Q

how long after TEE DCCV do you A/C?

A

4 weeks

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2
Q

which SVT is due to automaticity?

A

AT

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3
Q

Rx for MAT?

A

treat underlying dz

CCBs

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4
Q

which SVT has a pseudo RSR’ and retrograde p?

A

AVNRT

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5
Q

if you see an EPS w/ everything lined up in a row, what does this mean?

A

simultaneous A & V activation

Pathognomonic for AVNRT

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6
Q

Rx for recurrent symptomatic AVNRT

A

ablation
Verapamil, dilt
BB

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7
Q

Rx for recurrent AVNRT refracgtory to BB, CCB and pt does not want ablation?

A

flecainide, propafenone, sotalol

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8
Q

what happens to AVNRT w/ adenosine?

A

abrupt termination

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9
Q

is “no therapy” a Class I indication for AVNRT that is well tolerated?

A

yes

also can treat with meds or ablation

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10
Q

pre-excitation + ? = WPW

A

sxs

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11
Q

*what is a Class I Rx for Pre-excitation?

A

Nothing. (this is not WPW unless sxs)

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12
Q

*What is a class I Rx for WPW?

A

catheter ablation

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13
Q

*name 3 meds not to give in WPW

A

verapamil/dilt/dig

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14
Q

*can you give BB in WPW?

A

yes (class IIa), unless in afib!

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15
Q

*can you do ablation on Pre-excitation?

A

yes (class IIa), but doing nothing is Class I.

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16
Q

*if pt. refuses ablation for WPW, what meds can you give?

A

flecainide/propafenone
sotalol/amio
BB

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17
Q

what meds are contraindicated in WPW/pre-excitation with a fib?

A

BB

CCB

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18
Q

meds that can cause AT

A

Dig (AT w/ 2:1 AVB)
Albuterol
catecholamines/caffeine

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19
Q

mechanisms of AT

A

automatic
triggered
reentrant

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20
Q

MAT

A

> 3 p waves

- look for chronic dz

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21
Q

AT response to adenosine

A

variable

can be diagnostic

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22
Q

Rx for hemodynamically unstable AT

A

DCCV

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23
Q

acute Rx for AT rate control (Class I)

A

BB, vera/dilt

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24
Q

Class I Rx for RECURRENT AT

A

ablation
BB
CCB

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25
Q

do you treat non sustained & asymptomatic AT?

A

No

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26
Q

ablation success rate in AT

A

90

27
Q

ablation success rate in AT

A

90

28
Q

whats the best rate-control Rx for poorly tolerated Afl?

A

BB>CCB

29
Q

whats the best conversion med for stable Afl?

A

ibutilide

30
Q

3 EKG findings in AFL

A
  • sawtooth in II, III, F
  • +p in V1, V2
  • -p in V3-V6.
31
Q

effects of BB on fetus

A

FGR
reduce placental weight
brady/hypoglycemia
preterm labor & reduced baby weight

32
Q

effects of BB on fetus

A

FGR
reduce placental weight
brady/hypoglycemia
preterm labor & reduced baby weight

33
Q

can you use CCBs in pregnancy?

A

No

34
Q

Amio effects on fetus

A

congenital goiter
hypo/hyperthyroid
Long QT

35
Q

Amio effects on fetus

A

congenital goiter
hypo/hyperthyroid
Long QT

36
Q

can you perform DCCV on pregnant pt’s?

A

yes

37
Q

quinidine side effects on fetus

A

oxytocic properties/preterm labor

38
Q

Class I recs to acutely convert pregnant pt. in SVT

A

Vagal maneuvers
DCCV
Adenosine

39
Q

*Class III recs for SVT Rx in pregnant pt’s

A

atenolol

amio

40
Q

Class III recs for SVT Rx in pregnant pt’s

A

atenolol

amio

41
Q

what BB can you NEVER use in pregnancy

A

atenolol

42
Q

what is NOT associated with RVOT VT?

A

structural heart dz

43
Q

ECG findings for RVOT VT

A
  • LBBB-like

- tall R in II, III, F

44
Q

Rx for 1st episode of RVOT VT

A

BB

CCB

45
Q

Rx for RVOT VT refractory to meds or unstable or with syncope/pre-syncope

A

ablation

46
Q

which drug used pre-transplant can cause arrhythmia post-OHT?

A

Amio

47
Q

Ddx of arrhythmia etiology in OHT

A 
rejection
Pre-OHT amio
suture lines (AFL)
surgical trauma to SAN/AVN
accelerated atherosclerosis/preservation ischemia
48
Q

what is the most common EKG abnormality post-OHT?

A

Incomplete -RBBB

49
Q

Is VT/VF common post-OHT

A

No. look for other causes (MI/rejection/CM)

50
Q

are AF/AFL commonly assoc. w/ rejection post-OHT?

A

yes!

51
Q

what to do if you see AF/AFL post-OHT

A

Bx–>steroids

52
Q

why don’t you give adenosine post-OHT

A

due to adenosine supersensitivity (5-fold inc in response by SAN/AVN after loss of parasympathetics)

53
Q

what determines the onset/prognosis of tachycardia-induced CM?

A

rate and duration

54
Q

Rx for Tachycardia CM

A

rate control
CHF OMT
ablation

55
Q

can you reverse all types of tachycardia-CM?

A

no

56
Q

How quickly is Tachycardia-CM reversed?

A

48hrs, full resolution in 2 weeks

not all TCM are reversible

57
Q

PVC burden of ?% distinguishes CM vs. nl EF? what to do if PVC burden > 10%?

A

40%

ischemic w/u

58
Q

What type of SVT is WPW?

A

AVRT

59
Q

Name the type of AVRT (orthodromic or antidromic):

Down AVN, up bypass tract, narrow complex

A

Orthodromic

60
Q

Name the type of AVRT (orthodromic or antidromic):

Down bypass tract, up AVN, wide complex

A

Antidromic

61
Q

Which SVT does. It require AVN, His-purkinje, or accessory pathway for its initiation or maintenance?

A

A tach

62
Q

Mech of RVOT VT

A

cAMP mediated triggered activity

63
Q

Precipitates for RVOT VT

A

Exercise
Stress
Caffeine

64
Q

Why is the initial treatment of RVOT VT counterintuitive?

A

Because you give BB or CCB, NOT ablation/ICD

` (31 decks)

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